Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Hospitals pledge to fight admin price transparency plan in court

healthcaredive.com

Post reply on HN
Print view View original

261–270 of 311 posts

Re: Hospitals pledge to fight admin price transparency plan in court

#261

Post by travisoneill1 »

SilasX wrote: post #243
noelsusman wrote: post #124

Earlier quoted context omitted.

Not secure in the sense that it's encrypted, though that's part of it. Secure in the sense that you know you're communicating with the patient and only the patient, not their spouse, or their grandson, or Google's servers.

If that's actually a requirement, then why are most providers happy to accept that it's me over the phone/at the pharmacy if I simply say I'm Silas and maybe give the right date of birth?

Because it's not actually about meeting the stated goal. It's about checking all the boxes on some asinine bureaucratic form that assumes if all the boxes are checked, then the goal is met. This is how stupid people do things when you give them authority.

Re: Hospitals pledge to fight admin price transparency plan in court

#262

Post by travisoneill1 »

njharman wrote: post #89
lotsofpulp wrote: post #73

Earlier quoted context omitted.

Is it illegal to write “we will bill your insurance for procedure codes x y z for your visit”? They don’t need to tell you the cost, but they know what they’re going to charge you beforehand. They should be able to tell you the codes so you can give it t your insurance company to find out how much it will cost. The reason healthcare providers don’t give out codes for known predictable procedures is it would enable cu…

HIPPA and privacy laws. Communications have to be secure.

But, of course they can leave a printed copy in your mailbox for anyone to grab. That is defined as "secure".

Re: Hospitals pledge to fight admin price transparency plan in court

#263

Post by frankharv »

bootlooped wrote: post #176

I called a pharmacy once and asked how much a vaccination would be. I had insurance. They told me they couldn't tell me how much it would be until after I got the shot.

PBS has an excellent report about flu vaccinations and the widely varying prices. Millions of shots given every year and prices from free to $85.

I wonder what the actual vaccination vile costs in this whole scheme compared to the overhead.

https://www.pbs.org/newshour/health/the-hidden-costs-of-free...

Re: Hospitals pledge to fight admin price transparency plan in court

#264

Post by Broken_Hippo »

noelsusman wrote: post #66
istjohn wrote: post #48

Earlier quoted context omitted.

Thing is, this was self-pay for a single routine lab test. It's the simplest possible scenario.

So few people self pay that hospitals just aren't set up to make the experience make sense. All of their resources are devoted to dealing with insurers and the government.

Sure, few people self-pay for the entire thing.

Many, many people pay a deductible, though. Many people pay a copayment. For these, you can still quote the cash price, I would thing, or give a range for what the entire thing costs, explaining the range is because of insurance discounts. In the age of modern tech, this shouldn't be a big deal.

Re: Hospitals pledge to fight admin price transparency plan in court

#265

Post by Broken_Hippo »

enjo wrote: post #172
notyourday wrote: post #149

Earlier quoted context omitted.

> The first, which is reasonable, is that a lot of treatments are bespoke. Fine. That's a justification for their being costly not for your having to imagine the cost because no one can tell you. Treatments are billed using billing codes so they are definitely not bespoke.

Those billing codes are CRAZY complex tho. One example: when you see a doctor you may generate multiple billing events. For instance they may draw blood, take an X-Ray, and perform a specific type of test. In a sane world you would generate three billing codes, sum them, and you'd have your price. But that's not how it really works. Instead certain billing codes can be combined to form new billing codes which makes t…

"Basically we're inefficient from basically every direction in the USA"

This, and so much this. And I don't always understand this. To use the example here, billing codes: I'd think this is something that could be standardized - and being such, pricing would need to be standardized. I truly don't understand why this isn't coded into law.

The negotiation gets me as well - it means that no one can tell you a price. In a more perfect world, there would just be a price, and you could simply get the price from the hospital and it would be illegal for the hospitals to charge one price for cash patients and another for those with insurance.

Re: Hospitals pledge to fight admin price transparency plan in court

#266

Post by mc32 »

soapboxrocket wrote: post #249
mc32 wrote: post #240

Earlier quoted context omitted.

I think lots of people say “ER” for trauma center.

I think lots of people say "ER" for "ED" Emergency Department became the most common term about a decade ago and Emergency Room faded from building guides and hospital documents.

Either way most don’t have trauma centers, in SF I think only SF General is the only level 1 trauma center although some of the people also rotate through UCSF’s ED.

Re: Hospitals pledge to fight admin price transparency plan in court

#267

Post by Broken_Hippo »

devicetray0 wrote: post #241
mywittyname wrote: post #129

Earlier quoted context omitted.

> This isn't to say I think nurses or doctors are overpaid The probably are. Clearly hospital executives and administrators are raking in most of the money, but we can't sit here and pretend that caregivers don't directly benefit from such an arrangement as well. There's a reason urgent care centers and small clinics pay their doctors less than most of us make, or skip employing doctors at all in favor of nurse pract…

> skip employing doctors at all in favor of nurse practitioners Hold up. I hope you're not being negative on hiring NPs. As someone who is in favor of NPs (and knows many NPs), they provide excellent primary care and hiring them can help bring down the overall cost of healthcare. I say we should teach and hire MORE NPs to provide cheaper primary and preventative care, not blame clinics for hiring them.

This, and exactly this. NP's are great for the run-of-the-mill sicknesses and minor injuries that most adults and children get. In conjunction with a PCP, they provide excellent primary care even for more complicated patients.

In addition, specialist nurses are a great addition to a specialist's team. I don't see a neurologist all that often, but I have checkups with one of the team of wonderful nurses at the office, some of which specialize in the disease I have. It works out wonderfully and allows the specialist to take care of more patients and still provide pretty wonderful service.

Re: Hospitals pledge to fight admin price transparency plan in court

#268

Post by TurkishPoptart »

wavepruner wrote: post #211
braythwayt wrote: post #46

Earlier quoted context omitted.

I have empathy for where you're coming from, but to me it feel like the following: Imagine that in America, husbands are allowed to beat their wives, and the government proposes a law that they may not use a stick with a girth bigger than their thumb. Alice says, "This is insane. Husbands are not allowed to beat their wives in Canada, that is the correct solution." And then Bob says, "Well, that's just unrealistic he…

Did you read my entire post? Universal health care does not solve the problem. Canadians that have my illness have just as much difficulty as I do. I swear you kinds of healthy people do not even read/listen to the words that I and other crippled people say. Your analogy is not even remotely appropriate. And how is open pricing incompatible with universal health care? Is your ideology so important to you that you wil…

I just wanted to say that your original post made plenty sense, and that I agree. And I found parent's wife-beating analogy quite confusing and unrelated.

Re: Hospitals pledge to fight admin price transparency plan in court

#269

Post by digikata »

tptacek wrote: post #245
digikata wrote: post #213

Earlier quoted context omitted.

Its from a book, Code Blue: Inside Americas Medical Industrial Complex, by Mike Magee. The author is a Doctor and distinguished medical academic and past hospital executive.

I believe you, but it's hard to square that ratio with the actual administrative overhead of US health care, which is under 15%.

The book contains many references, but it's dense. I thought admin overhead tended to go to 15% because of ACA provisions of 85% spending requirement on direct care? I would likely have to do a fair bit of digging to compare how the scope is defined exactly vs an ACA definition. Makes for something of a perverse incentive if the companies want/need to route additional absolute dollars into their service depts - but I don't know how much it actually gets bent in that direction.

Re: Hospitals pledge to fight admin price transparency plan in court

#270

Post by fzeroracer »

Price transparency is a losing battle.

Let's say they make prices transparent. You ask them about the cost of getting an X-ray done and they quote you $Number. You go and get an x-ray done and you're billed for $number plus a few extra thousand for any number of unknown costs.

Hospital billing is a lot like getting billed for internet/phone/cable etc. They'll throw all kinds of bullshit charges, ding you for not using certain things and more. Then you have to waste energy calling them up to talk with someone whose job is to get you off the line.

That's assuming you can even shop for your needs. If it's an emergency then you're screwed either way. The only change this would cause is that insurers and hospitals would adapt and figure out other ways to sneak in charges.

If you want to fix this problem at the core, then trying to make it more of a free market won't work. You need stronger oversight and control to keep things in check.

Post reply on HN