Just about everyone seems to have his or her own rationale about urgent care clinic.
Effort to Decipher Hospital Prices Yields Key Finding: Don’t Try It at Home
A federal price transparency rule that took effect this year was supposed to give patients, employers and insurers a clearer picture of the true cost of hospital care. When the Trump administration unveiled the rule in 2019, Seema Verma, then chief of the Centers for Medicare & Medicaid Services, promised it would “upend the status quo to empower patients and put them first.”
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A series of columns by Bernard J. Wolfson addressing the challenges consumers face in California’s health care landscape.
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I set out to test that statement by comparing prices in two major California hospital systems. I am sorry to report that, at least for now, that status quo — the tangled web that long has cloaked hospital pricing — is alive and well.
I have spent hours toggling among multiple spreadsheets, each containing thousands of numbers, in an effort to compare prices for 20 common outpatient procedures, such as colonoscopies, cataract surgeries, hernia repair and removal of breast lesions.
After three months of glazed eyes and headaches from banging my head against walls of numbers, I am throwing in the towel. It was a fool’s errand. My efforts ultimately yielded just one helpful piece of advice: Don’t try this at home.
I was most of the way to that realization when a conversation with Shawn Gremminger helped push me over the line.
“You are a health care reporter, I’m a health care lobbyist, and the fact that we can’t do this ourselves is an indictment of where things stand at this point,” said Gremminger, health policy director at the Purchaser Business Group on Health, which represents large employers who pay their employees’ medical bills directly and have a big stake in price transparency. “The subset of people who can do this is pretty small, and most of them work for hospitals.”
I heard similar comments from other veterans of the health care industry, even from the former managed-care executive who inspired the story.
He had come to me with a spreadsheet full of price info that appeared to show that a Kaiser Permanente hospital in the East Bay charged significantly higher prices for numerous procedures than a nearby hospital run by archcompetitor Sutter Health.
Helpful Health Insurance Tips
Our most precious possession is our health. Although there are countless ways to help ensure we are healthy into old age, it is vital to own health insurance for those unexpected emergencies. Many people don't even know where to start in their search for the right health coverage, and if you are one of them, the tips in this article will help get you started.
When choosing health insurance, it is important to know what your coverage will encompass. When you have a health insurance plan that will cover incidents like this, it can make a huge difference when you have to pay for things during you downtime.
It's a good idea to research your state's insurance regulations to make sure that you have the best health coverage possible. Different states will have different rules regarding health policies and what they have to cover. You can usually find these on the state's government web site, or you can call or write for help.
Avoid replacements to health insurance plans. Some alternatives to health insurance plans offer very specific coverage. While they might cover anything from cancer to Ebola, they are mostly useless to you. Save the money you would be throwing away on them. Just buy a proper health insurance plan, when you can afford it.
As your children age into adults, their health insurance coverage will eventually run out. You need to begin talking to them early (say, in the last two years of college) about their insurance needs so that they understand how the transition will occur. Since many employers are cutting benefits, parents are keeping children on their policies longer and longer, but this gets expensive. Perhaps the best advice is to point out the advantages of full-time employment which will provide them with their own independent health coverage.
When choosing between catastrophic and comprehensive health insurance, remember that comprehensive health insurance costs more and covers everyday health care requirements, and preventative health care. Catastrophic health insurance is much cheaper, but it only covers catastrophes, as the name indicates. If you have an ongoing medical condition that requires frequent attention, choose comprehensive insurance. If you are generally healthy but want a safety net, choose catastrophic insurance.
If you like your current doctor and you do not want to change providers then you need to make sure that you find out whether he or she is one of the network providers before signing up with any company. Many health insurance companies will not cover you if you see a doctor that is out of the network.
Before re-enrolling in your current plan when annual enrollment time comes, make sure you look for changes in what is or isn't covered. Plan benefits and coverage do change, and it is worth examining all of your plan options every year to ensure that you get the best coverage for your health care needs.
Each state regulates private insurance on their own, which means you are not allowed to purchase from another state. This would violate interstate commerce laws. One consequence of this is that coverage may be reduced or nonexistent if you receive care outside your home state. Each insurer is different, so read the fine print before you buy.
When you're admitted to a hospital, expect a great deal of documentation from your health insurance company as well as all the other people and groups who may have treated you. Although it can be bewildering, please make the effort to thread your way through the insurance bill details so that you can be completely sure you understand what you were charged for. This way if something was not covered to your satisfaction, you will be able to identify it and call it out to the health insurance company for follow-up.
Learn all of the different options available to you with health insurance. With all of the different plans and choices, choosing health insurance can get really confusing. Plus, you might miss an important option because you didn't even know to look for it. Use one of the online health insurance quote providers and request quotes. The service is anonymous, and it's the quickest way to see all of the options offered by different health insurers and compare policy offerings against each other so you can get the most health insurance coverage for your dollar spent.
When it comes to preparing more info to change your health insurance policy, be sure to make a list of all the medications that you or your dependents are taking. Add the annual total. If they're covered by your current plan, add your co-pay separately and view the cost of what it'd be without your policy.
You should remember that one reason health insurance is so complex is to dissuade you from doing your own research in the field. Insurance companies make more money off of ignorant clients. You can foil their intentions and improve the treatment you get from them by reviewing the valuable information available on health insurance.