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Wed Sep 19, 2018, 09:54 AM

Behind Your Rising Health-Care Bills: Secret Hospital Deals That Squelch Competition

The article is in this morning's print edition on page B!, as "Secret Hospital Deals Drive Rising Health Costs." It has been online for 24 hours.

“If you’re the single hospital system in an area, you essentially can set your price.” Inside the secret world of hospital contracting -- and what it means for health costs. https://www.wsj.com/articles/behind-your-rising-health-care-bills-secret-hospital-deals-that-squelch-competition-1537281963 … via @WSJ

if you have guaranteed money of insurance, you can do same. Insurance drives up the cost of healthcare, and the govt mandates that we have it. This happens over and over. Since the advent of unfettered student loans, tuitions have risen 200%. Organic competition lowers cost


Behind Your Rising Health-Care Bills: Secret Hospital Deals That Squelch Competition

Contracts with insurers allow hospitals to hide prices from consumers, add fees and discourage use of less-expensive rivals

By Anna Wilde Mathews
Sept. 18, 2018 10:46 a.m. ET

Last year, Cigna Corp. and the New York hospital system Northwell Health discussed developing an insurance plan that would offer low-cost coverage by excluding some other health-care providers, according to people with knowledge of the matter. It never happened.

The problem was a separate contract between Cigna and NewYork-Presbyterian, the powerful hospital operator that is a Northwell rival. Cigna couldn’t find a way to work around restrictive language that blocked it from selling any plans that didn’t include NewYork-Presbyterian, according to the people.

Dominant hospital systems use an array of secret contract terms to protect their turf and block efforts to curb health-care costs. As part of these deals, hospitals can demand insurers include them in every plan and discourage use of less-expensive rivals. Other terms allow hospitals to mask prices from consumers, limit audits of claims, add extra fees and block efforts to exclude health-care providers based on quality or cost.

The Wall Street Journal has identified dozens of contracts with terms that limit how insurers design plans, involving operators such as Johns Hopkins Medicine in Maryland, the 10-hospital OhioHealth system and Aurora Health Care, a major system in the Milwaukee market. National hospital operator HCA Healthcare Inc. also has restrictions in insurer contracts in certain markets.

—Melanie Evans contributed to this article.

Write to Anna Wilde Mathews at anna.mathews@wsj.com

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