Posts Tagged - ‘hospitals’

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Uninsured Intensive Care Patients Less Likely To Survive

Tuesday, May 18th, 2010

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According to a study of ICU units in Pennsylvania, people without a health insurance plan were 21% more likely to die within a month than those who were insured through private coverage, even though they visited the same hospitals.

Although nobody is accusing hospital intensive care units of conscious discrimination, the study showed that uninsured patients tend to receive less intense treatment–treatment that may have been able to save them.

There is also speculation that uninsured patients, having neglected treatment for such a long time, reach the ICU in worse health to begin with. Also, high costs may mean that those patients themselves chose less aggressive end-of-life treatments and shorter periods on life support. Some believe that healthcare reform, which seeks to insure millions of these Americans, will decrease the number of deaths.

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Should Hospitals Pay For Small Business Health Insurance Plans?

Monday, May 17th, 2010

For now, this is only happening in Massachusetts, but it could spread nationwide: hospitals are now required to make a one-time contribution to a fund that subsidizes the purchase of health insurance plans by small businesses. They will pay the insurers directly, and the health insurance companies will refund eligible businesses for two years.

After only one major hospital system–Partners HealthCare–agreed to contribute voluntarily, the State Senate President included a provision that forces them to pay $100 million to the fund. The amounts will be split based on the hospitals’ profit margins and the makeup of their patient populations.

According to supporters, small business health insurance premiums will drop by 2.5% as a result of the subsidy–although they acknowledge that it’s only a temporary solution. Detractors, including the Massachusetts Hospital Association, are worried that the mandatory assessments will negatively impact the finances of and quality of care from their facilities.

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Do You Trust Sitting Doctors More Than Standing Ones?

Friday, May 14th, 2010

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Strange but true: many people do. A recent study from the University of Kansas found that patients are significantly more satisfied with the quantity and quality of health care they receive when their doctor sits by their bedside, as opposed to standing.

Cost and timing pressures–due to health insurance and other issues that encourage quicker turnaround times–have unfortunately resulted in shorter doctor’s appointments. The act of sitting doesn’t cost any more money or take any more time, but makes patients feel that physicians are paying attention to them more. Maybe that’s actually true.

When patients feel more comfortable and less rushed with their doctors, they’re more likely to speak freely about their symptoms and compliance. This will allow doctors to better diagnose and treat them, while requiring fewer expensive tests. The result: cheaper health insurance plans!

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Will Your Health Insurance Company Drop Some Hospitals?

Thursday, April 22nd, 2010

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A growing trend in the health insurance industry is to eliminate certain elite hospitals from their provider networks. They believe that refusing to cover those hospitals–that charge significantly higher rates for services than the average–will save money for them and their consumers.

Massachusetts is promoting these so-called restricted provider networks, with a 10-20% discount on health insurance plan premiums. These plans also promote using free-standing imaging centers for medical scans.

Elite hospitals are truly superior in some areas, but their outcomes are similar to more affordable community hospitals in others. Proponents of this strategy feel that diverting some patients from these teaching hospitals will encourage them to clamp down on medical costs in order to regain their business.

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Will Hospital Report Cards Help Insured Patients?

Monday, April 19th, 2010

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A new trend in medicine is the hospital report card. Online websites give consumers more power to shop around, with information about the prices and quality of various services.

Although such sites are very convenient, they may not be as useful to patients who already have a health insurance plan. Many plans force policyholders to remain within a certain preferred provider network, which may prevent people from choosing another, more inexpensive hospital. The sites only indicate the sticker price, which doesn’t take into account the discounts health insurers receive or the portion they pay for.

However, they are still worth checking out, especially if you are looking to buy a new health insurance policy or considering switching. Pick a plan that includes the hospitals in your area with the best prices and safety ratings for procedures you may need.

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How Could Hospitals Reduce Health Insurance Rates?

Wednesday, April 14th, 2010

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Health insurance companies are often blamed for increasing premiums. In turn, they point the finger at hospitals. According to them, hospitals demand ever-increasing reimbursement rates, which must be passed onto policy holders.

A group of teaching hospitals in Massachusetts, Partners HealthCare, is trying to lessen their impact on costs. They are putting $40 million towards a proposal intended to reduce the cost of a small group health insurance plan for small businesses. Insurers will receive the money, and be required to use it to decrease premiums.

State Senate President Therese Murray also plans to propose a change to the current fee-for-service system that encourages uncoordinated care, where hospitals get paid on a per-procedure basis.

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Health Insurance Rates Go Up With Medical Imaging

Thursday, March 11th, 2010

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Medical imaging tests are an innovation that have helped many people catch diseases before they spread and improve their health. However, they have caused health insurance rates to skyrocket over the past two years.

There are several factors responsible for the 20% increase:

  • Investment in expensive new machines, such as digital mammography machines
  • More imaging tests being performed in hospitals, instead of cheaper freestanding clinics, which are up to twice as expensive
  • An increase in the number of tests performed by doctors
  • Hospitals substituting tests with higher reimbursement rates (e.g. CT scans) for ones with lower reimbursement (e.g. X-rays)
  • Hospitals increasing prices for the same treatments

Health insurance companies often require pre-authorization before paying for medical imaging, but they often pay high rates when it is approved.  They pay significantly higher amounts to hospitals that perform digital mammograms as opposed to standard film mammograms, even though the former have not yet proven to be more effective. Doing so encourages hospitals to encourage such tests, even when it may be wasteful.

The cost is then passed onto patients through their health insurance plans.

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    Health Insurance Companies Often Pay For Wasteful Claims

    Wednesday, March 10th, 2010

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    Did you know that many health insurance companies don’t bother to look into the details of many reimbursements? While the number of health insurance plans denying claims and leaving patients with the whole cost is more widely publicized, the other side of the coin is insurers who fail to catch obvious waste.

    Some experts state that a health insurer may not bother to look into claims under $100,000. That means that thousands of dollars can fall through the cracks, and those numbers can add up. A woman with Georgia health insurance used one IV bag during a two-hour emergency room visit, yet her insurance company was charged $4,000 for 41 bags. The insurance company initially paid the amount in full!

    Why do hospitals overcharge? Sometimes it’s a simple billing error. Quite frankly, many do it because they can. Most Americans have health insurance, and health insurance providers tend to ignore small expenses. Meanwhile, public health insurance provides lower reimbursement rates. They increase the sticker price less severely for uninsured patients, though they are still affected.

    As an informed consumer, you should report potentially wasteful medical expenses, in order to save yourself money on health insurance rates in the future. Beware that they can be hidden in the bill statements.

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    Why Is Health Insurance Spending Rising in Massachusetts?

    Thursday, February 18th, 2010

    Gov. Deval Patrick

    In Massachusetts, a recent report shows that healthcare spending on those with health insurance has risen by over 15% in three years. The state is one of the first in the nation to have enacted its own healthcare reform: theirs involves a health insurance mandate, coupled with government subsidies for lower- and middle-income individuals to increase access to affordable health insurance. The Senate has clearly taken their example as model for their bill.

    Still, spending has continued unabated. Despite the mandate penalizing those who fail to buy health insurance, prices of health insurance plans have only increased. Some young, healthy people prefer to take the risk and pay a $1,000 annual fine instead of monthly premiums. That continues to leave older, sicker individuals in the risk pool–whom health insurance companies need to charge more in order to make a profit.

    The state government’s report is a boon to Democratic Governor Deval Patrick, who wants the state to have the ability to cap health care prices. However, it also vindicates Massachusetts health insurance companies. It shows that at least some of their price increases are legitimately due to the higher cost of providing care.  A higher percentage of outpatient care is being offered in expensive hospital settings, as opposed to less costly facilities.  Spending in this category increased by over one-fourth, much of it passed onto consumers of health insurance.

    Health care in Massachusetts, even with reform, is 15% more expensive than the national average. That figure can’t be entirely due to the higher cost of living in Boston! State legislators plan to hold a summit in March to get to the bottom of the issue.

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    Posted in Health Insurance Blog, Reform & Regulation | No Comments »

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    Decreased Hospital Infections = Lower Health Insurance Costs

    Friday, January 22nd, 2010

    Hospital-acquired infections make up a significant portion of health insurance costs in America. They add up to over $28 billion to healthcare expenses each year. More importantly, 99,000 Americans die each year from sicknesses they got in the very places that are supposed to make them feel better. Meanwhile, 1.7 million people fall ill annually. It costs health insurance companies millions of dollars to nurse all of these patients back to health. The saddest part is that the vast majority of these illnesses and deaths are preventable.

    Doctors, nurses, and other hospital employees try their best to keep their patients from acquiring devastating bugs like MRSA. Some hospitals are placing a greater focus on hygiene, and using technology that allows less room for contamination. This is a change from the previous goal of eliminating all bacteria from the hospital environment, which just made things worse for patients. It seems counter-intuitive, but allowing sick patients to be exposed to naturally occurring, healthy bacteria (by limiting the unnecessary use of antibiotics and feeding them yogurt containing probiotics) may give them a better chance of survival.

    Simple accountability has also helped. States such as Pennsylvania and Michigan have seen infection rates decrease after the establishment of strict reporting standards. A hospital group in the latter state created a checklist that decreased central line infections and saved health insurance plans and patients $246 million!

    In 2008, Medicare stopped paying for the treatment of infections related to surgery or catheters. Many private medical insurance companies may follow suit in the future.

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    Posted in Health Insurance Blog, Individual, News | No Comments »

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