How much health insurers pay for almost everything is about to go public

Re:How much health insurers pay for almost everything is abo... by refurb on Saturday July 02, 2022 @01:00AM (#31956405)

The honest answer is because that’s what insurer negotiation had led to with hospitals having using their negotiating position.

If you’re a hospital in an area with standalone MRI clinics the negotiation pressure is high, insurers can say “ill send patients elsewhere”, so you give on price, maybe below cost.

But that same hospital is the only cath lab in 100 miles. Great! We’ll just tell the insurer “we’re charging 300% the normal cost of a cath procedure, take it or leave it”. So the insurer takes it because how can you offer insurance and tell customer they have to drive 100 miles for a heart procedure?

Hospital is happy because they’re profitable overall. Insurer just lives with paying 3x for cath procedures in that area.

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Re:How much health insurers pay for almost everything is abo... by datavirtue on Saturday July 02, 2022 @08:53AM (#31958612)

Hospitals don't let you obtain imaging elsewhere. They force you to use their imaging services--full stop.

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Re:How much health insurers pay for almost everything is abo... by refurb on Saturday July 02, 2022 @09:14PM (#31964136)

Pretty sure that's not legal, but yeah, you'll basically be told that.

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