Hits and Misses
VA hospital administrators close operating rooms at 3 p.m.
ObamaCare causes hospitals to cut back on charity care.
Reference pricing for elective surgeries saved one large public employer $5.5 million in two years.
77 percent of doctors sanctioned by New York State Department of Health continue to practice.
“The men and women who have served in our armed forces should be supplied with a federally issued insurance card allowing them to receive their care in the community where it can be delivered better and more efficiently.”
This I would gather would ensure our veterans receive much better care than at the VA.
The VA has bad policies all around for providing our veterans with health care. There should be reforms now that injustices have come to light.
Hospitals are lobbying to obliterate Medicare oversight that has recovered $8 billion in improper payments.
This is unconscionable. There is no reason why hospitals should not be forced to play by the rules.
In theory, the low income uninsured should be able to either receive a big subsidy for coverage or be eligible for Medicaid. It shouldn’t throw too many individuals into a tail spin if they can get a $20 premiums thanks to subsidies.
Charity care can only go so far. Health care is still a business, and these facilities need their reimbursements.
Hey, hospital administrators have to eat too!
“Improper Medicare payments cost taxpayers and beneficiaries about $50 billion a year,”
The type of payments that go to eye doctors and chiropractors? They seem to be on the short list of winners in Medicare payouts.
Or just hospitals who want to overcharge Medicare for higher payouts. Either way its a giant waste of taxpayer money.
Could reference pricing serve in lieu of networks?
Seems like a great way for insurers to save a lot of time and money.
Imagine negotiating all those contracts every year, the time and expense involved.
Don Levit
The primary problem that I can see is that consumers will have a demand curve independent of the reference price. Say consumers are willing to spend $100 to see a doctor. The insurer sets the reference price at $75. It makes sense the patient would have $25 in cost sharing. But pretty soon, the physicians’ list price could creep up to $175. If enrollees have high-deductible plans or HSAs, that wouldn’t be as likely.
The purpose of the network could be merely to negotiate an agreement in which in-network providers agree to accept the reference price as payment in full or possibly agree to accept the reference price plus a nominal co-pay as full payment. I don’t actually care what the doctor charges as long as there’s price transparency.
The reference price is supposed to be high enough to ensure significant access to providers
If that does happen the gougers will have to prove their worth
Don Levit