Health Care Providers Try Lump-Sum Pricing
Reports
and investigations are causing a wave of concern among health care experts and
health care consumers. Hospitals charge a variety of different prices for the
same medical procedures across the nation.
According to The Los Angeles Times,
in Northern California hospital charges for hip-replacement surgery can cost a
patient $41,000, $85,000 or $103,000 depending on what hospital a consumer
visits in Southland.
Now physicians and hospitals in California are working
with health insurance companies to make changes. In August, some of California’s
best health care providers will be working with Aetna,
Blue
Shield of California, CIGNA
and HealthNet
California to start a pilot program for lump-sum pricing.
Lump-sum pricing is expected to cover the costs of
treatments from surgery through 90 days of recovery. It is still uncertain what procedures will be
covered and if chronic conditions will be covered in the pilot program. Consumers
will be charged only once and the cost of that charge will still rely on the
hospital that provided care.
This program has the potential to provide better
care for patients while driving down health care costs and administrative costs
for both health insurance companies and hospitals.
Right now the government is testing a similar
program for Medicare in four states and the new health insurance legislation
may explore these same options for surgical services given to the elderly and
poor.
Dr. Richard Afable, chief executive of Orange
County’s Hoag Memorial said, “We want to innovate. This is not about making money. It’s
about how we align financial arrangements so we can get the best outcomes for
patients while reducing costs for all involved.”
View original post on GoHealth Insurance Blogs
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