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Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

healthcaredive.com

101–110 of 463 posts

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#101
Around 2012 before my wife and I were married, we both got pneumonia. I was insured through my employer, she was uninsured.

We went to urgent care at the same time on the same day, saw the same doctor and got prescribed the same drugs.

About a month later when the bills came, her bill with no insurance was somewhere in the $160 range. My bill after insurance was nearly $300.

I'm still peaved about this.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#102
post #38

Earlier quoted context omitted.

Psychologists want to charge $200-$250/hr, but insurance only reimburses $120-$160/hr. You might think these are high prices, but chargeable hours isn't hours worked for psychologists, since they have to do notes for every meeting, manage the business, appointments, etc, which reduces their total take home to something below $200k/yr, which is below a typical bigtech Eng II with only a couple years of experience, pot…

> You might think these are high prices, but chargeable hours isn't hours worked for psychologists, since they have to do notes for every meeting, manage the business, appointments, etc, which reduces their total take home to something below $200k/yr, which is below a typical bigtech Eng II with only a couple years of experience, potentially not even going to college if they are clever and self motivated enough. Sili…

Yes, all high paying careers are competing with each other for ambitious workers.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#103
post #33

It will be fun to watch people be positive on this until they are reminded who we have to thank for it. Edit: CNN hasn't forgotten, notice the obvious negative spin, with literally zero argument of how this may be beneficial: https://www.cnn.com/2021/01/04/politics/hospital-price-trans...

I'm not a fan of the guy, but this is probably the most important/good thing he did with his presidency. Price transparency is the most fundamental first step to driving down health care costs. Once people get a taste of it, it will drive even more, better and accurate data. Start real conversations about costs and open the door to measureable improvement through innovation.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#104
If you are interested in this topic, I found this podcast to be enlightening: https://www.econtalk.org/keith-smith-on-free-market-health-c...

Basically, there's a surgery center in OK which posts every price online and doesn't take insurance. A surgeon who works there talks with the host about how it works and the nuttiness of health care pricing in America.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#105

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

Emergency care accounts for just 2% of healthcare spending. https://www.politifact.com/factchecks/2013/oct/28/nick-gille...

And yet: Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income.

https://www.amjmed.com/article/S0002-9343%2809%2900404-5/pdf

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#106

I am one of the people responsible for making these lists. The fact that the general public as well as journalists think this data is accurate in anyway is really funny. This an exercise of futility that only increases the overall cost and provides job security for me :) No one working in a hospital knows how much do we acquire things for, or how much we get paid for doing things in advance. And only like 8 people ca…

>And only like 8 people can tell you that information 3 months after the fact.

It's like that in every large organization. But it turns out businesses are pretty good at tracking costs, no matter how complex.

Besides, the specifics of any single case don't matter all that much. The variation can be smoothed out given enough data and a few common points of comparison.

But all of this is asking the wrong question...not 'how much does this cost now?' which is hopelessly mired in historical cruft but 'how much would this cost if done efficiently?'.

I wonder if the VA has open books...if not, they should.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#108

I am one of the people responsible for making these lists. The fact that the general public as well as journalists think this data is accurate in anyway is really funny. This an exercise of futility that only increases the overall cost and provides job security for me :) No one working in a hospital knows how much do we acquire things for, or how much we get paid for doing things in advance. And only like 8 people ca…

I think the issue here is that the system that has been setup is so dysfunctional that there is some validity to the phrase "the cost is unknowable".

But prior to this regulation, it was extremely difficult to even ascertain just how dysfunctional it all was. Putting it out in the open means more accountability for providers and insurers. Which in due time means more regulation :)

Which is how it goes when an industry misbehaves for so long. Eventually the public will get fed up, and demand that changes be made. This is just one step on that journey.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#109
post #3

There is obviously a ways to go to create a system where price transparency is feasible, but I’m very interested in how the community might think it would affect the value based healthcare industry with respect to total cost of care management and bundled services? You cannot always look at a service in isolation because of complications on episodes like joint replacements or the impact of chronic conditions over the…

You’re right, my estimate for a short surgery in a private Thai hospital last Monday was “10k/11k THB excluding fees.” I walked out of the hospital 2 hours later having paid 9.1k THB (270 USD) painkillers included.

Estimates are fine, it’s just that they don’t benefit US hospitals. Stop justifying them, they’re scamming you.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#110

I am one of the people responsible for making these lists. The fact that the general public as well as journalists think this data is accurate in anyway is really funny. This an exercise of futility that only increases the overall cost and provides job security for me :) No one working in a hospital knows how much do we acquire things for, or how much we get paid for doing things in advance. And only like 8 people ca…

I think you made the biggest argument for requiring these lists in the first place.

For your simple exercise, it seems like we need to have that breakdown for those four different factors (and have that explicitly listed). Then we can figure out why the cost for a $0.22 jumps to $20 for those with insurance but $12 when paying cash. I agree it probably is a huge plus for you and your job security. :)

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