Even researchers don’t know which doctors Medicare Advantage covers: The New York Times

Filed Under: Costs, Health plans, Patients

Even researchers don’t know which doctors Medicare Advantage covers: The New York Times

“If you try to use Medicare Advantage, figuring out which doctors are available (and where) can be exceedingly difficult, if not impossible,” Austin Frakt writes over at The New York Times. “Medicare Advantage is the government-subsidized, private alternative to the traditional public Medicare program. It has had strong enrollment growth for years. That growth has […]

So, Trump says he wants health cost transparency. What’s up with that?

So, Trump says he wants health cost transparency. What’s up with that?

So the Trump Administration issued an executive order on June 24, 2019, saying that it would set in place a process to make health prices available to consumers. Historically, of course, the prices people will pay to the doctor or hospital have been shrouded in secrecy — characterized as “trade secrets” by the hospitals, insurers […]

How much U.S. households with employer insurance spend on premiums and out-of-pocket costs: Commonwealth Fund

How much U.S. households with employer insurance spend on premiums and out-of-pocket costs: Commonwealth Fund

“In the years since the Affordable Care Act (ACA) took effect, public debate over the cost and quality of insurance has focused primarily on health plans sold through the marketplaces established by the law,” Susan L. Hayes, Sara R. Collins, and David C. Radley write for the Commonwealth Fund. “There has been less attention on […]

How much does a blood pressure check with a physician’s assistant cost, $25 or $464?

Filed Under: Costs, Health plans, Patients

How much does a blood pressure check with a physician’s assistant cost, $25 or $464?

A blood pressure check and medication adjustment with a physician’s assistant costs $464? How can that be? The share was from New Orleans, and the provider is University Medical Center, a part of LCMC Health, the big New Orleans chain. “University Medical Center charged a $308 ‘facility fee’ and after insurance discounts I’m out of […]

‘I always price out any labs or tests, even prescriptions’: How people shop for health care

‘I always price out any labs or tests, even prescriptions’: How people shop for health care

“I always price out any labs or tests, even prescriptions before hand the price variations are wild, I then choose the lowest’” — she commented on a Facebook post on my TED talk. I queried her: “Thanks for this! This is my TED talk. I’d like to write about your experience for my blog. Can […]

How much does an emergency room visit cost? Or how to successfully argue a bill

How much does an emergency room visit cost? Or how to successfully argue a bill

His kid was treated at the emergency room at Children’s Medical Center – Plano, Tex., he told us when he shared his experience on our website. The charge was $1,770; insurance paid nothing, and he was asked to pay $1,501.24. His remark: ‘Waited six hours. Very expensive treatment for a kid’s tummyache.” I asked him […]

A missed opportunity for the malpractice system to improve health care: The New York Times

A missed opportunity for the malpractice system to improve health care: The New York Times

“The American medical malpractice system is doing almost nothing to improve the quality of health care, research suggests,” Aaron E. Carroll writes over at The New York Times. “What may be more concerning is that there is very little discussion, much less action, about changing this. Despite worries among doctors that they are at financial […]

Strategies for Effective Cost-of-Care Conversations with Patients: Revcycle Intelligence

Filed Under: Costs, Health plans, Patients

Strategies for Effective Cost-of-Care Conversations with Patients: Revcycle Intelligence

“Patients are paying more and more for their healthcare services, making effective cost-of-care conversations a skill that providers need to successfully treat patients,” Jacqueline LaPointe writes over at RevCycle Intelligence. “Health plans with deductibles are becoming commonplace. A new analysis from the Kaiser Family Foundation (KFF) shows that about 85 percent of covered workers had […]

How much does a hip replacement cost, $95,459 or $77,967? Or, why does the insurance company pay more than the bill?

Filed Under: Costs, Health plans, Patients

How much does a hip replacement cost, $95,459 or $77,967? Or, why does the insurance company pay more than the bill?

How much does a hip replacement cost, $95,459.83 or $77,967? Or $63,604? A friend had a hip replacement recently, and she sent over her bill. What’s interesting to us is, among other things, the Hospital for Special Surgery bill and the Cigna bill don’t add up. Cigna reports that it was billed $95,459.83; HSS reports […]