Costs, fraud-busting and consolidation

Filed Under: Costs, Providers, Regulators

From the news:

An appendectomy in Texas can cost as little as $1,747.35 at Providence Memorial Hospital in El Paso, or as much as $7,335.94 at Lake Pointe Medical Center in Rowlett, according to an interactive tool posted by The Texas Tribune.  The Tribune used public data from Medicaid, the joint state-federal health care program for indigent children, the disabled and the very poor.  The full analysis, with article, is by Emily Ramshaw.

A profile by Reuters of a crime-busting official who’s working to ferret out health-care fraud includes these passages:  “The National Healthcare Anti-Fraud Association (NHCAA), a watchdog group, cites information from the FBI that anywhere between $70 billion and $234 billion is lost annually. That ranges between 3 percent and 10 percent of the $2.34 trillion Americans spent on healthcare in 2008. … Thomson Reuters, an industry leader in healthcare data, estimates the cost of fraud at about $150 billion per year.” By Tom Brown.

Physicans are leaving private practice, writes Pauline Chen, M.D., at the Well blog at www.nytimes.com. It’s widely regarded as one consequence of the turmoil in the health-care marketplace and the difficulty of managing the business side of a practice.  She writes: “Over the last decade, there has been a nearly 75 percent increase in the number of doctors employed by hospitals. Nearly three-quarters of hospital leaders say they plan to increase that percentage over the next three years.”