Hospital Pricing Data Dump Won't Hurt You, Yet

Philip Betbeze, for HealthLeaders Media , May 17, 2013

Whether or not bureaucrats 30 or 50 years ago cooked up insane compensation guidelines is, of course, out of your control. If you want to get paid, you have to play that game. But the rules are slowly changing, and you have to adapt.

Because of this convoluted system, you can't kill your chargemaster today, but over time, you may be able to minimize its importance and its outrageousness. We've at least dispensed with the myth that the chargemaster doesn't matter.

See Also: Kill Your Chargemaster

In fact, it does matter a lot. The chargemaster is one variable in the Rube Goldberg device that determines how you are reimbursed for the work your organization does. It also matters in public perception, but you should have known that for the past decade or so.

Still, take solace in the fact that you have time to rectify the situation. Or so suggests a report from Moody's Investors Service that maintains that the near-term credit impact of the big CMS data release is minimal. (Moody's is supposed to be in the business of measuring risk, after all, for institutional investors in your bonds). The report says, in part:

"The CMS data provide transparency in hospital charges, but given the fact that the actual price for a given service depends on the negotiated price between the hospital and insurance company, the disclosure of charges does not allow consumers to compare actual prices. Therefore, we believe the immediate credit impact to individual hospitals and the industry as a whole is minimal."
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1 comments on "Hospital Pricing Data Dump Won't Hurt You, Yet"

Frank Poggio (5/20/2013 at 1:31 PM)
"Stop being a victim", good idea. Now how can we accomplish that? Well lets see, we can't just do a wholesale overhaul of our charge master, that will probably cut our DRG payments in half = bankruyptcy. Or how about a a separate table of charges for private payors (or indigent folks)...Oops can't do that either - Medicare has a class of payor rule, all charges across all payors MUST be the same. How about a nice big fat discount for a private payor? Nope Medicare will not allow unless it's a big payor (like an insurance company). Well here's one – stop treating Medicare/Medicaid patients. Overnight you can make all your charges 'sensible' not have to worry about convoluted government rules. I know, sounds crazy, but I just read where many private docs are doing just that, even some specialty hospitals. In my opinion that's where it all will end up if we (and our government) keep up this insane system. A two class health care system, one for the discount boys, the other for the reasonable charge paying folks. . Frank Poggio The Kelzon Group




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