Kill Your Chargemaster
A major joint replacement at St. Thomas Hospital, an Ascension hospital, is billed to Medicare at $45,029, and Medicare pays $12,081. At Vanderbilt University Medical Center, a teaching hospital, a major joint replacement is billed to Medicare for $59,822, and Medicare pays $18,386. I can reach both of these hospitals from my house in five minutes. Which one appears to be the better value, no matter who's paying?
And finally, insurers should ponder the relevance of the release of hospital pricing data. In my experience, they use chargemaster data to show you, as a patient, how much they're doing for you in getting cheaper care.
If you pay first-dollar coverage like I do, you cast a jaundiced eye at explanation of benefits memos that list the charge for the care and then show you the negotiated rate as a means to convey how much they've saved for you based on your premiums. Others likely see that information less cynically, but they're learning.
If chargemasters are so irrelevant to reimbursement, find a way to get rid of yours.
And if they're not irrelevant, find a way to make sure yours doesn't portray you as a greedy outlier, because this is only the latest attempt to shine the light of day onto how we as a nation pay for healthcare. Others are on the way.
Philip Betbeze is senior leadership editor with HealthLeaders Media.
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