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Medicare To Require Hospitals To Post Prices Online (pbs.org)
An anonymous reader quotes a report from PBS: Medicare will require hospitals to post their standard prices online and make electronic medical records more readily available to patients, officials said Tuesday. The program is also starting a comprehensive review of how it will pay for costly new forms of immunotherapy to battle cancer. Hospitals are required to disclose prices publicly, but the latest change would put that information online in machine-readable format that can be easily processed by computers. It may still prove to be confusing to consumers, since standard rates are like list prices and don't reflect what insurers and government programs pay.
Likewise, many health care providers already make computerized records available to patients, but starting in 2021 Medicare would base part of a hospital's payments on how good a job they do. Using electronic medical records remains a cumbersome task, and the Trump administration has invited technology companies to design secure apps that would let patients access their records from all their providers instead of having to go to different portals. Seema Verma, head of the Centers for Medicare and Medicaid Services, also announced Medicare is starting a comprehensive review of how it will pay for a costly new form of immunotherapy called CAR-T. It's an expensive gene therapy that turbocharges a patient's own immune system cells to attack cancer. The cost for such a procedure can exceed $370,000 per patient.
Likewise, many health care providers already make computerized records available to patients, but starting in 2021 Medicare would base part of a hospital's payments on how good a job they do. Using electronic medical records remains a cumbersome task, and the Trump administration has invited technology companies to design secure apps that would let patients access their records from all their providers instead of having to go to different portals. Seema Verma, head of the Centers for Medicare and Medicaid Services, also announced Medicare is starting a comprehensive review of how it will pay for a costly new form of immunotherapy called CAR-T. It's an expensive gene therapy that turbocharges a patient's own immune system cells to attack cancer. The cost for such a procedure can exceed $370,000 per patient.
Dammit.
Price list... http://bit.ly/25Au4TG
"Tempers are wearing thin. Let's just hope some robot doesn't kill everybody." --Bender
and use cookies to tell if you've been there before and raise the prices?
just an excuse for hospitals to keep you and run lots of tests. happened to a family member where she spent a month in the hospital and was told she might have cancer only to leave diagnosed with a bacterial infection. and one of my kids. a day in the ER with an MRI and lots of other tests only to be diagnosed with strep.
people need to accept the fact that medicine is not perfect and doctors don't know everything and not sue anytime a diagnosis is wrong
Will be even better if they post patient outcomes too. That would be pretty significant data in determining whether cost of care correlate to results.
Time is what keeps everything from happening all at once.
Let me check:
Free
Free
Free
Yeah, everything is free. Don't even need a pricelist for that.
inb4 muh taxes, ignoring the fact that 80% of your tax bill is wasted on the industrial war complex. Stay mad Americucks.
What did Trump have to do with it? Did he tweet something or is his being a traitor lowering hospital bills somehow?
Here is the simple reality of the medical system. IT is full off overpriced and downright illegal pricing tactics. when people see what medical systems have the balls to charge you compared to other services around especially on a global scale... there will come a change. having a basic universal health coverage will be totally doable once people figure out they are getting charged $1000 for a dose of Tylenol and nip that crap in the butt.
Hospitals overcharge for pretty much everything. Any prices they show shouldn't be trusted anyway.
It's another example of why insurance is nothing but a scam.
Also dental, and I imagine vision, too. Nobody can tell you what something is actually going to cost you out-of-pocket, because the insurance company will say "we'll pay this much", but when the doctor/dentist goes to submit the claim, they say "oh well we're only really going to pay this much, LOL" and the patient gets stuck with the bill. WHY IS THIS ALLOWED!? If it were anything else I'm pretty sure it would be considered fraud.
Old people vote.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
If providers were bound by a 20% price variation for any given service or product, the health care problem would be eliminated.
Imagine such a world. if you pay for something yourself, use your small insurance plan or your big insurance plan, the price would be roughly the same(from least to most discounted would be at most a 20% difference.
This would increase direct competition between products, expose more realistic prices across the board (usually lower).
Imagine the price difference now between the price an individual pays, and an insurance company with a million people.
Such a system would approach the price normalization of single payer without needing the government at all (except for the price range mandate).
Don't like 20%, pick another number that is fair. 50, 100?
Just don't pick 1000%. That would be our current system.
Indeed, it's not clear in the article where the rule and/or enforcement came from.
Also note this:
This would imply that publishing it to the public was already a rule, but something changed to require it also be available in "machine-readable" form, such as CSV files.
Therefore, this will not directly impact most consumers, who usually want a prepared list, not raw data.
Table-ized A.I.
Nothing is black and white except in propaganda. Not even [insert most emotion-triggering enemy or friend].
That does not make him all-good, of course. Just human.
I say let's support him when he does good, so he gets motivated to be that person. (And not pull him back into the mold of evil.)
He signed an executive order named (IIRC) Promoting Healthcare Choice and Competition Across the United States. I work QA for a medical billing company, and we're working on adding "value" that Trump talked about in his campaign and has in his EO to Electronic Health Records. I have no idea how you do that since I'm not in product, and I don't envy their job. He also called for providers to share data between providers, which surprisingly doesn't happen today, to reduce duplicate and unnecessary tests. So far we've made no progress to getting our competitors to work with us. Even our own customers don't often use their own EHR to see if someone already had a particular test so there's a lot of duplication even within the same hospital system. I looked at one record last week where a guy had six testosterone level tests in a single month. It's normal to do that test multiple times, but you do it over time to correct dosages. That was I think about $5k worth of unnecessary tests for just one patient for one month!
Medicare pricing? What about for everyone else?
Standard prices, insurance prices, list prices, and government prices are fake prices. I wonder what the market prices for medical services would be if there was even the slightest shred of capitalism in the American medical system. Is an American free to buy an MRI or have spinal surgery with no insurance? I don't know, probably. Is an American free to provide an MRI service or perform spinal surgery without government permission? Absolutely not. I expect supply is far more throttled than demand and therefore would expect free market prices for medical services to be far less than these fake prices. I expect that the medical rules and regulations are the biggest contributors to medical pain and suffering in the US.
One doesn't even need to abolish these government regulations and restrictions. Just making them optional (including Obamacare of course) and allowing medical services to advertise that they are government regulated would be enough to release the pressure and unlock most of the potential value with a minimum of harm. People that don't want to risk unregulated medical services don't have to use them, they can continue to stick with expensive medical. Pretty much the only problem would come from those people who have artifically low insurance made possible by stealing from healthy people but this system has only been in place for a few years. On the plus side? freedom and justice.
and an ER price cap / must be in market for any ER service
i will be sure to leave by rotting stinking corpse in front of a hospital so all their customers can enjoy the smell of death as they go in to visit the hospital
Politics is Treachery, Religion is Brainwashing
mortgage your house or just punch a cop and let the system pay for it/
In other countries, the government tends to regulate medical services quite heavily so this is easy. The US phone network shows how lassez-faire capitalism fucks-up standardization, so don't expect this to work for the next 10 years.
The problem is health insurers lying about the level of coverage provided: Until there's more honesty in advertising, US healthcare can't improve. I'm assuming that when Americans see how anti-competitive insurance and pharmaceuticals are, they'll make it an election issue. That's a big ask of the American people.
This could be a good thing. Forcing the hospitals to reveal the secret charge-master prices. Then we can call them out on their bullshit.
In reviewing insurance bills for a recent uncomplicated procedure, the hospital billed a total of $65000 and the insurance paid about $8000 after prenegotiated discounts were applied.
The insurance then ran into a technical problem/mistake in which it was retroactively cancelled. The hospital actually returned their payment. During the year it took to straighten that out, I was facing $65K in bills that they wouldn't negotiate to less than about $30K despite the existence of documentation that they had been satisfied with $8K from insurance. Needless to say, I focused on (and eventually succeeded in) reversing the insurance problem.
I've heard that the real reason for this is so they could write off $65K if a patient doesn't pay instead of $8K. I'm not an expert in the accounting, but I'm sure in my case that is what they would have been claiming as their loss.
The experience left me with a solid belief that posting prices alone would do nothing. That approach will only serve to drive more people into the wasteful net of insurance.
What is needed is a truth in pricing act. Hospitals should be required to have fixed, public, non-negotiable prices that apply to all payees whether insurance or cash. If the hospital chooses to pay some of those themselves in indigent cases, that is the price they should be allowed to write off. This approach would make some true headway in getting the insurance problem reigned in.
Posting their false prices does nothing except bolster their already drastically inflated claims of losses.
What would be far more helpful would be seeing what Medicare pays for each procedure.
I have a couple of friends who work in the medical industry and we were discussing the high cost of medical care. One thing they told me was that a huge part is dealing with the insurance industries. There is no fixed price for each procedure and usually the medical providers have to negotiate with the insurance companies for everything. The doctors go high and the insurance company goes low with the hope that the final bill is somewhere in the middle where the doctor can make money, but it takes a huge amount of time and overhead. My friend said that in the case of Medicare it was easy because they tell the medical providers up front what they pay. While it may not be as much as the insurance providers, there is also far less overhead since there is no bargaining back and forth over the final bill.
Now the prices hospitals charge consumers is astronomical, though it often is possible to negotiate a lower rate. Oftentimes the prices they charge consumers is what they start at with the insurance companies.
One of the best solutions I see going forward is offer to allow anyone to buy into Medicare and allow them to compete against the insurance companies. This would really shake up the market and likely result in lower prices for everyone.
http://www.drugchannels.net/
run by a person very knowledgeable in the industry. Short story is there is a gross to net bubble of about $150 billion which gets redistributed to every other entity (GPO, health insurer, wholesalers, manufacturers) except the consumer.
About 15 years ago I was working a shit job with zero benefits - so no medical coverage. My shoulder was hurting a massive amount and the problem wasn't going away. I went to a local medical service to have it checked out but could not get them to give me any kind of estimate of the cost for just looking at my damn shoulder. You have to just accept whatever they decide to charge you after the fact.
No other business that I know of can get away with this.
* it was bursitis
-- Will program for bandwidth
Needless to say, I focused on
The problem with USA health system. You shouldn't have to focus on anything other than recovery and going on about your life.
My own experience in Australia:
1. Had a hernia
2. Went to the doctor. He asked which system I wanted to be referred to, waiting list on the public system was 4 months. I said private.
3. Went to private specialist. He quoted $8900 including a week at the hospital, gave him my insurance number, he said that my gap will be $2200 after insurance.
4. Said fuck that went back tot he doctor and asked to be re-referred to the public system.
5. 2 days later I was in hospital for a triage appointment. Was classified as a very low risk so went in the 4 month queue and went about my life.
6. 3 weeks later get a call saying there was a cancellation do I want to come in for my op.
7. Went in the day after for the op.
8. 4 days later I was discharged from hospital with a prescription for painkillers.
9. Bought pain killers.
10. End.
Total cost to me: $3.50 for a 24 pack of strong painkillers subsidised under the PBS.
Yeah it could have taken 4 months, but I also had the option to have it fixed that same week with an agreed upon up front cost, but my cheap private insurance (which costs $600/yr before taking into account the $500/yr tax credits I get for having it) didn't cover that specific op so I didn't bother.
+1 insightful.
You forgot to mention how much your private health insurance costs, and why you carry that vs relying on the public health system for all of your care.
I had a surgery of similar complexity to a hernia repair in the US, $22k bill from the hospital, I only paid $150 the copay to my insurance company and the explanation of benefits says they paid the hospital around $8k. My plan costs $95 biweekly from my employer.
It's an expensive gene therapy that turbocharges a patient's own immune system cells to attack cancer. The cost for such a procedure can exceed $370,000 per patient.
Rather than trying to Find a way to pay for it; we need to figure out WTH is the cost per patient so high for such a promising procedure --- is it due to the actual amount of work involved, or is some company levying an arbitrary tax based on how much they think it's "worth" for those that need it? What are the complexities in the process that make it expensive to perform?
The cost of the process needs to be made reasonable to become a viable treatment option.....
You forgot to mention how much your private health insurance costs,
(which costs $600/yr before taking into account the $500/yr tax credits I get for having it)
You don't understand. In the USA, about half the population values "freedom" over civilization.
It's partly inherent in the "the frontier" culture, and partly from the rich paying billions to convince them inequality and social Darwinism is a good thing. Who knows, maybe they are the future Kevin Costners and will evolve gills to survive Water World. All the coddled "socialists" won't have gills when the world warms and floods, and the Gillites will have the last laugh. At least we get the first laugh ;-)
Table-ized A.I.
Ok, it's a step forward. I mean, Amazon posts its prices, but it can still make money, right? Oh wait, different folks get different prices. Same with hospitals.
Posting "standard" prices means just about nothing. The only people that pay those prices are the poor slobs who have no insurance, and actually later pay their hospital bill.
But, even for those people, posted charges (called "chargemaster" in the industry) will not help you figure out how much your cholecystectomy is going to cost. That's because all the people who touch you bill separately, and there is no way to know how many $500 IV saline bags they will use on you, or how many $200 IV needles, or $50 Tylenol pills. You can be sure that the bill you get will be as unpredictable as ever.
All you can find out is just how absurd these chargemaster prices are in the first place.
A friend (no insurance) got a bill for blood drawn DURING stomach-stapling surgery which was mailed to a lab in the midwest for analysis. I still can't figure out why they did this, much less charged a couple $hundred for it. Hospital: it's our policy. MY policy would have been to tell them to sue me and explain it to the judge, but it wasn't my bill.