Washington leaders tackle how to make health care more affordable

Health care costs continue to rise, spurred in part by hospital consolidation, lack of cost transparency and a lack of courage to go against the status quo, industry experts said at a panel at the State of Reform Washington Health Policy Conference in Seattle this week.

“We are facing an affordability crisis,” said Bill Kramer, senior adviser at the Purchaser Business Group on Health, which represents private employers. “Health care has many crises – the behavioral health crisis and the workforce crisis – but affordability is something that suffuses the entire system.”

Earlier at the daylong conference, state Rep. Nicole Macri (D-Seattle) said the Legislature will need to have “uncomfortable conversations” this session on how to address health care costs. “The cost of care continues to go up at a rate that is totally unsustainable.”

Several leaders cited a report from the Office of the Insurance Commissioner that found that health care consolidations in Washington “do not improve quality of care, but rather, drive up prices and impact access to care for patients.” According to the report, as of 2017, nearly half of hospitals in Washington were affiliated with large hospital systems. In 1986, only 10 percent of hospitals in Washington were in large hospital systems.

“That kind of consolidation nearly always results in price increases, without increasing quality,” said Emily Brice, deputy director of Northwest Health Law Advocates. “This is just Economics 101: if you’re the big guy in town and there’s nobody left, there is no reason to try to compete.”

Washington lawmakers this session will be considering legislation that would help level the playing field for patients in the face of increasing hospital consolidation. The bill would stop hospitals from using anti-competitive clauses in their contracts with insurers to gain market leverage.

The contracting legislation, along with another proposal to allow the state attorney general to review health care mergers and acquisitions, would put immediate “safety rails” on market behavior while policymakers take a deeper look at the impacts of health care consolidation, Brice said. “We need to take corrective measures now so we have the opportunity to think about this thoughtfully together.”