re: Mark Cuban is fed up with rural and urban hospitals crying poor/claiming insolvency

quote:

---

What they charge and what they get are 2 wildly different things.

The Medicare rate for lithotripsy $750

As always most people know very little about this topic.

---

This post is a great summary of the problem with “medicine.” No one knows what anything costs - hospital charge, insurance reimbursement, Medicare / Medicaid rate, copay - it’s the frickiest pricing in the world and you act like people not knowing is a people problem. It is not.

quote:

---

Rural hospitals & hospitals all over the country have been decimated by illegal aliens as you can't deny them care.

---

Combined with poor people who do NOTHING to prevent multiple hospitalizations a year. “I can’t afford my medicines” but they never can’t afford cigarettes or sugar water.

quote:

---

You understand you don’t need a hospital for normal doctor visits right? You can just have local ER’s and physician offices.

---

I don't understand? LMAO. This is what I do. I've worked thousands of hours in the ER, medical director for best and largest EMS service in our area and several smaller, volunteer ones to coordinate care in the largest geographic county in our state. My clinic services over 14,000 individual patients, 3 of the largest defense contractor sites in the country, and all the largest plants in the area. I've owned a nursing home (was going to be an LTAC/Geripsych but nixed by Obama moratorium during construction), owned a pharmacy in a rural area, served on numerous boards and committees, advisor to governors, senators, and house reps.

So yeah, I'm kinda know a little bit about this topic. And our small rural hospital, which is the largest in south Arkansas, serves a population of around 100k people For profit groups ran it into the ground, lost physicians, nurses, etc and didn't maintain the facilities. it now needs $30-50million in repairs and up keep just to keep it up to code and to continue with what limited services we have. They are only 3 doctors in south Arkansas that deliver babies and two are in their 70's. No specialist on staff except two general surgeons. We are the lowest re-imbursemed state by Medicare which makes us the lowest from private insurance as well. That's a federal issue. We are hemorrhaging doctors, nurses, rad techs etc to LA (Yes, LA faciities get paid much better than in AR) and Texas.

So 100 transfers for things that can't be handled in south Arkansas is not unrealistic as we have zero full time specialists to handle anything. This is putting a huge burden on facilities in central Arkansas as they are having to assume a much larger burden of the states healthcare and simply don't have the staff or rooms to accommodate. Thank Obamacare and the ICD coding system. Add in the ban on physician owned hospitals and you get a inefficient system that basically mandates a top heavy administrative organization to stay compliant with Medicare and hospital regulations. They are no longer ran by people that know jack shite about medicine and the physicians have no say so and are just rank and file employees now.

Private clinics are not going to tolerate medicaid and cash (no-pay) patients. And we damn sure aren't going to lose our asses and go bankrupt offering 24/7 care. Thanks to medical inflation/Obamacare regulations/ICD coding/billing, my overhead for a relatively small clinic that is very streamlined by focusing more on industrial medicine is still about $1.5million/year. just for staffing, supplies, x-ray. Not couting building and related expenses or malpractice insurance. And we have a very low overhead in comparison to other practices both state and nationwide.

So yeah, I do know what I'm talking about.

quote:

---

Nah, they know. It’s not that hard to figure out. They just don’t want to disclose it for cash and insurance customers.

---

You can literally go online and check Medicare rates for your state, and in bigger areas, your city.

We don't get fee schedules anymore. We have to search code by code with modifiers, disallowances and all sorts of other shite. EVERY insurer is different, even different plans with the same insurer. Want the price? Check with your insurer. Be a big boy. It's not my job to do it for you. If I have to, it's gonna cost more. And cash price at most every place I've ever seen will at least get Medicare prices or less if they are willing to work out a reasonable payment plan and adhere to it. The more you pay up front and the faster you pay, the better deal.

quote:

---

Congrats. Yours is the exception, not the rule. 4 is a fairly solid census for CAH.

Do you have inpatient occupational therapy bumping that census? That’s one creative solution I’ve seen is leverage some form of inpatient care (not traditionally performed at a hospital) as a way to generate more revenue.

I’ve also seen some hospitals with care facilities adjacent to them. That also helps cash flows.

---

Yes, there are exceptions to every rule and many of these facilities are mismanaged and abused just as Cuban describe, but not every single one.

And like I said earlier, if they were just money making mf'ing machines like Cuban and most of the dumbasses on here think, buy them sumbitch's and make $millions!!!!! It sounds like it's just that easy. How many has Cuban taken over and made bank?

How's his mail order RX going? He paid a shite ton of money to do it as well and there are regulations working in their favor. My wife used to mail prescriptions all over the country and we could beat Cuban's arse on damn near every prescription he had posted. Notice, Cuban's pharmacy had a dispensing fee of like $6/rx on EVERY single med. Many prescriptions filled at your local pharmacy are at cost or below. We also were notified years back that due to a rule change, you couldn't mail medications unless you were a "mail order pharmacy" AKA PBM. Wasn't realistic to spend $10's of millions of dollars to become one and compete with the monopoly already owned by ExpressRx, OptumRx, CVS/Caremark, Humana.

Most people need to STFU for a little while and do their research, maybe listen to people that really know what the hell they are talking about and maybe we can get some shite changed for the better. Until then...Stay dumb my friends!!

quote:

---

NB4 "It's also because Doctors and Nurses are paid too much..."

---

Very true.

quote:

---

Plus, I have NEVER seen an industry that is worse than hospitals when it comes to buying medications and items like implants, screws, other devices. They overpay for everything.

And then when you show them how to save money, their “supply chain” employees resist any change.

---

I think it's funny that this is one of the first places he goes. It's not like they can run down to the local hardware store and buy the products they need. Any vendor they use would need a rigorous quality assurance department. I imagine any product they purchase requires a stack of paperwork that includes the material certs to make sure it meets basic minimum standards. And, in order to switch to a new vendor requires another stack of new paperwork and procedures, including field audits, and an open bid process.

I am sure some of this is not happening because of complacency and laziness, but at the same time it is not an easy process to change vendors in highly regulated fields.

I think the reason Cuban’s viewpoint seem to resonate with a lot of people:

1) those with private/company insurance see their premiums increase
2) Medicaid spending has soared to historic levels in the past few years
3) medicare is running a huge deficit and will be insolvent without reforms


There is so much money flowing into the healthcare system, yet we have doctors and nurses crying poor, hospitals crying poor, etc


How can it be the case that historic levels of money are flowing into tbe system yet the providers are still “struggling”?

quote:

---

Drive four hours for care for all I care. We shouldn’t waste any more government dollars on them.

---

Hmmmm ... MedicAid pays for transportation, too. That's where a ton of fraud occurs by billing for ghost patient rides.