Thoughts on this article?

[Timeoutofmind]

Hospitals Serving The Poor Struggled During COVID. Wealthy Hospitals Made Millions

The financial gap between wealthy hospitals and safety-net hospitals, which take everyone who walks through their doors, has widened during the pandemic, an NPR and PBS Frontline investigation found.

www.npr.org

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[BLADEMDA]

IMHO, we already have a 2 tier healthcare system in this country. The poor use the "safety net" hospitals while the rich use the profitable hospitals.

In general, Medicare patients have been able to gain access to some of the nicer hospitals by paying extra ( if the hospital doesn't participate) or getting procedures which do pay enough to the fancy hospitals.

Today, Medicare patients can access most of the for profit surgery centers but that may be changing soon. Medicare pays so little that many ASCs struggle to turn a profit with these patients. For example, Medicare reimburses so little to a private ASC for a total joint replacement that many ASCs simply don't do them there.

This division between the poor/Medicaid/No pay will likely widen as Medicare patients get forced more and more into the safety net hospitals. For the specialty of Anesthesiology "safety net" means 15th percentile reimbursement levels unless the hospital provides as subsidy. The vast majority of safety net hospitals are forced to heavily subsidize their anesthesia departments.

The fancy hospitals are earning record profits as private insurance pays quite well. That disparity will only widen over the next few years.

For Anesthesiology the difference between private insurance and Medicare is typically around 400-500% per case. That means an Anesthesiologist performing the same service on a private insurance patient will receive 5 times the reimbursement vs a Medicare patient.