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A Couple of Health Care Research Notes

By January 21, 2022Commentary

I like the original purpose of the blog, which was to look at boring health policy, research and business issues.  Here are a couple of recent interesting studies.  The first compares “list” prices at hospitals, which is what they might charge a self-paying individual, versus typical prices for the same service negotiated with health plans.  List prices are kind of a joke, the hospitals just set them very high and then can claim they are giving third-party payers big discounts, but they are what hospitals often try to charge self-paying individuals.  Seventy different services were covered by the research and it is based on the newly-imposed requirement that hospitals disclose prices.  Hospitals are playing games with this requirement, so as the authors note, they are being very selective in the services they pick for disclosure.  So, surprisingly, in a number of cases the cash price is equal to or lower than negotiated contractual rates, although in the majority of cases it is the reverse.  It appears that disclosing price is leading some hospitals on at least some services to try to look like they aren’t ripping the self-paying consumer off.  But in general it remains the case that list prices, and what is often charged to self-paying patients, are usually much higher than the prices health plans pay.  (JAMA Study)

ECRI is an organization that does research on safety and other issues in health care.  They release a brief each year on the top technology hazards in health care.  This year’s list includes cybersecurity, supply chain issues, damaged infusion pumps, telehealth workflow, use of artificial intelligence for imaging, and WiFi dropouts and dead zones.  Not included are PCR tests, masks, plastic barriers and other futile efforts to stem the spread of CV-19.  (ECRI Brief)

For decades there has been a focus on eliminating low-value and unnecessary services in health care, with a focus on testing.  (As a side note, so why are we pushing low-value CV-19 testing like crazy–testing with no clinical utility for the most part.)  This study tried to identify hospital characteristics that were linked to a lot of low-value services.  Hospitals with more beds, that were investor-owned, that had fewer primary care physicians and more owned-physician practices tended to deliver more low-value services.  (JAMA Article)

Join the discussion 2 Comments

  • joe kosanda says:

    Hospital / health care pricing

    I had ACL reconstructive surgery several years ago.
    The negotiated price for the surgen was approx $900

    the Ice pack, pump and cooler was apprx $800

  • Kurt Anderson says:

    i’ve always speculated that ‘retail’ prices also are a bean-counter trick so that the hospital can show much higher losses. i’ve had a hospitals try to make me pay the difference between the negotiated insurance price paid and their retail price. the Mpls hospital tried to get $140,000 above the $95,000 negotiated price and an ER doc wanted $500 over his $50 negotiated price. the insurance company quickly putdown both of these attempts.
    so in both cases do you suppose the tax account wrote both off as losses? i do

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