Lower-Cost May Mean Better Health Outcomes

[funologist.org]

Proponents of health care price and quality transparency believe that by providing cost and quality information about physicians and hospitals, individuals will choose those providers with high quality scores and lowest costs. The argument is that providing this information to patients, the demand for high-quality health care at the lowest cost will reinvigorate competition in the health care market, thereby driving down the overall cost of care.

Because higher costs are not always indicative of the best quality, the goal is to showcase the connection between quality scores and price so that patients can more easily make informed decisions about their health care.

This disconnect between lower costs and better care is not unusual. An analysis by Modern Healthcare reported this weekend indicated that in seven of 12 cities examined, the hospital with the lower average cost for inpatient and outpatient percutaneous coronary intervention ("PCI") also had the lower readmission rate for PCI patients.

This analysis emphasizes the importance of providing side-by-side cost and quality data. In order for the U.S. healthcare market to start behaving like other markets, consumers (or patients) must have access to the same kinds of information for their health care insurers and providers as they do for cell phones and cars. Then, hospitals will no longer be able to add a large markup over their actual costs of delivering the services because the value-add simply won't be justifiable.

Demystifying Hospital Bills

A new price transparency law in North Carolina now requires hospital bills to be "in plain, easy-to-understand language without obscure codes and medical jargon." (Raleigh News & Observer.)  

Beginning next June, North Carolina hospitals must post pricing and payments for their most common admissions, surgeries, and imaging procedures.  Hospitals must also list prices and reimbursement rates for Medicare, Medicaid, large private insurers, and uninsured patients.

The bill also provides increased patient protection from bill-collecting, requiring hospitals to provide written notice to patients before sending the patient's bill to a collection agency, and to not refer unpaid bills to collection agencies while a patient request for charity care is pending.  Finally, the bill prevents hospitals from collecting unpaid bills from pateints' state tax return or lottery winnings.

"Financially speaking, patients soon will find visits to North Carolina hospitals to be a less painful and less mystifying experience." (Raleigh News & Observer.)

Read more here: http://www.newsobserver.com/2013/07/28/3064787/under-new-law-patients-hospital.html#storylink=cpy

Read more here: http://www.newsobserver.com/2013/07/28/3064787/under-new-law-patients-hospital.html#storylink=cpy