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Forget About Health Insurance, Darling!
Only the little people pay with insurance.
By Dr. David Edward Marcinko MBA CMP™
[Editor-in-Chief]
www.CertifiedMedicalPlanner.org
Like many other doctors, I remember my dismay when I saw uninsured patients paying full price for their medical care. Insurance companies used their market clout and patient volumes to negotiate discounts for their insureds that have always been unavailable to the uninsured, MSA, HSA participants or individual healthcare consumers.
The Insider Gossip
There is even industry hearsay that some charity-care and non-profit hospitals charge their indigent patients up to four times more than their insured patients in order to have huge write-offs [bad-debt expenses] so as to secure private and public monetary grants. After all; many non-profit CEOs are well paid, indeed.
But, the tide may be turning on the healthcare institutional level as cash becomes king in the new economy and world of healthcare 2.0
Cash Patients Rule – Insured Patients Drool
Of course, we’ve written about direct care, concierge care and cash care medical practice business models before on this ME-P. And, I’ve been ranting and raving, opining and testifying, as well. It is being written about in the blog-o-sphere, on the hospital level, increasingly.
Link: http://www.kevinmd.com/blog/2012/06/hide-health-insurance-status-pay-cash.html
We even have an entire Chapter 29 devoted to the codified topic in our newest book The Business of Medical Practice.
Link: http://businessofmedicalpractice.com/chapter-29/
Source: Austin Frakt PhD’s TIE cartoon via Brad Flansbaum.
The Coming Payment Apocalypse
The days of paying more when paying cash may be coming to an end. Doctors and hospitals are starting to do what every other business has done since the beginning of time – give a discount for cash. States are beginning to require pricing transparency and hospitals and physicians are starting to publish their “cash prices” for all to see.
And, why not when it can take up to two years to be reimbursed a fraction of the billed amount from Medicaid and Medicare payers, and CMS, etc? Now, don’t get me started on some highly discounted private payers and managed care plans.
Assessment
What do you think of this trend as a healthcare provider; Financial Advisor, medical management consultant or patient? Are you in favor of this private business arrangement; or do you favor the proposed public Obama Care business model? Is it even legal? How about keeping the status-quo?
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
Our Other Print Books and Related Information Sources:
Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Hospitals: http://www.crcpress.com/product/isbn/9781439879900
Physician Advisors: www.CertifiedMedicalPlanner.org
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Filed under: Health Economics, Health Insurance, Op-Editorials, Touring with Marcinko | Tagged: cash care, concierge medicine, david marcinko, direct care, discount medicine, Dr. Marcinko, wholesale medicine |
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 
Strategic discount – worthy of dentists’ consideration and insurers’ attention
I’ve noticed that when patients ask about the price of dentistry, they increasingly point out that they don’t have insurance – hoping for a discount.
In the past, I’ve recited my worn-out spiel many times that my fees are the same whether patients have insurance or not. And even though I’ve started offering a discount when my practice can save money on the costs of handling insurance claims and delayed payments, the statement is still true. I’m just no longer filing for and waiting on insurance reimbursement as a thankless courtesy to insurance companies. Nevertheless, that service is still available for full price.
I’m starting at a 10% discount for payment in full at the time of service, and we will continue to provide the documentation insured patients need to file for the payment themselves. The discount can be adjusted up or down along with the full price depending on how much it costs me to continue to provide administrative assistance with their policies.
Since the insurers’ clients in my practice who pay the premiums will be awaiting reimbursement, rather than a dentist hoping for fairness from a 3rd party that has no respect for their clients’ dentists, the strategic discount returns accountability to the dental benefits industry in my neighborhood.
If such transparency were to catch on, insurance CEOs could be domesticated for once.
D. Kellus Pruitt DDS
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Stark contrast between gross charges and charity care at some hospitals
Pennsylvania’s Crozer-Chester Medical Center is suing a low-income insured patient for more than $240,000 after treating him for strokes and seizures–a rate far higher than its costs, reported The Philadelphia Inquirer.
http://www.kansascity.com/2012/05/31/3634984/missouri-hospitals-reporting-more.html
Hope Rachel Hetico RN MHA
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Poor patients sue hospital district for charging copays
Hope – One of the nation’s largest urban hospital districts has been sued for withholding care from poor patients, reported The Houston Chronicle.
http://www.chron.com/news/houston-texas/article/Hospital-District-sued-by-indigent-patients-3623601.php
Chesley
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Hospital Expansion [Coordinated Care or a Vie for Insured Patients]
In what has been termed the “geographic expansion race,” U.S. hospitals have begun employing new strategies to expand their market presence and compete for valuable insured patients. A fourteen-year study by the Center for Studying Health System Change analyzed the various expansion strategies employed, and the market composition that resulted.
Click to access hosp.pdf
While hospitals insist that geographic expansion will allow them to improve access to care, others in the industry have criticized this new trend for its potential effect on access to care for uninsured patient populations.
Ann Miller RN MHA, via
http://www.HealthCapital.com
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BUT – Is Price Transparency More Than Just a Pipe Dream?
An essay by Marty Stempniak who is a H&HN Staff Writer:
http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=300004309
Enjoy.
Leticia
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Surgery prices vary significantly across hospitals
Hospital prices significantly vary for surgical procedures, with location and market power playing an important role in marking up prices, concludes a new report from consumer advocacy group CALPIRG Education Fund.
Click to access Your%20Price%20May%20Vary%20web.pdf
Dr. Humphries
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For America’s “Best Hospitals,” Reputation Doesn’t Hold as Much Weight
The U.S. News and World Report has released its annual lists of the best hospitals in America, but this year the rankings were based more on performance data and less on reputation.
http://thehealthcareblog.com/blog/2012/07/18/for-americas-best-hospitals-reputation-doesnt-hold-as-much-weight/
Kenneth
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Primary Direct-Care Cash, Too
One possible answer to rising healthcare costs?
http://thehealthcareblog.com/blog/2012/08/10/costs-continue-to-rise-what-can-employers-do/
Stanford
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What if buying surgery was like buying a car?
An essay by Sarah Kliff.
http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/10/24/what-if-buying-surgery-was-like-buying-a-car/
Ann Miller RN MHA
[Executive-Director]
http://www.CertifiedMedicalPlanner.org
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More doctors are switching to cash-only practices
The numbers are still small but rising, creating both cost savings and some new headaches.
Ann Miller RN MHA
[Executive-Director]
http://www.CertifiedMedicalPlanner.org
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CASH – NOT ANY TIME SOON
https://www.msn.com/en-us/money/insurance/hospitals-often-charge-uninsured-people-the-highest-prices-new-data-show/ar-AALPZHw?li=BBnb7Kz
Ann Miller RN MHA
[Executive-Director]
http://www.CertifiedMedicalPlanner.org
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