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re: Study: significant increase in patients who can't afford to pay full hospital bill

Posted on 6/28/17 at 8:49 am to
Posted by the_watcher
Jarule's House
Member since Nov 2005
3451 posts
Posted on 6/28/17 at 8:49 am to
quote:

As if anybody could actually pay $85,000 for a short, fairly common surgery, and as if it actually cost that much.


Most of you are so ignorant about this topic it makes my head hurt. Congrats to the808bass for being the only informed person in the thread.

I worked for a healthcare company that staffed/managed ED's across the country for several years. My job was to literally analyze patient/third party insurance payments every day and predict future revenue per patient broken out by payer class by facility. I was responsible for over 50 separate facilities.

Hospitals know exactly what actual payment they will get based on demographics and insurance companies/CMS know exactly what they will pay. What price would you charge for a broken ankle surgery if the actual cost to the hospital was $8.5k but you knew you will only get 10% of what you charge?

Also, spoiler alert - most people don't pay their medical bills. Our company wrote of tens of millions in bad debt PER MONTH. Most facilities average anywhere from $125-$250 dollars per patient when you factor in what medicare/medicaid pay, write offs, self pay patients that you know will never pay a dime, and insurance/third party disputes. The system is terrible and the main problem is the two decisions makers in a hospital transaction (doctor and patient) are not the ones making decisions on third party reimbursement levels.
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