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How much health insurers pay for almost everything is about to go public

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Re: How much health insurers pay for almost everything is about to go public

#11
post #4

> “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.

Well, if they can negotiate a particular incident down then they pay less for it, but in the long run big picture you're exactly right. So long as they can inject noise into the plan shopping channel and so long as they aren't doing worse than their competitors by that noise margin, they'll do fine. Which in practice means that they just pass along the costs.

Re: How much health insurers pay for almost everything is about to go public

#12
post #4

> “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.

If insurers’ customers were not price sensitive, then they would have higher profit margins than 5%.

Re: How much health insurers pay for almost everything is about to go public

#14
post #4

> “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.

If insurers’ customers were not price sensitive, then they would have higher profit margins than 5%.

The accusation here isn't that they are skimming a disproportionate amount, it's that they aren't doing their job, which is to put downwards pressure on provider prices.

Re: How much health insurers pay for almost everything is about to go public

#15
post #2

I'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…

What do you serve to gain from scraping all of this information?

I was guessing it was this bit at the bottom of their landing page:

> Are you a transparent provider or payer? > There is a market for transparency. Let patients find you by claiming > your provider page and listing your services. It only takes 10 minutes.

But following through that link says it is a free program.

Re: How much health insurers pay for almost everything is about to go public

#17
post #8

This 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?

That would get in the way of unadulterated profit , you see.

Health insurers in the US have a cap on how much of premiums can go to profits.

Re: How much health insurers pay for almost everything is about to go public

#18
post #4

> “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.

If insurers’ customers were not price sensitive, then they would have higher profit margins than 5%.

In the US, isn't there regulations that effectively cap their profit margins? Since they have no incentive to increase their margin through negotiation, their only incentive would be to lower their costs below competition.

Re: How much health insurers pay for almost everything is about to go public

#19
Question 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?

Re: How much health insurers pay for almost everything is about to go public

#20

Earlier quoted context omitted.

What do you serve to gain from scraping all of this information?

The information on their landing page was immediately relevant to me https://turquoise.health/ I hope they have a good business plan and manage to stick around!

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!"

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