Hits and Misses

Surgeon Operating on a PatientVA 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.

Hospitals are lobbying to obliterate Medicare oversight that has recovered $8 billion in improper payments.

Comments (11)

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  1. Matthew says:

    “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.

    • Bill B. says:

      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.

  2. Studebaker says:

    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.

  3. Walter Q. says:

    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.

    • Jay says:

      Charity care can only go so far. Health care is still a business, and these facilities need their reimbursements.

  4. Perry says:

    Hey, hospital administrators have to eat too!

  5. James M. says:

    “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.

    • Walter Q. says:

      Or just hospitals who want to overcharge Medicare for higher payouts. Either way its a giant waste of taxpayer money.

  6. Don Levit says:

    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

    • Devon Herrick says:

      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.

  7. Don Levit says:

    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