Should be extended to require:
* Prices _actually_ paid vs. list price for procedures
* All-in prices for the ten most common/expensive procedures (e.g. all associated costs of a heart surgery).
Hospital prices are about to go public in the U.S.
11–20 of 390 posts
Re: Hospital prices are about to go public in the U.S.
#12This 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…
that problem sounds like a market opportunity
Re: Hospital prices are about to go public in the U.S.
#13Presumably, this is based on ICD10 codes... but there can be 30 different services tied to a code. You still won't know what code is being charged until after the service is rendered, and if it's rack rate you won't know the actual rate your insurance will be charged, until THEY tell you... because that is proprietary information (just like the reason why your treatment was denied coverage).
Imagine you have diabetes and want to know which provider or insurance company will give you better endocrinology rates... it's the best case treatment knowledge scenario, but you can't figure anything out without knowing the secret negotiated rates for each possible coverage pair.
Re: Hospital prices are about to go public in the U.S.
#14List 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.
Sadly, I've seen worse billed/reimbursement ratio in reality.
Re: Hospital prices are about to go public in the U.S.
#15This 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…
"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."
Another problem is, for many, you won't even know what your ailment and treatments will be until after.
Re: Hospital prices are about to go public in the U.S.
#16It's funny that co-pay I am paying for a service in the USA is comparable to a full private treatment with the same quality in Poland, where I grew up.
Re: Hospital prices are about to go public in the U.S.
#17It's funny that co-pay I am paying for a service in the USA is comparable to a full private treatment with the same quality in Poland, where I grew up.
It can be difficult for a patient to determine quality of care.
And difficult to compare country against country.
Poland is similar to USA in cardiovascular care, but much worse in cancer : https://en.m.wikipedia.org/wiki/List_of_countries_by_quality...
Re: Hospital prices are about to go public in the U.S.
#18My 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.
This is one of those nice ideas that has some pretty serious hidden costs. You’d struggle to compare healthcare in the US to other countries, because the quality of healthcare available (talking about availability, not accessibility) in the US is generally superior to other countries. So you could end up simply eroding the quality of care in the US. Another thing people tend not to talk about when discussing healthcare in the US is how much the US contributes to medical research and innovation. No other nation on earth even comes close. If you adjust the system so much that you remove the incentive to carry out that research, then the quality of care in literally the entire world would suffer.
Re: Hospital prices are about to go public in the U.S.
#19fyi, Medicare made their reimbursement data available some time ago, including billed vs reimbursed.
https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
CEDARS-SINAI MEDICAL CENTER in CA billed on average $2.8 mil for one heart transplant (nearly 50 performed) while Tufts Medical only billed $586k on average for similar number of procedures.
They were reimbursed $345k and $280k per procedure respectively.
Insurance companies should follow suit.
Re: Hospital prices are about to go public in the U.S.
#20Earlier quoted context omitted.
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.
This is one of those nice ideas that has some pretty serious hidden costs. You’d struggle to compare healthcare in the US to other countries, because the quality of healthcare available (talking about availability, not accessibility) in the US is generally superior to other countries. So you could end up simply eroding the quality of care in the US. Another thing people tend not to talk about when discussing healthca…
You're implying that both the quality of care and the amount of medical research done is a result of the profits of the medical companies. I'm not sure that this is the case.