IN THIS ISSUE:
- Would You Rather Pay $1,560 or $50 Per Visit?
- Need for "Clinically Integrated" Hospital Bills Touted
- Hospitals Waking up to Consumer Driven Health
- Not-for-Profit Hospital Lawsuits Find Tough Sledding
- Concierge Medicine Works for Low-Income Workers
- New Health Clinic Opens in California Drug Store
- Company Offers Improved Tools for Decision Making
Would You Rather Pay $1,560 or $50 Per Visit?
The Miami Herald recently featured an article about hospital pricing in Florida. It cites an example of a woman who was looking for physical therapy services after a car accident. She started going to Palmetto General in Hialeah, a Tenet Hospital. She tried to find out what the treatment would cost her but got very little cooperation. After eleven sessions, the bills started coming in, and she discovered the 45-minute treatments were costing an average of $1,560 per visit. Once she got over the shock, she started asking around about alternatives The article says, "A friend recommended a therapist at Memorial Regional in Hollywood [FL]. She went. Cost: Less than $50 a session." She is quoted as saying, "Basically, it was the same kind of treatment… If I'd known about those price differences before I started, I certainly would have made different choices." The article goes on to mention there is a bill in Congress that "would require hospitals nationwide to reveal the prices of their 25 most common procedures." And that "A measure passed last year by the Florida Legislature would make pricing of some procedures available."
Need for "Clinically Integrated" Hospital Bills Touted
Writing in HealthLeaders Dr. Richard Reece asks, "What good is consumer-driven healthcare when consumers can't understand a hospital bill?" He says this is especially true for "costly elective procedures… [which] often comprise a significant portion of hospitals income stream." He says, "Consumer Reports recently surveyed 21,000 consumers for satisfaction with hospitals, and 11,000 complained about incomprehensibility of hospital bills." This has led to a call for "transparency" in prices, but "for hospitals, transparency is a very dangerous game." He argues that the complexity of hospital bills is partly caused by the complexity of hospital services. But Michael Blau of the McDermott, Will, and Emery law firm is pushing for "some form of a clinically integrated bill" that would combine all the elements of the care received (or proposed). He says this is already being done at the Texas Heart Institute and other "integrated health institutions."
Hospitals Waking up to Consumer Driven Health
The hospital industry is beginning to wake up to the potential of consumer driven health care. The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) jointly conducted a survey of health plans to find out what's going on. It found there is "a diverse mix of products filling the fast-growing…market." And it found that "Four out of five insurers surveyed believe consumer-driven products will dramatically change the nature of the health insurance industry." Despite that prospect for dramatic change, the hospitals seem reassured that "95% of HSA and HRA enrollees are in plans built on the insurance company's existing provider network and negotiated rates." (Darned if I understand why the hospitals find that comforting. Providing "deep discounts" to health plans is nothing but trouble for the facilities.) It also found that 60% of the plans provide comparative cost information and half "express cost in exact dollars, while 36% express cost as a range of dollars." And it found about half of the HRA and HSA plans publish quality information. The press release reports that HSAs and HRAs have doubled their share of premium dollars in the past year and 70% of employers are expected to offer the plans by next year.
Not-for-profit Hospital Lawsuits Find Tough Sledding
Richard Scruggs is not having a good time with his lawsuits against not-for-profit hospitals that overcharge the uninsured. Federal courts have already dismissed 22 suits, and now settlement negotiations with North Mississippi Health Services have broken down, according to an article in the April 18 issue of Report on Medicare Compliance. Scruggs is reported as saying, "North Mississippi refused to accept the Judge's demand [that] they implement a conflict of interest policy. Apparently members of the board that may be benefiting from sweetheart deals don't want such a policy." A spokesman for the hospital said that its level of charity care has spiked since it agreed to a Memorandum of Understanding with Scruggs. Although 22 lawsuits have been dismissed, most are still active in the state courts, according to the article.
Concierge Medicine Works for Low-Income Workers
And in Michigan, The Grand Rapids Press reports on a woman who "works three days a week as a Holland hotel clerk and can barely afford to put gas in the car or food on the table. It takes all she makes to pay for high-deductible health insurance that provides only hospitalization and no basic care." She "had been shelling out $50 a week just for allergy shots" when she came across a physician who has set up a concierge practice that promises "primary care for $1,500 per person or $2,000 per family." She called him up and discovered he answers his own phone. She went in for a visit and he spent an hour with her the first time. She has to pay for the prescription, but the shots are all part of the package. The article sees this as an example of something that "has exploded into a grassroots movement, with annual fees doctors say many people can afford." It says this is an alternative that "is catching on because doctors and patients aren't happy with their increasingly strained relationship."
New Health Clinic Opens in California Drug Store
The idea of conveniently located walk-in clinics seems to be catching on as well. ABC News is seeking comments about the trend, and in California a new company is starting to offer such services in drug stores. Called WellnessExpress Clinic, the first facility is opening in Davis, CA at Longs Drugs. It will be open seven days a week during regular store hours. According to a press release, company president Dr. Wesley Chan says that "these offices will ease emergency room congestion for minor medical conditions and provide convenience to the public." He adds, "This high-quality, easy access care will serve a variety of consumer demographics, including families, working parents, seniors, students, visitors away from home, people wishing to extend their HSAs and the large number of uninsured in the state."
SOURCE: Visit the web site at www.wellnessexpressclinic.com
Company Offers Improved Tools for Decision Making
William Haggett, the president and CEO of AmeriHealth says, "With more people enrolled in a consumer-driven health care plan, AmeriHealth has been honing its online tools to give our members more decision-making power about their benefits." The company has announced that members will be able to access "hospital ratings on more than 100 procedures and diagnoses, see expanded physician information and relative hospital cost data to help them make more informed decisions," according to a company press release. The company is using HealthGrades, Inc. for quality assessments, publicly available information on costs, and the Leapfrog Group's patient safety information.
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