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I would tend to think ER and ICU are money pits. It only takes one long term patient in an ICU bed with no insurance, and there's plenty of them. Most of your general wards or floors make money if they're run properly, but usually not a lot. You're true money makers in the hospital setting are day surgery clinics. Everyone is prequalified before walking in the door.Originally Posted by RhythmDawg
Day surgery...
I have had knee surgery twice at the Natch day surgery unit, and I joked with them they need a drive-through! I checked in at 9am and by noon I was headed home. Yes, it was that laproscopy (sp?) procedure. In and out. And, before obummercare wrecked our HCI, I paid only $100 out-of-pocket for both of those surgeries. I haven't had any major procedures since we've had to suffer the changes with all the crap piled on, but my out-of-pocket for the exact same procedures would be considerably higher. I think it would be at least $1,000 and we get to pay higher premiums for the privilege of having HCI now.
Thinking out loud....
would it be feasible for a hospital, and doctors/surgeons, and the necessary other services, to form a private entity whereby they offer self-funded insurance to members? Kind of like buying a burial policy at a funeral home. Members of this organization pay a monthly premium...well, now that I think about it. I suppose if that medical organization did not take any deadbeat patients, provided ZERO services to anyone unable to pay. They could take cash or a major credit card from non-members.
Of course, the real problem for HC providers, including hospitals, is not non-paying customers (although that contributes greatly) but is really their over-pricing of their services. I am supposed to believe that the cost of insurance: liability, mal-practice, etc. does not contribute to the costs of HC providers. Yeah, right. So! it's really an artificial price hike. Just look at the EKG example provided by RhythmDawg, and apply that to all services.
Seems to me a self-contained membership-driven provider could work. But, yes, obviously, to make it work and make it worthwhile for customers to join, the membership pool would have to be a certain size. (chicken and the egg?)
Great idea. Some already do it. They certainly self-insure their employees. I am helping one hospital with a program that takes self-pay patients and allows them to have a membership in which they pay a monthly fee and have unlimited access to a limited number of services. To participate, they must comply with wellness and preventative initiatives.
One of the ideas we debated in BR a couple of years ago when I was part of the collective pushing alternative reform was to take a Louisiana hospital, apply a regional tax to everyone within its service area...easily 2-4 parishes for most. Between the people who pay taxes and, for those who don't, a governmental subsidy, tax everyone $1,000 per year. Everyone buys, or receives, a catastrophic major medical policy...maybe even 100% paid for by the state for everyone. We looked at 25 different rural Louisiana hospitals...
Every single case would:
1) realize an increase in collected revenue for the hospital of 20% or more...and in almost every case more than 30%
2) create extremely predictable and stable cashflow that is not seasonal
3) dramatically reduce fraud
4) dramatically reduce administrative costs
5) reduce labor costs and other overhead
6) reduce patient payment burden - no patient accounts receivable, no statements, no EOBs, no copays, no co-insurnace, etc.
7) eliminate major medical premium costs to patients and/or companiesAll of this is paid for by taking $.60 of every $1 spent in healthcare away from insurance companies and sharing it with providers and patients at a rate of about $.50/$1 with providers and $.10/$1 with patients. With this kind of revenue increase, you'd see rural and urban Louisiana hospitals both become state-of-the-art within 5 years. Additionally, Louisiana would not be on a path toward Medicaid induced bankruptcy. Medicaid could supplement its portion for non-taxpayers at an estimated 60% of its current budget.
- In this model, you go to your hospital. There is no cash transaction whatsoever. Doesn't matter if you need a shot or have a 30 day inpatient stay. $0.
- If you choose to leave your service area and seek services at another hospital or a larger urban hospital, you have the choice to do so...but you pay for it, and your $1,000 in tax money stays local.
- If you have an emergency or some issue with an acuity level higher than what your hospital can handle, you get transferred and your catastrophic policy kicks in. It is feasible that a small portion of, or a small amount in addition to, the $1,000 tax could be allocated to a tertiary facility for this care. We did not fully analyze this option, but it makes sense based on what we know that a large urban facility could thrive in this same model with direct contributions from its large urban population, supplemented by smaller tax contributions from outlying rural areas whose patients would only access the most acute care. The poor rural South is really the only question mark. Set up this model on a street corner in DFW for example...no worries.
- All of this also requires care coordination between hospitals...something that we developed a plan for but does not yet happen. But there are about 8 hospitals starting a venture in this direction.
The bad part is I would have to reinvent my company, because the insurance reimbursement business is what drives our business. But I'd gladly accept that challenge. No doubt hospitals would need consultants to get all this implemented.
Looking for some commentary on this spin job.
http://www.memphisflyer.com/memphis/...nt?oid=5866932
I stopped reading after the third paragraph and skimmed the rest. It isn't worth the time. There are so many fallacies in it its beyond ridiculous. The only thing that he got correct was that "Trumpcare" wouldn't have worked.
Paul Ryan is horrible.
Our political class is bankrupt of talent.
It's time to close the doors to the Temple of Janus.
I'd say neutered coward would be a more fitting description.
In case you missed it, this went public this week:
Statement from LifeCare Specialty Hospital of North Louisiana
LifeCare Specialty Hospital of North Louisiana began notifying employees, patients and physicians this week that we have made the difficult decision to close our hospital.
We anticipate most of our current patients will be able to complete their recovery with us. We have discontinued accepting new admissions and will work closely with our physicians and care teams to ensure a smooth transition for any patient who requires ongoing care at another facility. Area residents will continue to have access to expert inpatient and specialized post-acute care at the three locations of LifeCare Hospitals of Shreveport.
The healthcare industry is constantly evolving and a number of factors influenced our decision to make this change. We appreciate the dedication of our approximately 168 Ruston employees and regret this decision will affect them in a deeply personal way. We are encouraging them to apply for open positions in our other hospitals.
Rosemary Plorin
President & CEO
I'm too distracted...what's the deal with the new bill? Do our healthcare and insurance dawgs approve?
Time is your friend. Impulse is your enemy. -John Bogle
So I have been in DC since Tuesday. Yesterday I met with some elected officials and staffers on the bill and what is required. They took me into a small meeting room. They were mostly pessimistic about this upcoming bill, and some didn't think it would pass. They took some notes and seemed interested in what I had to say. Rep. Abraham and others have some understanding about the ideas I talked about but don't know how to implement it. They were very interested in what I had to say about that. But they said exactly what I've been saying...they don't think anyone can fix it because they don't care about fixing the actual problem...just fixing some of the outlying details to make people happy and vote. Pretty pessimistic about the whole thing, especially the ones who have worked in healthcare previously like Abraham, because he has a unique perspective compared to other politicians. Nothing new or innovative will be done now outside of the immediate changes the repubs in charge are trying to get done. It was said to me...it is all a dog and pony show for the people...just like with the democrats. Disappointing.
And I saw Paul Ryan for about 10 seconds.
Now let's let the Senate GOP fix it and make it even better.
I'll read it if the Senate acts like they will approve it. The pre-ex clause has become just another hands off entitlement. Such a mess...
"All roads lead to Putin" -- Thomas Jefferson
The azzhole returns! Welcome back salty.
Hey, salty, I'll make you the same challenge I do to all the libtards I know. Start your own insurance company. That's right, you and all your libtard friends pool your money...of course you'll have to sell everything you have to get the cash...and start a healthcare insurance company. You guys can specialize in selling insurance for pre-existing conditions.
Now, I know under the stupid current laws, it would take every dime you slugs could muster just to get set up to sell in every state. In fact, I doubt your bunch could manage even that. But! for argument sake, let's assume you can. Now, just think about it. Y'all will be heroes! Every American with a "pre-ex" will flock to your company. By the hundreds of thousands, millions even! And then they will start paying a fair premium (because as a good libtard you wouldn't want to be unfair) and then, oh my! People who have paid you a few hundred bucks will start running up bills in the tens of thousands, which you will happily pay. Pretty soon, you'll be taking in maybe $300 million premiums per month, and paying out a $billion every month. But, according to libtard math, that'll work!
Oh, and on behalf of everyone with pre-ex conditions, I want to thank you for committing financial suicide.
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