Hospital prices are about to go public in the U.S.
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Re: Hospital prices are about to go public in the U.S.
#2This is a start but will be useless unless how these published prices are arrived at are regulated so they can’t be gamed behind discounts, copays, deductions, insurer discounts, tacked on items, etc. It’ll be like buying a mattress and trying to do price shopping.
The published prices will need to have a readily useful and predictable meaning and interpretation.
Re: Hospital prices are about to go public in the U.S.
#3This is a start but will be useless unless how these published prices are arrived at are regulated so they can’t be gamed behind discounts, copays, deductions, insurer discounts, tacked on items, etc. It’ll be like buying a mattress and trying to do price shopping. The published prices will need to have a readily useful and predictable meaning and interpretation.
Exactly. As it is, everytime we end up with a sizable bill I call and ask for a discount, and right away they tend to give a 10% pay in full discount. I've seen this through different providers and insurance plans. I would have never thought about it until someone suggested it to me.
Re: Hospital prices are about to go public in the U.S.
#4This is a start but will be useless unless how these published prices are arrived at are regulated so they can’t be gamed behind discounts, copays, deductions, insurer discounts, tacked on items, etc. It’ll be like buying a mattress and trying to do price shopping. The published prices will need to have a readily useful and predictable meaning and interpretation.
Exactly. As it is, everytime we end up with a sizable bill I call and ask for a discount, and right away they tend to give a 10% pay in full discount. I've seen this through different providers and insurance plans. I would have never thought about it until someone suggested it to me.
Hah, yeah, I even pad my product prices so that when I run a sale, I still get my profit.
Re: Hospital prices are about to go public in the U.S.
#5One way we could wheedle useful information out of this is how the published prices relate to other providers, especially if there are huge discrepancies.
Telling me an average MRI has an average list price of $1000 at provider A tells me nothing. But if provider B says theirs is $10,000? That could be pointing to something important.
Re: Hospital prices are about to go public in the U.S.
#6List price $72,588.00
Insurance co pays $5600
OK, maybe I am exaggerating a bit but this is useless. Someone brought unconscious to the hospital should pay reasonable and common fees when they leave the hospital, not whatever the hospital dreams up. What the insurance companies pay the hospital for the procedure, maybe with a 20% increase should be it for everyone.
Re: Hospital prices are about to go public in the U.S.
#7One way we could wheedle useful information out of this is how the published prices relate to other providers, especially if there are huge discrepancies. Telling me an average MRI has an average list price of $1000 at provider A tells me nothing. But if provider B says theirs is $10,000? That could be pointing to something important.
I think that one is a key point. Regardless of the insurance carrier-negotiated discounts, this kind of transparency should make people say "wth?"
Especially as people start working and thinking of how to provide 1:1 comparisons between providers. That's the next step but we need the data first.
Re: Hospital prices are about to go public in the U.S.
#8This is almost completely meaningless unless it's paired with some serious help in figuring out the total cost of a visit.
Every service that offers this sort of price transparency I've seen so far lists the prices for single insurance billing codes at a time. A lay person isn't going to understand the total cost of the visit from that, because there's no way to figure out which billing codes are going to be make up everything that's been billed for different types of visits.
An average price also means absolutely nothing, if the variance is significant or the medical care depends on circumstances and can, as an example, vary from a single day hospitalization to a 2 week hospitalization.
While this is positive progress, I would really appreciate more effort put on actually reducing the prices themselves.
I guess the more expensive hospitals could see patients choose less expensive hospitals, and forcing them to lower their prices, but I'm not too optimistic of that happening in any meaningful way.
Re: Hospital prices are about to go public in the U.S.
#9My guess is that eventually the govt will step in and start regulating prices if providers don’t.
One interesting idea (not well thought out at all) would say that all prices need to be +\- 50% of what Medicare pays.
Medicare pays $20,000 for stent placement? Great! You can charge whatever you want up to $30,000.
A lot of effort goes into setting Medicare rates (and they are based on self reported costs across the country), so forcing providers to be in the ballpark of those might help.
It wouldn’t solve the issue, but it would eliminate those ridiculous “why do you charge $10,000 for an MRI when the clinic down the street charges $1,000?”.
Re: Hospital prices are about to go public in the U.S.
#10My guess is that eventually the govt will step in and start regulating prices if providers don’t. One interesting idea (not well thought out at all) would say that all prices need to be +\- 50% of what Medicare pays. Medicare pays $20,000 for stent placement? Great! You can charge whatever you want up to $30,000. A lot of effort goes into setting Medicare rates (and they are based on self reported costs across the co…
If you look at healthcare vs GDP, the US is way above the line compared to comparable countries. https://www.healthsystemtracker.org/chart-collection/health-...
I think scaling the average costs from other countries accounting for GDP would be a good way to set the rates.