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Montana insurance summit examines rising healthcare costs

Posted at 3:59 PM, Sep 19, 2019
and last updated 2019-09-19 17:59:23-04

Front-and-center at State Auditor and Insurance Commissioner Matt Rosendale's annual insurance-summit were efforts by his office - and others - to control rising healthcare costs.

Rosendale's office is taking a hard look at two big drivers in health-care costs: Hospitals and prescription drugs. In particular, they're taking a close look at how hospitals set their prices - and whether those prices reflect the actual cost of services.

Special projects coordinator Marilyn Bartlett says her research indicates that government-funded health programs are covering close to 100% of Montana hospitals' costs.

But, she noted that hospitals repeatedly claim these programs don't cover costs - and therefore, the hospitals say they must charge privately insured patients more.

“We have been told and we have heard in testimony that hospitals are only recovering 40 percent of their costs from these gov't programs. That is sometimes used as a reason to do some cost-shifting to the commercial payer,” Bartlett said. “And if that's true, if these facts bear out, isn't there room for commercial payers to be paying less for hospital costs?”

The Montana Legislature this year voted down a bill supported by Rosendale to regulate some hospital prices.