Hospital Pricing Data Dump Won't Hurt You, Yet

Philip Betbeze, for HealthLeaders Media , May 17, 2013

MU proposed rules

How much hospitals charge for the same procedures (source: The New York Times)

So, even if you can't kill your chargemaster, you can modify it appropriately, and by doing so, you could go a long way toward rationalizing the insane numbers that make it up. Better yet, perhaps you could adopt a strategy of being the low-cost, high quality leader in your area.

At its core, this data release paints a portrait of what a screwy health reimbursement system we have in those numbers in black and white on the map application I steered you to last week at the New York Times.

Anyone can look into the black box that cooks up their  payment rate and make a reasonable guess as to whether their the high-cost outlier in their area. Those numbers have the power—at least in non-near-monopoly markets—to steer business to competitors if the difference is enough.

Even if that educated guess isn't enough to move your customers (that is, payers, employers, and patients) to the competition, you can bet they'll assume the worst, and at the very least ask you to prove that you're not the high-cost outlier, despite what the CMS data says about your chargemaster and what the government pays you.

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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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