Rising Emergency Room Costs in Missouri is Focus of McCaskill Inquiry

Billing rates skyrocketed at emergency rooms run by EmCare in Missouri and across the country

WASHINGTON - U.S. Senator Claire McCaskill, the top-ranking Democrat on the Homeland Security and Governmental Affairs Committee, is seeking answers from Envision Healthcare and its subsidiary EmCare Holdings, Inc. following reports of skyrocketing costs at emergency rooms (ERs) run by EmCare. According to those reports, EmCare tripled the highest rate for ER visits at one hospital that was studied and allegedly pressured ER doctors to order expensive, unnecessary tests for patients. EmCare manages more than ten hospitals in Missouri.

“Emergency room visits can be far too expensive already—and if EmCare is gaming the system just to up their profits, that needs to be thoroughly investigated,” McCaskill said. “I’m committed to protecting patients in Missouri and across the country by getting to the bottom of what’s going on with EmCare’s billing.”

In a letter to Envision President and CEO Christopher A. Holden, McCaskill detailed her concerns with EmCare’s reported practices, writing that “EmCare staffing and management have led to a decline in health care quality and access for patients in communities around the country.” One study that looked at 16 hospitals found that out-of-network billing rates increased by over 70 percent—rates that were often passed onto patients. Because of actions like these, many Missourians are now facing higher bills after they go to the emergency room. Another report found that similar services at a hospital rose from $467 to $1,649 when EmCare took over the hospital’s staffing and billing.

“These [rising] costs have a significant adverse impact on the communities where EmCare operates and on the unsuspecting patients,” McCaskill continued. She requested answers from Envision including information on bonuses physicians may receive related to their lab testing rates, how much Envision or EmCare has received from the federal government, and their percentage of out-of-network billing.

McCaskill has continually worked to improve healthcare in Missouri and across the country. In response to rural hospital closures across the country, McCaskill called for an investigation into the challenges these hospitals face, trends in rural hospital closures, and recommendations for the federal government about addressing these issues. Earlier this year, McCaskill introduced legislation aiming to protect access to health insurance for Missourians on the individual insurance market, amid reports of insurers withdrawing from those markets. McCaskill also joined Republican Senator Susan Collins of Maine to introduce a bill to increase competition for generic drugs and lower prescription costs.

Read McCaskill’s letter to Envision HERE.

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