Until they find out their insurance isn't in network, the co-insurance is cheaper somewhere else, they found a center closer to where they live etc.
It'll be interesting to see what the specialty leadership says about "financial toxicity" if it turns out the Farbers and Moffitts of the world have been charging more for 8x1 than many places charge for 5-10 fractions.
Global charge to Medicare is a good rule of thumb IMO. That should be the "MSRP" on the list where providers can be compared. Medicare without a secondary and many Medicare HMO/advantage plans will end up having close to a 20% co-insurance pt responsibility.
So self pay pts don't go to Mayo? You're probably right, they end up at a cheaper freestanding center closer to home when they see the chargemaster quote, which is often used to set self pay pricing
Price transparency will help employers better negotiate costs, that’s where savings come in. Ie how can sutter health Charge twice as much as UCLA for xrt? (Most large employers are self insured with commercial insures just acting as middleman/ providing organizational framework and management and then taking a commission- like real estate agent on a house.)
Because they own the market. Consolidation and buying everyone else out gives you that kind of pricing power. SoCal has many more players and much and, as a result, is more competitive price wise from what i can tell
Absolutely, but taken to an extreme you start to have lawsuits, and large employers and unions have deep pockets for anti trust battles.
these same centers feature self anointed health disparity experts/ careerist mds (Guess who is the one at mskcc in xrt) to mask the fact that it is these very institutions that are driving health disparity. Like McDonalds hiring nutritionists to spin benefit?
Ok, I am going overboard. But while financial toxicity to an individual cancer pt is a heartbreaking story, the bigger hidden toxicity is the real story- the outrageous rates being paid out by unions, large employers through compliant insurance cos that take commission on managing and organizing the transactions. It is making us all poorer.
But they are not setting the prices/ rates. Apart from capitated products which places like mskcc will never take, insurances are just making a commission on what the employer is paying out. Of course if the hospital rates are higher, the absolute commission is higher so they benefit when hospitals raises prices.
You may be right if we lived in a society where hospitals could turn away pts in the er. But we don’t, and so someone has to ultimately fit the bill macroscipically so even if you don’t hold health care as a right, we are going to end up paying for that of others one way or another.
You are right but from what I understand , transparency will lead to shaming which eventually brings down costs. Imagine if mskcc had to show negotiated rates for prostate and breast imrt and those rates turned out to be absurd. There would be a lot of social pressure both amongst their own physicians and outside to lower rates? (They couldn’t show their faces on twitter or speak about hypofract at conferences If they are charging 5x what everyone else is.) the social pressure would be enormous.
Which makes it all the more perplexing that Obama/RomneyCare was not more embraced on the right. Probably the closest we'll ever have gotten to any kind of consensus on healthcare reform.
