Tag Archives: Controlling healthcare costs

Ridiculous Healthcare Pricing

All over the country people are commenting on the ridiculous pricing from healthcare facilities and providers.  Here is a recent example I came across:

Lab Bill

You’ll note that the gross price for these lab tests is $837.74 and the person was told their out-of-pocket responsibility could be $109.85.  What is so amazing about this is I have heard of wellness companies that purchased lab services for their programs being charged $21 for a similar series, without the PSA, if the draw was done at a laboratory service center and $65 if the draws were done onsite at the employer.

So lets take out the PSA at $148.48/$19.47 and there you have it, gross pricing for these services is almost 33 times what they sell this service to wellness vendors on a wholesale basis (which obviously has a profit in it), and the person getting these tests could potentially pay four times that amount out of pocket with their PSA portion excluded.

I assume that the insurer, Continue reading

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The Health Value Awards -My Interview at WHCC 18.

This past spring I was interviewed at the World Health Care Congress 2018 by Mabel Jong.  We discussed the Health Value Awards.

 

The Health Value Awards recognizes health care vendors, brokers and purchasers who consistently deliver high value that can be replicated throughout the continuum of clinical and financial risk management. Validated categories are evaluated by the Validation Institute, an independent certifier for performance and methodologies and all categories are then reviewed by a panel of nationally prominent judges for market viability, impact and innovation. The Health Value Team: World Congress, Validation Institute and Health Rosetta Institute, showcase these organizations based on their performance and illumination of issues of national importance.

I’m honored to serve as a judge again for the 2019 Awards. You can learn more about the Health Value Awards and apply here.

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The Triple Aim, Well Two Out of Three… Really is Bad

One of the Triple Aim‘s has gotten lost. Will anyone in the healthcare sector publicly declare that they are in fact working on the Double Aim?

The Triple Aim, that lofty set of goals that the healthcare system claims to have embraced:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and.
  • Reducing the per capita cost of health care.

I agree with them and believe they are appropriate and necessary.

Everyone it seems, Continue reading

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A Letter from Dr. Shetty and the Costs of Care

Sometimes we here in the United States, me included, when dealing with all the problems we face with our healthcare system need to step back and understand why we are really here. In the end, it is about the patient, the person needing help.

If I had my druthers I would do nothing but work in Medicaid.  After spending almost 20 years providing disease management services to Medicaid programs and running a Medicaid health plan, the joy of helping this population improve their health has always felt like the pinnacle of my work.

While much of what we have done and continue to do is laudable, there are many flaws with our healthcare system, we spend too much, get too little, and are constantly looking for new solutions to the unique problems the system we created, creates. It seems as if we harp on the negative, but is it really negative to harp on the waste, inefficiencies, fraud and abuse, to point out these wrongs in an effort to fix them?

Recently I received a copy of a letter written by Dr. Devi Shetty. He is a world-renowned heart surgeon, but more importantly he is a heart surgeon who says about healthcare:

dr-devi-shetty

   “If the solution isn’t affordable, it’s not a solution,”

and

“For 92 per cent of people living on this planet, heart surgery is a distant dream,”

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Employers, unions look to direct contracting for health system contracts

Brian Klepper and I just published a piece entitled:

Employers, unions look to direct contracting for health system contracts

Some key points:

“Industry denials notwithstanding, reducing healthcare costs is fundamentally against nearly every healthcare organization’s perceived economic interests.”

“Florida’s Gov. Rick Scott, former CEO of Hospital Corporation of America, pointed out at a venture capital conference a few years ago, ‘What business wants to make half this year what they did last year? That’s why the healthcare industry won’t fix the healthcare industry.’ “

So purchasers beware. You can read the article by clicking the link to the story at Employee Benefit News:

ebn

And if you’d like to learn ways to lower your healthcare costs, contact Brian or me at Health Value Direct

HVD

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