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Hospital Pricing Data Dump Won't Hurt You, Yet

Philip Betbeze, for HealthLeaders Media, May 17, 2013

So, your commercial payers and local employers are looking at it, even if individual patients aren't—yet. That brings us to the health insurance exchanges, which, at least in states with significant payer competition, may prove another blow to high-cost hospitals.

What some hospital leaders don't seem to understand is that you are doing the work, and you're billing for it, despite how screwy the system is. So, although blame can be heaped upon the government for getting you into this mess—and the former CFO above makes a good case for that—you are at the end of the line. You're holding the bag on public perception.

Besides that, it's tough to successfully claim hardship when your hospital has that 10-story crane building a new patient tower and attached parking garage.

This is not an attempt to demonize hospitals. All I'm saying is don't be caught flat-footed as the high-cost leader in your area. Take small steps to rationalize your pricing structure so you don't have to make big gouges later, when the government, individuals and commercial insurers start to hold your feet to the fire. In the meantime, use this reprieve to find a better way. Let's stop being victims, shall we?


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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1 comments on "Hospital Pricing Data Dump Won't Hurt You, Yet"


Frank Poggio (5/20/2013 at 1:31 PM)
"Stop being a victim", good idea. Now how can we accomplish that? Well lets see, we can't just do a wholesale overhaul of our charge master, that will probably cut our DRG payments in half = bankruyptcy. Or how about a a separate table of charges for private payors (or indigent folks)...Oops can't do that either - Medicare has a class of payor rule, all charges across all payors MUST be the same. How about a nice big fat discount for a private payor? Nope Medicare will not allow unless it's a big payor (like an insurance company). Well here's one – stop treating Medicare/Medicaid patients. Overnight you can make all your charges 'sensible' not have to worry about convoluted government rules. I know, sounds crazy, but I just read where many private docs are doing just that, even some specialty hospitals. In my opinion that's where it all will end up if we (and our government) keep up this insane system. A two class health care system, one for the discount boys, the other for the reasonable charge paying folks. . Frank Poggio The Kelzon Group