{"id":20026,"date":"2025-01-15T09:00:10","date_gmt":"2025-01-15T10:00:10","guid":{"rendered":"https:\/\/medexperts.pro\/?p=20026"},"modified":"2025-01-15T10:25:30","modified_gmt":"2025-01-15T10:25:30","slug":"how-a-company-makes-millions-off-a-hospital-program-meant-to-help-the-poor","status":"publish","type":"post","link":"https:\/\/medexperts.pro\/?p=20026","title":{"rendered":"How a Company Makes Millions Off a Hospital Program Meant to Help the Poor"},"content":{"rendered":"<div><\/div>\n<p id=\"article-summary\" class=\"css-79rysd e1wiw3jv0\">A private business has helped supercharge a controversial federal drug program. Patients and insurers have been left with big bills.<\/p>\n<section class=\"meteredContent css-1r7ky0e\">\n<div class=\"css-s99gbd StoryBodyCompanionColumn\" data-testid=\"companionColumn-0\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Soon after being diagnosed with metastatic breast cancer, Virginia King sat in an outpatient clinic in Santa Fe, N.M, while a nurse injected her with a powerful drug to slow damage to her spine, where the disease had spread.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Even though the drug had a list price of about $2,700, the hospital that owned the cancer center billed Mrs. King\u2019s insurance company $22,700. Her insurer paid $10,000, but the hospital wanted more.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">She got a bill for over $2,500 \u2014 \u201cmore than half my take-home salary for a month,\u201d said Mrs. King, 65.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">She had unknowingly sought care from a hospital that participates in a federal program allowing it to buy drugs at a steep discount and charge patients and insurers a higher amount, keeping the difference.<\/p>\n<\/div>\n<\/div>\n<div data-testid=\"Dropzone-1\"><\/div>\n<div class=\"css-s99gbd StoryBodyCompanionColumn\" data-testid=\"companionColumn-1\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The intention behind the program was for a small number of safety-net providers to have access to affordable drugs and be able to expand their care for needy patients. But instead, the program has exploded: Now, more than half of nonprofit hospitals in the United States take part. While some providers say it has helped keep their doors open, others \u2014 especially large nonprofit health systems \u2014 <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2022\/09\/24\/health\/bon-secours-mercy-health-profit-poor-neighborhood.html\" title>have been accused<\/a> of maximizing payouts and swallowing the profits.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The program\u2019s escalation has driven up health care costs for employers, patients and taxpayers, studies show.<\/p>\n<div class=\"css-1336jj\">\n<div class=\"css-121kum4\">\n<div class=\"css-171d1bw\"><\/div>\n<div class=\"css-asuuk5\">\n<div class=\"css-7axq9l\" data-testid=\"optimistic-truncator-noscript\">\n<div data-testid=\"optimistic-truncator-noscript-message\" class=\"css-6yo1no\">\n<p class=\"css-3kpklk\">We are having trouble retrieving the article content.<\/p>\n<p class=\"css-3kpklk\">Please enable JavaScript in your browser settings.<\/p>\n<\/div>\n<\/div>\n<div class=\"css-1dv1kvn\" id=\"optimistic-truncator-a11y\">\n<hr \/>\n<p>Thank you for your patience while we verify access. If you are in Reader mode please exit and\u00a0<a href=\"https:\/\/myaccount.nytimes.com\/auth\/login?response_type=cookie&amp;client_id=vi&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2025%2F01%2F15%2Fus%2F340b-apexus-drugs-middleman.html&amp;asset=opttrunc\">log into<\/a>\u00a0your Times account, or\u00a0<a href=\"https:\/\/www.nytimes.com\/subscription?campaignId=89WYR&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2025%2F01%2F15%2Fus%2F340b-apexus-drugs-middleman.html\">subscribe<\/a>\u00a0for all of The Times.<\/p>\n<hr \/>\n<\/div>\n<div class=\"css-1g71tqy\">\n<div data-testid=\"optimistic-truncator-message\" class=\"css-6yo1no\">\n<p class=\"css-3kpklk\">Thank you for your patience while we verify access.<\/p>\n<p class=\"css-3kpklk\">Already a subscriber?\u00a0<a data-testid=\"log-in-link\" class=\"css-z5ryv4\" href=\"https:\/\/myaccount.nytimes.com\/auth\/login?response_type=cookie&amp;client_id=vi&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2025%2F01%2F15%2Fus%2F340b-apexus-drugs-middleman.html&amp;asset=opttrunc\">Log in<\/a>.<\/p>\n<p class=\"css-3kpklk\">Want all of The Times?\u00a0<a data-testid=\"subscribe-link\" class=\"css-z5ryv4\" href=\"https:\/\/www.nytimes.com\/subscription?campaignId=89WYR&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2025%2F01%2F15%2Fus%2F340b-apexus-drugs-middleman.html\">Subscribe<\/a>.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>A private business has helped supercharge a controversial federal drug program. Patients and insurers have been left with big bills.Soon after being diagnosed with metastatic breast cancer, Virginia King sat in an outpatient clinic in Santa Fe, N.M, while a nurse injected her with a powerful drug to slow damage to her spine, where the disease had spread.Even though the drug had a list price of about $2,700, the hospital that owned the cancer center billed Mrs. King\u2019s insurance company $22,700. Her insurer paid $10,000, but the hospital wanted more.She got a bill for over $2,500 \u2014 \u201cmore than half my take-home salary for a month,\u201d said Mrs. King, 65.She had unknowingly sought care from a hospital that participates in a federal program allowing it to buy drugs at a steep discount and charge patients and insurers a higher amount, keeping the difference.The intention behind the program was for a small number of safety-net providers to have access to affordable drugs and be able to expand their care for needy patients. But instead, the program has exploded: Now, more than half of nonprofit hospitals in the United States take part. While some providers say it has helped keep their doors open, others \u2014 especially large nonprofit health systems \u2014 have been accused of maximizing payouts and swallowing the profits.The program\u2019s escalation has driven up health care costs for employers, patients and taxpayers, studies show.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and\u00a0log into\u00a0your Times account, or\u00a0subscribe\u00a0for all of The Times.Thank you for your patience while we verify access.Already a subscriber?\u00a0Log in.Want all of The Times?\u00a0Subscribe.<\/p>\n","protected":false},"author":1,"featured_media":20028,"comment_status":"close","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[],"class_list":["post-20026","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"_links":{"self":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts\/20026","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20026"}],"version-history":[{"count":2,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts\/20026\/revisions"}],"predecessor-version":[{"id":20029,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts\/20026\/revisions\/20029"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/media\/20028"}],"wp:attachment":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20026"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20026"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20026"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}