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 […]

Aetna sues in New Jersey, Pt. 2

Aetna sues in New Jersey, Pt. 2

The Aetna lawsuit in New Jersey seemed so puzzling that we continued reporting on it, following links. Why would Aetna pay such ridiculous rates, including a payment of $56,980 for a bedside consultation and “$59,490 for an ultrasound that typically costs $74”? That just seems absurd; we have a hard time getting $23.40 out of […]

Finding the money

Filed Under: Providers, Regulators

Finding the money

Groundbreaking reporting on the health-care payments system this year came from The Wall Street Journal.  The government is the largest payer of medical claims, and The Journal has made good use of what data it has to identify providers who have performed an outsize number of procedures, collected an outsize amount of money, and generally […]