Hospitals Say They Will Publish Previously Secret Prices

[Zorro]

Largest U.S. hospital chains say they will comply with new rules to make public confidentially negotiated prices with health insurers

Major hospital operators say they will comply with new rules to make public their prices for medical procedures starting Friday, exposing previously secret market rates in an industry that accounts for about 6% of the U.S. economy.

The roughly $1.2 trillion hospital sector will begin posting prices publicly in the New Year after losing a legal challenge to overturn new transparency rules that are a centerpiece of the Trump administration’s health-care policy.

Health and Human Services Secretary Alex Azar said earlier in December the hospital pricing data and other transparency rules put forward by the administration were fundamental to a competitive market.

Hospital pricing is negotiated confidentially between hospitals and the employer groups and insurance companies that pay for care, which has obscured market rates that have helped drive up the cost of health insurance premiums paid by employers and workers. Rising hospital prices accounted for about one-fifth of the nation’s health spending growth in the last half-century, federal data show.

https://www.wsj.com/articles/hospitals-say-they-will-publish-previously-secret-prices-11609442913
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This should prove to be interesting.

[bullimiami]

1. This is obviously a good thing for all of us. But why? As with everything trump. Who wins here?

[Demovictory9]

2. Bandaid $75, placement of bandaid $325

[ret5hd]

3. Something I have NEVER understood:

We are told we need to be "smart consumers of medical services". This implies that we are NOT "smart consumers"...that we need to do better. Like we get bored and get a recreational appendectomy...and we didn't call around for a price comparison.

Finding a price for a "procedure" is IMPOSSIBLE! We have tried. Hey, I understand I can't get an exact quote for a situation...too many variables. Where is the arm broken at? How many stints does that heart need? I know, I know! But how, exactly, am I supposed to make informed decisions when all pricing is double top secret?

The ONLY sane option is some form of "free at point of service" national health care.

[elias7]

4. Part of the problem is that medicare only pays $0.50 on the dollar, Medicaid even less...

Hospitals can’t survive with what the largest payor (the federal govt) is coughing up, so to make ends meet, they negotiate higher rates with insurance companies, of which we pay a percentage as co pay and deductible

[ret5hd]

5. So you know how to get a price for a liver biopsy or...

an appendectomy or whatever?

I’ve tried (not for those specific things) and I can’t get any info.

[elias7]

7. I'm in the business

I am a physician

[ret5hd]

8. So, can you tell me?

Or is it a secret?

[Hoyt]

6. That's questionable. Hospital charges are way above what they accept everyday

from insurance payers.

While I think Medicare payments are a bit low, they are not 50% too low. And, if hospitals got paid Medicare plus another 10% or so for every patient, they’d do OK. And, we don’t need multiple health systems in every metro area competing for the same patients.

[elias7]

9. Yes, this why those without insurance get such huge bills

They don’t negotiate reimbursement like insurance companies do. Medicare doesn’t negotiate much either. The insurance companies do, so they end up paying less than what the hospital charges, but more than Medicare and certainly much more than Medicaid. My main concern with single-payer is if the single payer pays only what it wants, hospitals will either eat the cost or pass it on to the patient. This is why senior citizens on Medicare have supplemental insurance if they can afford it. The hospital industry would be upended if they are reimbursed merely at Medicaid rates - salaries would be cut, hospital services would be cut, hospital jobs will be lost. And anyone who worked for an insurance company would also be out of a job. Single payer without supplementary insurance puts hospitals and those who work in them would be dependent on whatever the government decides it wants to pay for a service, rather than what the hospital wants or needs to charge. It is complicated and very interdependent.

[Hoyt]

10. Oh, it would be a mess. If hospitals were paid at Medicaid rates and even Medicare, we'd see big

wards again, one nurse for 3 times the patients as now, patients thrown out of recovery rooms and off floors long before medically advisable (it's bad enough now), etc.

On the positive side. I'm really not sure why larger cities have so many hospitals. They end up competing against each other for patients, building these massive facilities with big atriums, etc.

In any event, we'd need to spend much more than Medicare per patient unless folks are willing to accept a lot of mistakes in care. There are already enough of those. I used to do studies -- like medication errors -- in hospitals. There were lots of mistakes, although most were just recording errors.

Somebody will need to come up with a plan.

It's too big a topic to cover here.