Jun 25, 2014 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Uncategorized
Maricopa Integrated Health System reports that price transparency pays off by reducing uncompensated care and increasing business
Arizona has a new law that requires hospitals, medical laboratories, diagnostic imaging facilities, ambulatory surgery centers, and urgent-care centers to publish the prices they charge self-pay and uninsured patients for the 50 most common inpatient and outpatient services. The law took effect on January 1, 2014.
News accounts report that just one hospital took steps to publish its prices earlier this year. Pathologists and clinical laboratory managers will find the experience of Maricopa Integrated Health System to be instructive, as hospital administrators there publicly state that this was the right thing to do for patients in their community. (more…)
Jul 26, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations, Uncategorized
Clinical laboratories and pathology groups may want to review the prices they charge insured patients versus uninsured patients
There is a certain irony in the fact that hospitals and other medical providers typically charge patients without health insurance as much as three times what they charge Medicare or an insured patient. This situation is getting increased media scrutiny, which is one reason why clinical laboratories and pathology groups may want to review their own policies for charging patients without health insurance.
One good study on prices charged to self-pay patients was conducted by Gerard Anderson, Ph.D., a health economist at the Johns Hopkins Bloomberg School of Public Health. His study was funded by the Henry J. Kaiser Family Foundation and published in the May-June 2007 journal Health Affairs.
Anderson analyzed 2004 hospital billing data. He concluded that the gap between rates charged self-pay and insured patients has grown substantially since the mid-1980s. “In the 1950s, the uninsured and poor were charged the lowest prices for medical services. Today they pay the highest prices…,” wrote Anderson, noting that self-pay charges often reflect the hospital’s “chargemaster” prices–the top prices used to negotiate discounts with insurers. (more…)
