Transparency and accountability: the path to meaningful health care pricing reform
As the voice of Indiana's manufacturers, the Indiana Manufacturers Association (IMA) is deeply concerned about the escalating cost of health care — particularly hospital prices — which place Indiana businesses at a significant competitive disadvantage. Transparency and accountability are the answer.
The Employer Price Transparency Study – Round 5, conducted by RAND, has consistently shown that Indiana's hospital prices are among the highest in the nation, ranking 8th overall. Hoosier employers and employees are paying nearly three times what Medicare pays for the exact same services at the same hospitals — an average of 297% compared to the national average of 254%. This alarming statistic demonstrates a clear need for reform.
These inflated hospital costs have a direct and negative impact on Indiana's manufacturing sector. Every dollar spent on excessive health care charges is a dollar that cannot be invested in workforce development, technological advancements, or business expansion.
In a global marketplace, our ability to compete hinges on our efficiency and our ability to attract and retain a skilled workforce. The current high cost of health care in Indiana makes it more difficult for manufacturers to offer competitive benefits packages and to allocate resources strategically for future growth.
Since self-funded employers pay directly for their employees' health care claims, escalating hospital prices translate to immediate and substantial increases in their expenditures. These rising costs force employers to allocate more resources to health care, potentially diverting funds from other critical business areas. Ultimately, the financial burden of high hospital prices significantly affects the sustainability and competitiveness of all employers, but most acutely self-funded insurance models.
House Bill 1004 takes meaningful steps toward addressing this issue. It introduces measures to increase transparency in hospital pricing and to put pressure on exorbitant costs. For instance, the bill establishes a hospital facility fee excise tax for charges exceeding 265% of Medicare facility fees.
Under this legislation, nonprofit hospitals would be mandated to report aggregate data on billed services and their comparison to Medicare reimbursement rates. Nonprofit hospitals charging more than 300% of their modified Medicare reimbursement rate could forfeit their nonprofit status. These provisions are critical for bringing much-needed transparency and accountability to our health care system.
The passage of HB 1004 is not just about lowering health care costs; it is about strengthening Indiana's economy and ensuring a prosperous future for our manufacturing industry and its employees. By addressing the issue of high hospital prices, we can free up valuable resources that can be reinvested in our workforce, making Indiana a more attractive place to do business and create jobs.
SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
New York Post
5 hours ago
- New York Post
Viral images of starving Gaza boy don't tell the whole story because he suffers from genetic disorders, critics say
A horrifically emaciated Palestinian child held up by news outlets as the face of starvation in Gaza actually suffers from genetic and other disorders, which much of the coverage glossed over, according to critics. The heart-rending photo of Muhammad Zakariya Ayyoub al-Matouq made the rounds on outlets including the New York Times, NBC News, The Guardian, BBC and others as evidence that Israel's war against Hamas has led to the starvation of children in the Palestinian enclave. But pro-Israel group HonestReporting first spotted something the outlets either didn't notice or outright ignored: the boy's older brother, Joud, standing in the background looking like he was in much better condition. Advertisement 5 Palestinian child Muhammad Zakariya Ayyoub al-Matouq being held by his mother in Gaza City on July 21, 2025. Photo by Ahmed Jihad Ibrahim Al-arini/Anadolu via Getty Images 5 A photo of Muhammad went viral last week as alleged evidence of starvation in Gaza. Photo by Ahmed Jihad Ibrahim Al-arini/Anadolu via Getty Images In a video segment, CNN said Muhammad's own mother revealed that he suffers from a 'muscle disorder' for which he receives specialized nutrition and physical therapy, saying he was 'happy' and able to 'sit upright' when they were provided. Advertisement Pro-Israel journalist David Collier said little Muhammad has 'cerebral palsy, hypoxemia, and was born with a serious genetic disorder,' citing a May 2025 medical report from Gaza. In viral photos, taken on July 22 by Turkey's state-owned Anadolu news agency, Muhammad's spine protrudes from his tiny back as his mother cradles him in her arms. The BBC interviewed the image's photographer, Ahmed Jihad Ibrahim al-Arini, who suggested the photo was representative of the widespread starvation that has taken hold in the Gaza Strip. 5 Muhammad suffers from genetic disorders and other issues including cerebral palsy and hypoxemia, according to a report. Photo by Ahmed Jihad Ibrahim Al-arini/Anadolu via Getty Images Advertisement 5 Muhammad's mother told CNN that he has a 'muscle disorder' that requires physical therapy and specialized nutrition. Photo by Ahmed Jihad Ibrahim Al-arini/Anadolu via Getty Images The Guardian captioned a photo of Muhammad as 'facing life-threatening malnutrition,' while the UK's Daily Express described it as 'a horrifying image encapsulating the 'maelstrom of human misery' gripping Gaza.' The Israeli Foreign Ministry says it has allowed around 4,500 aid trucks into Gaza since lifting a blockade in May, and that 700 more are waiting to be picked up by the UN. A UN report earlier this month asserted that that 9% of children screened at health clinics across Gaza are suffering from severe malnutrition — a sharp rise from the 6% found in June. Advertisement 5 The image's photographer Ahmed Jihad Ibrahim al-Arini told the BBC Muhammad represents the situation in Gaza. Anadolu via Getty Images The Hamas-controlled health ministry claims that 20 children have died from malnutrition related causes in the last three weeks. The United Nations has also accused Israel of choking the flow of aid and making Israeli and US-backed aid efforts dangerous for civilians. Palestinians blame Israel for the sluggish pace of deliveries, but the Jewish state has repeatedly retorted that its efforts to allow aid to flow into Gaza must be carefully controlled so Hamas fighters don't intercept the shipments. On Sunday, the Israel Defense Forces said it will be initiating a 'local tactical pause' in military activity to allow more aid to get into Gaza, but that distributing food within Gaza 'lies with the UN and international aid organizations' who they say must 'ensure that the aid does not reach Hamas.'
New York Post
6 hours ago
- New York Post
Cluster of Legionnaire's disease cases found in NYC as health officials on alert
The city health department has launched an investigation after a cluster of Legionnaire's disease cases were identified in Harlem over the weekend — with officials urging New Yorkers to take precautions. Five cases of the potentially fatal pneumonia-like illness were diagnosed in the Manhattan neighborhood in recent days, although no deaths have been reported, the department said. 'Any New Yorkers with flu-like symptoms should contact a health care provider as soon as possible,' Deputy Chief Medical Officer Dr. Toni Eyssallenne said in a statement. Advertisement 'Legionnaire's disease can be effectively treated if diagnosed early,' Eyssallenne said. 'But New Yorkers at higher risk, like adults aged 50 and older, those who smoke or have chronic lung conditions should be especially mindful of their symptoms and seek care as soon as symptoms begin.' Legionella pneumophila bacteria existing in potable water biofilms revealed in the scanning electron microscopic. Getty Images Although potentially lethal if not treated in time, Legionnaire's disease is not contagious and can be treated with antibiotics if caught in time, the department said. Advertisement The disease is typically transferred through water supplies contaminated with Legionella bacteria that can pop up in plumbing systems, and can find favorable conditions in cooling towers, whirlpool spas, hot tubs, humidifiers and condensers in large air conditioning systems, health officials said. Last month officials in Sydney, Australia reported a death from a Legionnaire's case there. Legionella colonies illuminated using ultraviolet light, cultured on an agar plate, Getty Images In October, a dozen cruise ship passengers were diagnosed with the disease in two cases, including 10 who had to be hospitalized, while another outbreak was reported at two Las Vegas casinos in 2023. Advertisement In 2022, at least two dozen people in the Highbridge section of the Bronx were diagnosed with Legionnaire's, with two dying and others hospitalized with the disease. ,
Forbes
12 hours ago
- Forbes
Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage
There were two major announcements recently regarding prior approval of treatments and services for Medicare beneficiaries. In most medical insurance, many treatments won't be covered unless it is approved first by the insurer. It's been a source of controversy for some time. Original Medicare hasn't required prior authorization of treatments and services, with a few exceptions. For most care, providers and the patient agree on a treatment. After the treatment, paperwork for approval and payment is submitted to Medicare. Medicare recently announced a new model program that will test pre-approval. The voluntary model program will test pre-approval for some services and treatments, according to a recent announcement from the Center for Innovation of the Centers for Medicare and Medicaid Services. The model program is seeking medical providers to volunteer for the program from Jan. 1, 2026 through Dec. 31, 2031. The model will be restricted to New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Providers who volunteer and are accepted will agree to seek prior authorization for 17 items and services, including skin substitutes, deep brain stimulation for Parkinson's Disease, impotence treatment, and arthroscopy for knee osteoarthritis. A provider who volunteers for the program can choose not to seek prior approval for a case. There will be a post-treatment review of the case, and the provider will risk not being paid by Medicare for the treatment. CMS initiated the program and selected the services to be covered because of a series of reports showing waste, fraud or abuse in certain areas. For example, Medicare spent up to $5.8 billion in 2022 on unnecessary or inappropriate services that had no clinical benefit, according to the Medicare Payment Advisory Commission. Under the model, providers will submit the same information they currently submit for payment approval after a service is provided to a beneficiary. The difference is that under the model, the information will be submitted earlier and the provider will wait for approval before performing the services. CMS will select companies to receive and review the prior authorizations. It expects that they will use artificial intelligence and other tools in addition to medical professionals to review the submissions. The companies will be paid based on the extent to which they saved the government money by stopping unnecessary services. CMS said it will manage the program to avoid adverse impact on beneficiaries and providers. There was other news about pre-approval, this time involving Medicare Advantage plans. Pre-approval in Medicare Advantage plans has been controversial recently. There have been a number of recent reports and studies that found the authorization process was delaying treatment or causing patients to abandon treatment plans. Other reports indicated that a high percentage of treatments that initially were denied coverage eventually were approved if the patients or their providers appealed the than 50 major insurers who sponsor many types of insurance plans announced that they will voluntarily streamline prior authorization of treatments and services in all insurance markets, including Medicare Advantage plans. The insurers say they plan to have the new process in place by Jan. 1, 2027.
