Ever tried to figure out the cost of a surgery? Turns out, it’s like solving a riddle – brought to you by hospitals, insurers, and, of course, our federal government.
First, we had executive orders to force hospitals and insurers to reveal their negotiated prices. But instead of clear, useful information, we got a mess of confusing, incomplete, and just plain weird data. Case in point: New York insurers reporting payments to dentists for knee replacements. Zombie rates are real, folks.
Even when the data isn’t outright bizarre, it’s inconsistent. The same hospital charges anywhere from $47,000 to $70,000 for a heart attack – maybe they throw in a complimentary anxiety attack with the pricier option? And Aetna’s price of $6,292 for everything from heart attacks to psychosis? One-stop shopping at its finest.
Government enforcement? Let’s just say it’s more slapstick than serious. Turns out, the agency that’s supposed to make sense of this mess can’t even tell if hospitals are playing by the rules. No wonder price transparency hasn’t quite lived up to its lofty promises.
The Real Joke’s on Self-Funded Employers and Unions:
While hospitals and insurers are busy playing games, self-funded groups are left holding the bag. As fiduciaries, they have the responsibility to protect their members – it’s time to rewrite the script. Read the full article
Tags: #HealthcareTransparency #SelfFundedPlans #DirectContracting #HospitalPricing #EmployerBenefits #UnionHealthPlans #InsuranceWoes #PriceTransparencyFail