Posted on 04/12/2023 8:09:14 PM PDT by ConservativeMind
Two new studies shed light on current U.S. hospital practices.
In the hospital pricing study, the researchers analyzed prices for 70 common "shoppable" services disclosed by 2,379 U.S. hospitals as of September 2022 under the new Hospital Price Transparency Rule that went into effect in 2021.
For their analysis, the researchers used data from Turquoise Health, a data service company that collects hospital pricing information. On average across the 70 services, for nearly half of these services—47%—the cash prices were lower than or the same as the median insurance-paid prices for the same procedure in the same hospital and service setting. "Evaluation and management services" and "medicine and surgery" were the service categories that were most likely to have lower cash prices. The analysis also showed that nonprofit and government hospitals—which tend to serve a greater proportion of uninsured patients—were more likely to offer lower cash prices than insurer prices.
The findings suggest that in settings where market forces are more prevalent—in hospitals with more uninsured patients paying cash prices, for example—competition may be driving cash prices lower.
In a second hospital-related study, thought to be the first of its kind, Bai and colleagues examined compensation for the trustees who oversee nonprofit hospitals.
The researchers, using Internal Revenue Service data for 2019, found that 37.3% of the 2,058 nonprofit hospitals in the U.S. compensated their trustees. These trustee-compensating hospitals, compared to other nonprofit hospitals that did not compensate their trustees, delivered less charitable care as a proportion of their overall expenses: a 1.6% charity-care-to-expense ratio compared to 2.2% for nonprofits with uncompensated trustees. The researchers calculated that a $10,000 increase in average annual trustee compensation was associated with between $66,000 and $77,000 less charity care annually.
(Excerpt) Read more at medicalxpress.com ...
This isn’t news. Hospitals always stick it to insurers. That, and providing care for the uninsured, are why rates are so high.
That meant that I would just pay for my healthcare with a HSA debit card until I met the deductible, which happened exactly once. Because I was on a cash plan I got a lower price because for the billing office my account was service, payment in full, see you in a year. With people who had insurance it was service, code, file, wait, get rejected for some stupid reason, recode, refile, wait and maybe in eight months get partly paid.
And let's not forget all the stupid paperwork that was needed to remain an authorized provider. Not to mention things like Medicaid, Medicare, Tricare and whatever insurance the state was using.
Once you see what the medical business has to go through to get paid you start to understand why the price goes up the more people have insurance.
American health-care is a hairball of state and fed regulation and control
If they would just promote cash payments with no middle-man, many parts of the health-care system would return to a free-market, free-choice system, with much lower prices.
I’ve always thought Indian Reservations should add clinics and hospitals to their list of businesses - outside of taxes and Fed.gov control
The inevitable result from 3rd party payment systems.
I don’t remember what the procedure was, but I asked about the insured price, and they checked my coverage, and told me an amount. I asked for the NO INSURANCE price, and it was substantially less. I’ve experienced this both with a hospital, AND a dentist.
I am an educator in Texas with high deductible insurance. It is the only one available. What is so sad is that janitors and cafeteria workers in Texas schools pay for the same indurance. One janitor figured out the system. At the beginning of the school year someone in her family goes to the ER. They get a big bill. It meets their deductible. She can’t pay ER bill. She does not make enough. Contacts program at hospital that helps the poor. They magically waive all costs. Her family can now see regular doctors all year with just a copay. This is so sad and smart.
Could it be they are hoping to get something because most uninsured get the treatment and pay nothing.
Cash pricing usually cover cost with little or no profit. This is nothing new. We had the same policy in effect 40 years ago in the hospital where I was employed.
The insurance system is a scam that drives up prices
Having the morons in Congress regulate this complex system doesn't help, especially given half of then want it to fail.
They use the insured to subsidize those that aren’t. If they were to fix this those with bad or no insurance are going to get killed.
When I go to the chiropractor, he used to do the heat treatment to my back before the adjustment. All of a sudden he had to stop doing that because Medicare won’t compensate him if he does any therapy “for free”. He had been including some therapies in his charge of adjustment and Medicare came along and stopped it. So I no longer get the heat treatment because he has to charge extra for it out of my pocket. Medicare does a lot of dumb stuff that ends up costing us all more.
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