How health care charging and pricing are different from those in other industries

Thanks for pointing this out. AnnJo 21 The only complaint I have about my individual catastrophic plan is that since the Democratic Party took over the Insurance Commissioner's office and the State Legislature of my state Washingtonthey've been tacking on all kinds of required benefits, like acupuncture, chiropractic, naturopathic, massage therapy, mental health benefits, etc. And for a while, it looked like they were going to drive all private insurers out of the state with mandates to extend coverage with no limits for pre-existing conditions - kind of like allowing a homeowner to buy homeowner's coverage after the fire started. Everything was a bureaucratic maze, totally wasteful of my time and ignoring my convenience and with other people making all the choices for me.

How health care charging and pricing are different from those in other industries

Diners know the price of their cheeseburgers, for instance, but few patients know the price of their echocardiograms. These analogies hold weight, but only to a point. As maddening as it may be to frame healthcare as an industry unique from all others, there are some dynamics that make this valid.

Healthcare is essentially the one service that, when withheld or denied, could potentially result in death. That may be the largest differentiator of any. Consumers either want healthcare to behave more like other industries or remain immune from other industrial norms and trends. In many ways, hospitals are being pulled in two different directions.

Like any retail experience, patients want to know the price tag of their treatments before they get a bill in the mail.

How health care charging and pricing are different from those in other industries

They also want to eat tasty food and have a satisfactory hospital stay — something they may soon evaluate with star-ratings, just as they would hotels. Here are five ways healthcare differs from other industries and why, along with commentary from healthcare experts on how each distinction may take shape in the years to come.

Most physicians resist the idea of calling patients "consumers," where many other businesses pride themselves on mastering customer service. Although billing and collections is a business necessity, hospitals have been reluctant about their practices, as aggressive collections can result in public outcry and regulatory violations.

Conversations grow especially contentious when profits come up, particularly those of nonprofit hospitals and health systems.

Nonprofit healthcare has long been centered around altruistic principles, such as charity care and charitable missions.

These values are predominant in healthcare, as approximately 60 percent of U. Due to this composition, there is considerable reluctance around the idea of nonprofit hospitals profiting from patients and tax exemptions.

More cities, counties and states may exert more regulatory scrutiny toward nonprofit hospitals and even implement additional rules for tax-exemption in the face of growing federal deficits, shrinking tax revenues and shaky economic conditions.

Such has been the case for healthcare giant University of Pittsburgh Medical Center. It may be an antiquated mindset for the public to chastise nonprofit hospitals for their profitability, as this could hurt their financial sustainability in the long-run and affect access to and quality of care.

They can look at the names of the places on a website — a fine-dining establishment and a casual chain restaurant — and expect some discrepancy in pricing. Although nearly all restaurants post menu prices, few hospitals are expected to do the same. In healthcare, prices do not necessary reflect the quality of the product or service, either.

One hospital may have a higher price to treat a case of lung disease, but that does not necessarily reflect a more satisfactory hospital stay, higher-quality care or more proficient medical expertise. An especially pronounced fear is that chargemaster figures will confuse consumers, who may mistakenly believe hospitals are collecting the full price tag amount without factoring in payer reimbursement, charity care and uncompensated care.In health care, it’s illegal even when unilaterally funding an action would make things easier for both parties and the patient.

5. Standardizing the product – In most industries, the product or service can be standardized to improve efficiency and quality.

In health care, every person is chemically, structurally, and emotionally unique. For decades, technology has relentlessly made phones, laptops, apps and entire industries cheaper and better—while health care has stubbornly loitered in an alternate universe where tech makes.

As a $ trillion market with $ trillion in health care expenditures in , the US health care market can be a pretty tempting target to companies, entrepreneurs and investors outside of health care. Obamacare facts is an independent website dedicated to helping Americans understand Obamacare and the Health Insurance Marketplace for Billing Process What is the process that is utilized when producing a final bill?

In which ways are pricing and charging different in health care from other industries? What are the ways that private and government insurers and payers impact the actual reimbursement process in health care? The.

Aug 06,  · The August Congressional recess will be anything but a break from the health care reform debate. Democrats had hoped to spend this month selling hometown constituents on .

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