NYT: SOS Arbitrage

[drusso]

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Opinion | Even Doctors Like Me Are Falling Into This Medical Bill Trap (Published 2024)

Hospital outpatient departments, or HOPDs, are encouraging a surprise scourge on medical costs. It’s patients who bear the burden.

www.nytimes.com

"It turns out that I’d stumbled into a lucrative corner of the health care market called hospital outpatient departments, or HOPDs. They do some of the same outpatient care — colonoscopies, X-rays, medication injections — just as doctors’ offices and clinics do. But because they are considered part of a hospital, they get to charge hospital-level prices for these outpatient procedures, even though the patients aren’t as sick as inpatients. Since these facilities don’t necessarily look like hospitals, patients can be easily deceived and end up with hefty financial surprises. I’m a doctor who works in a hospital every day, and I was fooled."

Most HOPD doctors have no idea how their employer is ripping people off or are completely complicit to the scam...

 

[SSdoc33]

Opinion | Even Doctors Like Me Are Falling Into This Medical Bill Trap (Published 2024)

Hospital outpatient departments, or HOPDs, are encouraging a surprise scourge on medical costs. It’s patients who bear the burden.

www.nytimes.com

"It turns out that I’d stumbled into a lucrative corner of the health care market called hospital outpatient departments, or HOPDs. They do some of the same outpatient care — colonoscopies, X-rays, medication injections — just as doctors’ offices and clinics do. But because they are considered part of a hospital, they get to charge hospital-level prices for these outpatient procedures, even though the patients aren’t as sick as inpatients. Since these facilities don’t necessarily look like hospitals, patients can be easily deceived and end up with hefty financial surprises. I’m a doctor who works in a hospital every day, and I was fooled."

Most HOPD doctors have no idea how their employer is ripping people off or are completely complicit to the scam...

im pretty sure that all employed docs know about SOS(d). at least the vast majority.

there is no doubt there is a problem here. if we were to go to site-neutral payments, probably 1/4 - 1/2 of hospitals wouldnt be able to stay afloat.

we know that there are docs on this forum who send more complicated patients to tertiary care centers b/c the juice isnt worth the squeeze. we also know that PP generally wont take see the indigent or medicaid patients.

 

[Ronin1]

Do you guys really think site neutral will benefit the office based guys? They will bring everything down to the lowest payments.

 

[drusso]

Do you guys really think site neutral will benefit the office based guys? They will bring everything down to the lowest payments.

SOS arbitrage hasn't helped. I'd rather have a level playing field. I guess while we're at it, we could also "means test" the charity care/community benefit programs of all those hospitals that take Medicaid and "socialize" the tax exemptions to community physicians who see their "fair share" of those patients too.

 

[SSdoc33]

SOS arbitrage hasn't helped. I'd rather have a level playing field. I guess while we're at it, we could also "means test" the charity care/community benefit programs of all those hospitals that take Medicaid and "socialize" the tax exemptions to community physicians who see their "fair share" of those patients too.

it really makes no sense why an ESI pays $200 in an office but $1000 in a hospital (for argument's sake).

if there is a quality difference, then maybe there should be a difference in $$$

 

[lobelsteve]

Bottom line: Dance lesson for the kids are not cheap.

 

[Ducttape]

so do you check and see that all the places that you send patients for xrays or MRI scans do not do HOPD billing?

 

[drusso]

so do you check and see that all the places that you send patients for xrays or MRI scans do not do HOPD billing?

Yep. A lumbar MRI at the local Catholic non-profit hospital costs over $2K, but at the physician-owned imaging center, it's $800.

What would Jesus do?

 

[SSdoc33]

Yep. A lumbar MRI at the local Catholic non-profit hospital costs over $2K, but at the physician-owned imaging center, it's $800.

What would Jesus do?

wore this to an ugly sweater party. it didnt go over well

 

[cowboydoc]

wore this to an ugly sweater party. it didnt go over well

nice!

This is mine.

 

[cowboydoc]

Yep. A lumbar MRI at the local Catholic non-profit hospital costs over $2K, but at the physician-owned imaging center, it's $800.

What would Jesus do?

I don't think spitting in my hands to create mud and rubbing it in a patient's eyes would go over well in my patient population. Does that work in your region?

 

[SpineandWine]

Argument is always “they shouldn’t have the higher compensation”
INSTEAD, argue for physician owned HOPD- that should be allowed - not sure why it’s not

 

[Ducttape]

Yep. A lumbar MRI at the local Catholic non-profit hospital costs over $2K, but at the physician-owned imaging center, it's $800.

What would Jesus do?

you as a non-HOPD employee doctor are not under any obligation to have the patient get the MRI done at the local Catholic non-profit hospital.

neither are HOPD employees.


i refer to all the radiology departments in town. unfortunately all are now affiliated to hospitals, with 1 exception - a local chiropractor that offers MRIs. i refuse to refer to him, even if cheaper.

 

[PinchandBurn]

Yep. A lumbar MRI at the local Catholic non-profit hospital costs over $2K, but at the physician-owned imaging center, it's $800.

What would Jesus do?

Actually 300 to 500 by me

 

[bedrock]

More hospital misbehavior

Doctor blows whistle on 'facility fees' spike for routine treatment

Dr Danielle Ofri was horrified at a $1,168 bill for a couple of $100 X-rays before discovering that the 'urgent care center' which treated her daughter was in fact owned by a hospital

www.dailymail.co.uk

 

[BoardingDoc]

More hospital misbehavior

Doctor blows whistle on 'facility fees' spike for routine treatment

Dr Danielle Ofri was horrified at a $1,168 bill for a couple of $100 X-rays before discovering that the 'urgent care center' which treated her daughter was in fact owned by a hospital

www.dailymail.co.uk

??? Isn't this is just the dailymail posting a summary and quotes from the exact same NYT article above?

 

[SSdoc33]

??? Isn't this is just the dailymail posting a summary and quotes from the exact same NYT article above?

its the same article, but now not behind a paywall

 

[dmk5n]

https://archive.is/5WQDs

 

[clubdeac]

And how’s this blowing the whistle? They’ve been doing this **** for years and getting away with it. Apparently it’s legal. He’s blowing the whistle on legal, nefarious and amoral practices. It’s horrific but legal so what’s it matter if he blows anything. Not gonna matter

 

[pastafan]

In my area the local radiologist owned imaging center sold to university hospital. Goodbye $300 lumbar MRI and any reasonably priced imaging anywhere. Resistance is futile??