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Hospitals pledge to fight admin price transparency plan in court

healthcaredive.com

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

#291
post #87
post #48

Earlier quoted context omitted.

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

Couldn’t you have called Labcorp and got the test from a lab? My doctor doesn’t do any lab testing. It goes to the lab in my county that’s connected to the hospital or to lab corp.

Ultimately, yes, I went to an independent lab that quoted me a price over the phone on the spot.

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

#292

Earlier quoted context omitted.

Have you seen radiologist salaries? It's a scam, Jim. There are four pigs at the trough of US health care: Insurance Device/Drug Lawyers Doctors Everyone points the finger at other people and desperately fight to maintain their bloated share of the bloating pie. Unfortunately doctors are not your friends in hospitals. They are trying to get billing.

Indeed! As she was applying for residency programs, my wife briefly entertained the thought of becoming a radiologist because boy, they made a load of money for 8am-2pm work! We both are 100% self-aware that healthcare industry has a lot of bad actors including doctors, pharma companies, hospital admins, lawyers and pretty much everyone involved. If residents cry about 60+ hours/week of work during the first year res…

"advocating AMA to relax the residency and medical school requirements"

People talk about the constriction of supply of doctors, but aren't NPs and PAs doing everything these days anyway?

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

#293

Earlier quoted context omitted.

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.

I had an appointment that was billed at $400, if I recall correctly, while one insurance allowed $140 and another $70. That's the total cost, none of which was paid by insurance due to a large deductible. LabCorp I think has been similarly marked down from hundreds to tens, although I don't remember numbers. I don't think it's uncommon to have the official price be multiples of what's reasonable just in case someone might pay it.

A long time ago, I was told that a local hospital automatically gave half off if you paid cash. But that could well be gouging relative to insurance or Medicare.

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

#294
post #87

Earlier quoted context omitted.

Couldn’t you have called Labcorp and got the test from a lab? My doctor doesn’t do any lab testing. It goes to the lab in my county that’s connected to the hospital or to lab corp.

My father has been monitoring his calcium levels and uses Labcorp directly. It is great that you can cut out the middleman. They draw blood right there and you can view your results very quickly online. This process is a hidden gem in our bloated system. Go directly to the lab. Now obviously this is just for health maintenance and dietary checkups. Not to many people are aware that you can go right to the lab directl…

What? Who doesn't go "directly" to Labcorp? They have obviously cut costs to the bone, but that makes me nervous. They have basically one person per location who does everything, and I worry that they are too stressed/tired/burned out/disgruntled to do their job right.

I heard something years ago about a medical lab that was just throwing out all their samples and using a simple statistical model to return results. That's what you can get if you are just rewarding efficiency.

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

#295

Earlier quoted context omitted.

I'd pay more for quality. If I knew hospital X is better at hip replacement I'd pay extra to go there. Of course how much extra I'm not sure, and I'm also not sure how you compare hip replacement quality like that. It is only emergency rooms where I don't get a choice - if you need an emergency room close is important.

> It is only emergency rooms where I don't get a choice - if you need an emergency room close is important. i feel like the folks on here peddling this line have not ever spent any time watching who comes through an ER. most of the people who go into an ER aren't dying, or screaming in pain. they've just got a problem that can't wait until urgent care opens up again in the morning. or they need something done that ur…

Most people go to the ER for non-emergency conditions...

Though I will note that many emergency symptoms turn out to be non-emergency only after more tests.

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

#296
post #266

Earlier quoted context omitted.

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.

Yea, very true. Up here in Seattle I believe we are in the same boat, a single level 1 trauma center.

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

#297

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.

I am not, I'm just stating the fact that they are replacing physicians, mainly due to costs. I'm struggling to see how you read into that statement a negative tone on the matter.

FWIW, my partner was an NP before leaving direct patient care.

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

#298

Earlier quoted context omitted.

Lab tests are particularly complicated to price because usually they are being processed by someone else. Usually labs won't even try to get an authorization from insurance until they get your sample and start working on it as it affects their turnaround time which is one of their main differentiators, and each insurer will have different rules about what they will pay for under what conditions (insurers also have se…

> The short answer is they can't tell you because they don't know. Bingo. My partner works in revenue cycle management (arguing with insurance companies to pay their bills) for a large hospital chain, and even she can't get accurate prices for procedures. She can walk down the hall to the finance department, and ask them, but even they can't figure it out. I found this out after asking her why they don't prioritize c…

This is one of the reasons that medical pricing is out of control. If nobody knows the pricing for anything, how can anybody (not just patients, but anybody else involved with the system) make rational decisions?

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

#299

Earlier quoted context omitted.

Have you seen radiologist salaries? It's a scam, Jim. There are four pigs at the trough of US health care: Insurance Device/Drug Lawyers Doctors Everyone points the finger at other people and desperately fight to maintain their bloated share of the bloating pie. Unfortunately doctors are not your friends in hospitals. They are trying to get billing.

Indeed! As she was applying for residency programs, my wife briefly entertained the thought of becoming a radiologist because boy, they made a load of money for 8am-2pm work! We both are 100% self-aware that healthcare industry has a lot of bad actors including doctors, pharma companies, hospital admins, lawyers and pretty much everyone involved. If residents cry about 60+ hours/week of work during the first year res…

The crazy work hours for residents are basically a protectionist racket to keep wages for doctors high.

They don't serve any rational purpose in medical education and just serve as barrier to entry.

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

#300

Earlier quoted context omitted.

Have you seen radiologist salaries? It's a scam, Jim. There are four pigs at the trough of US health care: Insurance Device/Drug Lawyers Doctors Everyone points the finger at other people and desperately fight to maintain their bloated share of the bloating pie. Unfortunately doctors are not your friends in hospitals. They are trying to get billing.

Indeed! As she was applying for residency programs, my wife briefly entertained the thought of becoming a radiologist because boy, they made a load of money for 8am-2pm work! We both are 100% self-aware that healthcare industry has a lot of bad actors including doctors, pharma companies, hospital admins, lawyers and pretty much everyone involved. If residents cry about 60+ hours/week of work during the first year res…

> Everything about healthcare is business now

https://i.imgur.com/t22Lg5Y.jpg

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