Monday, June 25, 2018

Tales from the (Health Care) Front

First up, the joys of Government-run health "care," wherein the VA continues its #Winning ways:

"Secret data: Most VA nursing homes have more residents with bed sores, pain, than private facilities"

Sad and frustrating:

"More than 100 VA nursing homes scored worse than private nursing homes on a majority of key quality indicators."


[Hat Tip: ginny j]

Second, a report on one of the 58-state laboratory models (the concept of which I'm a big fan):

"Instead of starting with the hospital’s list price and negotiating down for discounts, [Montana] began telling these facilities how much it was willing to pay — a “reference price” — for each type of hospitalization."

In a kind of "reverse transparency," the state is using Medicare pricing as its benchmark, and so far it seems to be working:

"Two years in, the state calls the effort a success, saving $15.6 million this year over the estimate of what it would have paid without the change."

Will other states follow? That remains to be seen, but one wonders if the demographics here (Montana ranks in the bottom 15% in population) play a big part.

[Hat Tip: Elisabeth Rosenthal]

And finally, "Is The Cash Price The Best Price?" Well, that certainly seems to be the argument put forth by DPC proponents (and others, of course). The idea is that paying cash for medical services actually results in lower out of pocket costs (although for those with insurance, there's additional paperwork to get those payments to count towards one's out-of-pocket).

The folks at Green Imaging think this is the way to go, though:

"[W]hile the idea of big health insurance companies negotiating lower prices with the hospitals sounds excellent on paper, the reality is that negotiated prices may be more expensive, sometimes much more expensive, than if patients simply had no insurance to begin with."

Or choose to skip using it.

There are, of course, downsides, including doing that negotiating oneself (which many folks are loathe to do).

Unfortunately, Dr Dickerson has missed one excellent reason to go this route: "paying cash" can also mean using one's HSA (or HRA/FSA) funds for an additional economic boost.

Too bad, really.
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