House Ways and Means grills hospital CEOs on soaring prices, rural access and site-neutral payments

House Ways and Means Committee Chairman Smith opened a May 13 hearing by sharply criticizing hospital consolidation and high prices, saying hospitals with more than 100 beds now have higher profit margins than major U.S. companies and charging that market concentration and loopholes have left patients and taxpayers paying too much.

The hearing drew testimony from five senior health system leaders who gave differing explanations for rising hospital prices and recommended a mix of policy responses. Sam Hazen, chief executive officer of HCA Healthcare, said HCA provided about "$4.5 billion in uncompensated care" last year and urged stable, affordable coverage, fair competition and cuts to administrative friction such as excessive prior authorization. Wright Lacader, president and CEO of CommonSpirit Health, described his system’s community-benefit work and told the panel that CommonSpirit faces large unpaid Medicare Advantage claims and nearly $4.3 billion in outstanding MA payments. Brian Donnelly, president and CEO of NewYork–Presbyterian, cited $2.4 billion in community benefit and emphasized shifting care to lower‑cost settings where clinically appropriate. Mike Waldrum, chief executive of ECU Health, framed the problem in rural terms, saying consolidation is often the only way to sustain essential local services. Brad Woodhouse of Protect Our Care faulted recent federal cuts (HR1) and presented a nonprofit tracker of hospitals at risk.

Why it matters: Members pressed witnesses on…