Rising healthcare costs and system inefficiencies continue to affect patients and providers across the country, according to a May 26 panel discussion led by U.S. Congressman Aaron Bean during the third installment of his Path to Consensus Series focused on surprise billing and prior authorization delays.
Garrett Hohimer, Vice President of Policy and Advocacy at Business Group on Health, said, “The clearest win here has been on behalf of patients and taking them out of the middle. We are elated with the development of the No Surprises Act to really take patients out of the middle there.”
Patrick Velliky, Chief External Affairs Officer at HaloMD, addressed arbitration in payment disputes: “The IDR process is expensive and cumbersome on purpose. That is a feature, not a bug, because it is supposed to be more painful to go through arbitration for either party than it is to simply reach an in-network arrangement.” Ariel Bayewitz, Vice President for Health Economics at Elevance Health, added that “the majority of award dollars actually is going to elective and planned procedures. On average, we are seeing awards over eight times what we pay in-network physicians.”
Dr. Adam Bruggeman, Chairman at IndeMed, called for reforms: “It should be easier to pick up the phone and call and say, ‘Hey, let’s come up with a fair price and figure this out before we all have to spend a bunch of money.’” Mary Mayhew, President and CEO of Florida Hospital Association, said about patient care delays due to prior authorization: “We have a moral imperative. These are human beings. The care that they need cannot wait.” Jeanette Thornton from America’s Health Insurance Plans said that while most claims do not require prior authorization, it remains important: “The vast majority of claims aren’t subject to prior authorization. It is a really important clinical safeguard.”
Aaron Bean currently serves as U.S. Representative for Florida’s 4th district after replacing John Rutherford in 2023; he previously served in both chambers of Florida’s legislature, according to Wikipedia. Bean was born in Fernandina Beach in 1967 where he currently resides; he graduated from Jacksonville University with a Bachelor’s degree.
The full Path to Consensus Series discussion can be viewed online.
