tag:blogger.com,1999:blog-32053362.post3666911542268632162..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: We were surprisedPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-32053362.post-64326044034766681822012-10-17T08:35:28.044-04:002012-10-17T08:35:28.044-04:00A nearby hospital recently contacted me about DaTs...A nearby hospital recently contacted me about DaTscan, a new diagnostic compound sometimes helpful in the diagnosis of Parkinson's Disease.<br /><br />With repeated attempts, I have not been able to get anyone to provide information about the cost of the procedure.<br /><br />So while I get reams of literature about DaTscan and even a free lunch (cold cut subs from Acme), I'm still in the dark about cost.drbobhttps://www.blogger.com/profile/12824446619993944705noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-24880784511457907902012-10-16T08:14:40.562-04:002012-10-16T08:14:40.562-04:00Most physicians I've polled have NO idea what ...Most physicians I've polled have NO idea what things cost, especially with hospitals.<br /><br />Our local hospital gets paid over $3000 for a non emergent CT of the brain (I sent you the EOB a few weeks ago.) Most doctors think the hospital charges $1,500 and gets paid $300 for a head CT. They're only wrong by a factor of 10.<br /><br />The problem is there is no transparency of fees (in fact, it is almost impossible to get any information on what a hospital charges or gets paid.)<br /><br />Recently, one of the hospital's contractors offered to buy our sleep lab. We get $650 global and they can get $2,400 as they bill through the hospital.<br /><br />How can we save health care costs when hospitals get paid so much by Medicare (and many insurers too.)drbobhttps://www.blogger.com/profile/12824446619993944705noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-9381208754777367012012-10-16T05:27:34.273-04:002012-10-16T05:27:34.273-04:00More reasons to love the (yes, imperfect) NHS. I&#...More reasons to love the (yes, imperfect) NHS. I'm sure the same happens in private hospitals all over the world.DanUKnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-64467739299985623852012-10-15T20:10:25.110-04:002012-10-15T20:10:25.110-04:00I was equally surprised when In his recent "B...I was equally surprised when In his recent "Big Med" New Yorker article Dr Gawande referenced the thousands of dollars "saved" by optimizing knee replacement surgeries. Who recouped this value? Not consumers or employers. Data now publicly available through DHCFP shows that knee replacement surgery at BWH is significantly more expensive than all other major teaching hospitals in Boston despite the efforts Dr Gawande outlines. It sems that the "savings" he highlights accrue straight to the Partners bottom line-- much the way profits captured at the Cheesecake Factory do. His thesis that Big Med might result in greater efficiency ignored the market power "Big Med" consolidates as it gets larger and larger. That "too big to exclude" market size n enables them to keep their prices and their profits at their current (self-reported) lofty levels. Partners has reported 40% margins on their commercial business. No other adult teaching competitor in the city comes close to Partners prices and margins. <br /><br />As far as physicians being unaware that their hospital and professional fees are far higher than most? The vast majority of doctors know that quite well. Dr. Gawande's successful journalism career may have kept him out of the mainstream of the contracting and rate negotiation activities that the BWH Physician Organization has devoted considerable time and leadership to; but rank and file doctors are very much aware-- even if from the newspaper as you point out-- of their superior relative rate position.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-30170797076077716992012-10-15T20:00:22.004-04:002012-10-15T20:00:22.004-04:00From Facebook:
Until I became Chief of General Su...From Facebook:<br /><br />Until I became Chief of General Surgery at the University of Missouri, I just looked at my own individual P&L- that is how it is presented by the department managers. The message is to just continue to hit higher and higher RVU targets each year and the management/medical center would take care of the business of getting reimbursed (I was at Emory before Missouri). But, when I became Chief of the division, I felt obligated to actually look into the business side of things- what an awakening. I was shocked by what I have learned and how almost ten years later, we still have such a dysfunctional system. Thank goodness for the emerging transparency, with patients and other stakeholders, including you, Paul, demanding it, sharing the knowledge and commenting on it.Bruce Ramshawnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-64894168443039534062012-10-15T18:07:32.839-04:002012-10-15T18:07:32.839-04:00Disingenuous in the extreme, even if he may have b...Disingenuous in the extreme, even if he may have been taking poetic license to make a point about how disengaged from cost doctors are. The rest of his talk as blogged by Maggie makes some good points, even if none of them will be new to anyone here. However, it is beginning to be noticed externally that his own hospital often does not practice what he preaches. If it's just now noticing an issue, that's several years late, no doubt due to its comfortable financial cushion.<br /><br />nonlocalAnonymousnoreply@blogger.com