Cost shift prompts insurer lawsuit against provider

The dynamic of the medical care “cost shift” in which insured patients are effectively surcharged to cover the cost of the care for those lacking coverage is on full display in this San Jose Mercury News item.  It reports on the “SafetyNet” program at Santa Clara Urgent Care and the 10 other facilities operated by the Bay Area Surgical Management. The program gives 1,000 uninsured residents free health care, which includes urgent care, imaging and gynecological services and outpatient surgeries.   But that care isn’t exactly free and the cost must be covered somehow:  the provider faces legal action from Aetna accusing the provider of overcharging patients with coverage.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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Frederick Pilot

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