SHERIDAN — The Wyoming Legislature’s Labor, Health and Social Services Committee discussed a bill this week that would authorize an extensive study of the state’s health care system to identify the factors that contribute to high health care costs.
Sen. Charles Scott, R-Casper presented a report that showed Wyoming’s private heath care costs and hospital care prices are among the most expensive in the country.
Those high fees, Scott said, are compounded by Wyoming residents traveling to neighboring states for lower-cost treatments, which represent lost revenue for Wyoming health care providers. Further, the report showed Wyoming was second in the nation when it came to health insurance costs.
“That’s not a position we want to be in because our constituents are really being hurt by that,” Scott said. “…[And] it’s not apparent what’s causing this.”
Patients seeking care would also look to measure exactly how many patients are seeking care outside the state, as the latest data is from 2014. According to that data, however, nearly 24 percent of medical costs are going out of state.
“That is partly a concern for our economic development people,” Scott said. “We are out of line with all of the other states. On that one, we’re losing a good part of our economy over the border.”
In addition to the lost profits, patients leaving the state could also cause Wyoming hospitals to lose specialized treatments. Procedures like heart surgery have a high fixed cost because they require complicated and expensive equipment and specialized physicians.
Without a sufficient volume of patients, providers who perform those procedures run into both safety and economic concerns. From a safety standpoint, if physicians do not perform risky procedures regularly, they are less practiced and therefore more prone to error. Such procedures also tend to be expensive and the health centers who provide them need a regular stream of patients to continue offering the services. Losing the ability to perform those procedures can snowball and cost health centers related services as well.
For instance, Scott said a hospital that loses its heart surgeon would no longer be able to employ an advanced cardiologist because a cardiologist needs to have ready access to a heart surgeon in case their patient’s condition deteriorates and requires surgery.
“Then you’re taking a major illness where you need rapid treatment if you come to the hospital in crisis and saying you have to be transported out of state,” Scott said.
Wyoming Hospital Association President Eric Boley urged the committee to use the bill to explore the impact Medicaid expansion could have on the state’s health care costs, especially considering neighboring states like Montana, Idaho, Utah, Nebraska and Colorado have voted to expand Medicaid.
“One of the things we are hearing is Medicaid expansion has had a tremendous impact on surrounding states,” Boley said. “And we are now an island.”
The state Legislature voted not to expand Medicaid in 2016 and Governor-elect Mark Gordon has said he is opposed to expanding Medicaid.
Boley also said the study should incorporate a survey of acuity levels — which measure the amount of resources a patient requires to be treated — and diagnoses of patients being admitted, as hospitals treating patients with severe ailments can also drive up costs.
The draft bill proposes the Legislature appropriate $250,000 to hire a consultant to conduct the study, but Scott admitted he was not sure if that amount would be sufficient.
“It will be an expensive thing because we’re really trying say ‘What does the data really tell us about what is causing high hospital care costs?’” Scott said.
Legislators will continue to look at options and opportunities in the health care industry in Wyoming.