Re:Hospitals Block ‘Surprise Billing’ Measure
by Someone1234 on Friday July 12, 2019 @03:00PM
(#20423389)
Or they would just cap prices for specific procedures. Then the patient could use price transparency to see if they'd wind up with an overage bill, and consider if they'd be willing to pay the remainder (e.g. if the doctor was preferred).
Right now insurance either do cover something or they don't. That in itself is problematic. If insurance would cover a procedure up to e.g. $500 at one medical clinic why do they cover up to $0 at another? Shouldn't it be $500 here or $500 there?
Networks inherently pit you against both the insurer and healthcare provider. Instead you and your insurer should be on the same "side" against healthcare providers.
> Right now insurance either do cover something or they don't.
That's vastly oversimplifying. Insurance often covers part of something.
Re:Hospitals Block ‘Surprise Billing’ Measure
by rogerbinns on Friday July 12, 2019 @03:42PM
(#20423765)
Maryland addresses this by setting prices state wide that are the same for all payers. There is an independent commission that sets the prices. https://hscrc.state.md.us/Pages/default.aspx
It wouldn't. Insurers would still need to approve providers' prices, and those negotiations would have other levers that could be pulled.
But broadly speaking, yes--requiring insurers pay the same price that is advertised and available to the uninsured public is basic price-transparency policy.