Earlier quoted context omitted.
So do lawyers.
Lawyers don't have the ability to kill you.
[deleted]
How much health insurers pay for almost everything is about to go public
121–130 of 370 posts
Re: How much health insurers pay for almost everything is about to go public
#122I'm one of the co-founders of Turquoise Health, mentioned in the article here. We've been downloading and parsing this data all day. It's a really big deal in the industry that the prices that insurance companies pay doctors are now being shared publicly. It will have all sorts of positive impacts over time, hopefully making rate negotiations more consistent and fair between different insurance plans. Right now, 10x…
We really need to move to reference based pricing. We can cut so much waste out of the current system including brokers. Reference based pricing also get rids of the loopholes for things like anesthesiologists being "out of network" at a hospital/facility that is "in network". It also gets rid of the situation where if you offer cash you get one price but if you submit for the same code, it could be 3x or 10x or even more.
Re: How much health insurers pay for almost everything is about to go public
#123Earlier quoted context omitted.
The fact that there are at least 5 large insurers competing nationwide and all have 5% or less profit margins means there is lots of competition, and if they are not providing the best prices, their customers will go elsewhere. See pharmacy forums as an example for all the pharmacists complaining about how independent pharmacies are so tough to operate due to ever smaller payments from insurance companies for the pas…
No, it means that Obamacare is working as written[1]. Insurer profit margins are set to the legally permitted ((medical bills) * 15%) - operating costs. If insurers want to make more money, they can either make medical bills more expensive, or reduce their own operating costs. Reducing the cost of medical bills does not increase the amount of money they make, unless it means they are capturing market share from a com…
I agree with many of your points. But in terms of employers switching plans, I've experienced such changes several times as an employee of different companies. It's not particularly inconvenient to a business to switch insurers, though it certainly can be to the employees.
Re: How much health insurers pay for almost everything is about to go public
#124"Doctors hate this simple trick to reduce ." That's the strange spam message I could never understand. Surely doctors would be delighted at any method to improve health? So I always assumed the "trick" to be quackery with dangerous side effects. After all, why else would "doctors hate it"? Eventually I realised these messages are exclusively US American, the only place on the planet where doctors could plausibly rese…
> That's the strange spam message I could never understand.
Well the message is likely untrue so maybe it's best not to try to understand it.
Re: How much health insurers pay for almost everything is about to go public
#125Re: How much health insurers pay for almost everything is about to go public
#126> “What we’re learning from the hospital data is that insurers are really bad at negotiating” Do the insurers have any incentive to negotiate well? Since their customers are not very price-sensitive (since they aren't marketing directly to patients or doctors), I would imagine they don't have a huge incentive to do anything but apply a markup to whatever prices the hospital tells them it costs.
All they really need to care about is the average amount paid.
Ten $100 brain surgeries and $2,000,000 for 1000 routine neurological screenings is a fine outcome. (Or would be, if not for price transparency)
Re: How much health insurers pay for almost everything is about to go public
#127Earlier quoted context omitted.
Thanks! So far, so good. We don't sell anything to consumers. Our products are aimed at the healthcare industry which lets us post information for consumers for free and we have pretty good product-market fit. Obligatory "if anyone is interested in joining a fast growing, series A company doing impactful work, hit up our careers page!"
Interesting, I'm curious since you're in the industry, why do you think medical tourism has never taken off in a big way in the U.S.? I feel like I saw more people willing to go to Poland or Ukraine for things like dental work when I lived in Europe than people in the U.S. willing to go to Mexico or some other destination.
The US is really, really large and many people living there have never left it. There's also a belief that US healthcare is the gold standard (which is probably true at the very high end, but not necessarily on average).
In other words, it's a hard sell to convince a factory worker to travel 5-10 hours on a plane to a place they have no familiarity with to get what they believe to be inferior treatment. They might not even have a passport.
This is much less of an issue in Europe where countries are tiny and almost everyone travels between them on a regular basis.
Also, medical tourism is mostly limited to what the industry calls Shoppable Services - outpatient treatments that are not emergent/not life threatening. There is a bit of a cottage industry in Mexico for some services, like bariatric surgery for obesity or dental work, but it isn't a huge volume. The really expensive stuff in the US is emergency treatment which you can't shop for anyway.
All that said, I think the interest in buying prescriptions from overseas has never been higher.
Re: How much health insurers pay for almost everything is about to go public
#128Earlier quoted context omitted.
Could this backfire - similarly to how publicly traded companies' CEOs disclosing their pay caused their pay to skyrocket?
Can you support that claim? I couldn't find when CEO pay went public but it sounds very likely like one of those causes were correlation definitely doesn't imply causation.
It makes sense to me. Transparency benefits the party that is more free to go elsewhere. Lots of companies, fewer good ceos, means that the ceos can leverage this better than the company can.
To put another way - at work, if you knew how much every employee made at work, it would probably be helpful in salary negotiations. Dont see why it would be different for ceos
Re: How much health insurers pay for almost everything is about to go public
#129This is regulation everybody should be able to get behind. How are these markets supposed to function efficiently with healthy competition if critical information like this is hidden away?
Also why wages and other transaction data (like it is for real estate in most states) should be public.
i don't follow this argument.
thr salient point for me is that people should be able to see prices before they commit to contracting to pay them (e.g. by receiving healthcare).
With wages, employees (and employers) get to see their price before committing. So the need for transparency seems like it would need a different justification.
Re: How much health insurers pay for almost everything is about to go public
#130Question to somebody who might know as this seems like a relevant thread to ask in. If a person wants to pay directly in cash/credit-card for services rendered by a doctor, do doctors' agreements with insurance companies generally prevent them from offering a cash discount to cash-paying patiences lower than the insurance company negotiated price?
If a doctor accepts Medicare patients, that sets a price floor for cash. Legally, if you accept Medicare money, you cannot offer anyone a better price than you charge Medicare.