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Just pick up a telephone and call if you want to compare prices.
The need to compete generates the need to advertise. That adds another cost to the balance sheet.
How do you propose to make pricing public if not by advertising?
Also, insurance has badly skewed pricing for medical services. Medicare and Medicaid pay less than the actual cost for services, commercial insurance demands and gets huge discounts, uninsured with no money pay nothing, and paying uninsured patients get to pick up more than their share. The birth center you are describing probably is actually getting paid on the average more per birth than a hospital receives. If you show up at a hospital in labor, they cannot turn you away. And the birth center does not have to pay for operating rooms and high risk nurseries and the nurses to staff them.
By the way, if you are having surgery, do you necessarily want the cheapest option? Should surgeons and hospitals with more experience and fewer complications get paid more? Would you want your heart surgery done in a community hospital that does one a month or in a specialty center that does five a day?
how do i know the prices of a restaurant or store? these days, they can easily be listed on the internet for almost nothing and you could always provide a listing in the location or tell people when they call. when people are paying their own cash, they will ask, look at your price list or check it out online. the only reason medical pricing isnt easily available is because most people dont care. you make them care, the pricing will become more transparent.
i know you dont necessarily want the cheapest option. i know that the best service should be more expensive. thats why you have a market where some people will choose the more expensive option and some people will choose the less expensive. im not making their choice for them, thats their decision.
you seem to be applying many of today's realities to my suggestion which would change a lot of these realities. im not really sure why you are making the assumption that you cant have a market system for non-elective procedures. you could always do a market system in almost any situation. im not sure why you are assuming you cant do the market system when it isnt an elective procedure. the only real difference is that elective is paid out of pocket. so change that and you will have made it the same type of decision. some people will decide "i only want the most expensive everything when it comes to my health" but many people will consider cost and choose less expensive options. say i cut myself while doing some yard work and need stitches. i could go to an emergency room and maybe get it stitched up by a doctor or RN. but what if there is a clinic in town that will do it and their cost is 20% of the price? if im paying out of pocket, ill go to the clinic. if my insurance covers it, ill go to the emergency room.
If you relieve all hospitals from obligations to treat everybody regardless their ability to pay, including medicaid and medicare patients, then they will be able to provide you a price list for their services.
BTW In one very good hospital in California they said that they will need to close this hospital if number of Medicaid patients increase due to some provisions in Obamacare law
Last edited by tetka_grunya; 09-30-2012 at 11:36 AM..
you seem to be applying many of today's realities to my suggestion which would change a lot of these realities. im not really sure why you are making the assumption that you cant have a market system for non-elective procedures. you could always do a market system in almost any situation. im not sure why you are assuming you cant do the market system when it isnt an elective procedure. the only real difference is that elective is paid out of pocket. so change that and you will have made it the same type of decision. some people will decide "i only want the most expensive everything when it comes to my health" but many people will consider cost and choose less expensive options. say i cut myself while doing some yard work and need stitches. i could go to an emergency room and maybe get it stitched up by a doctor or RN. but what if there is a clinic in town that will do it and their cost is 20% of the price? if im paying out of pocket, ill go to the clinic. if my insurance covers it, ill go to the emergency room.
So who do you think will stitch up your wound at this "clinic"? Joe the Tailor? You don't seem to understand licensing requirements.
The difference between teeth whitening and cancer care is vast.
how do i know the prices of a restaurant or store? these days, they can easily be listed on the internet for almost nothing and you could always provide a listing in the location or tell people when they call. when people are paying their own cash, they will ask, look at your price list or check it out online. the only reason medical pricing isnt easily available is because most people dont care. you make them care, the pricing will become more transparent.
i know you dont necessarily want the cheapest option. i know that the best service should be more expensive. thats why you have a market where some people will choose the more expensive option and some people will choose the less expensive. im not making their choice for them, thats their decision.
The only stores I know of that post prices online are the ones that sell online.
How does having to pick up the telephone and call and ask a physician's office for pricing make the pricing less transparent? If you want to shop for outpatient services, you can do so. Someone who is pregnant can call every obstetrician and midwife in town if she wishes and be given a price for prenatal care, delivery and postpartum care and the usual blood tests and ultrasound procedures. Most doctors use something called a "super bill". It lists the most common services for the practice and the price. here is a template for one for an OBGYN office. The actual form would also include the fees for each service listed in the block headed "CPT". The hooker is that those prices are only for self pay patients. Insurance companies do not pay those prices.
The only way to make insured patients interested in fees is to make the patient totally responsible for the premiums. Take the employer out of the equation.
Also, it is frequently impossible to price a service until after the patient has been seen. If you have a laceration, for example, the cost depends on the location and complexity of the repair. A three inch laceration that nearly severs a thumb is not the same as a three inch laceration on the calf of the leg.
Should insurance companies have to make their reimbursement rates public? Doctors are not allowed to ask their colleagues how much insurance companies are paying them. Shouldn't insurance companies have to make their prices public and then let doctors decide whether to accept those prices?
Regarding super bills, our office has several different types of office visit fees, such as "new patient" (more expensive), extended visit, stuff like that. (I don't have one in available right now to give the exact wording.) A simple visit can turn into a complex visit pretty fast.
I'd like to figure out a way to keep the advantages of group coverage (large group to spread the risk around) w/o the disadvantages (tied to ins, etc). Don't have the answers though.
this site Health In Reach has doctors and dentists who offer discounts for patients without insurance who are paying in cash.
I have tried to self pay before(with cash upfront) and most doctors still didn't want to see me.
They said they don't accept patients without insurance.
Anyone know why lots of physicians won't treat anyone with out insurance?
Healthcare in the 70s and 80s when the RN salaries were much lower was just as good and most of the RNs had either hands on training out of high school or an associates. My point is a BSN shouldn't be required in the first place for a job that only requires an associates.
You are grossly misinformed. There is a direct link to better patient outcomes from care rendered by an RN with a BSN, compared with an RN with an associates degree.
From JAMA (Journal of the American Medical Association). 2003;290:1617-1623:
"Context Growing evidence suggests that nurse staffing affects the quality of care in hospitals, but little is known about whether the educational composition of registered nurses (RNs) in hospitals is related to patient outcomes."
(A study was done on surgical patients. Details, methodology, sample size, etc. are cited in the Journal.)
"Conclusion In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates."
(Emphasis mine.)
An article in the American Association of Colleges of Nursing entitled, "The Impact of Education On Nursing Practice", cited:
"In a study released in the May 2008 issue of the Journal of Nursing Administration, Dr. Linda Aiken and her colleagues confirmed the findings from her landmark 2003 study which show a strong link between RN education level and patient outcomes. Titled “Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes,†these leading nurse researchers found that every 10% increase in the proportion of BSN nurses on the hospital staff was associated with a 4% decrease in the risk of death."
"Several studies have demonstrated an inverse relationship between the proportion of BSN nurses and mortality of the hospitalized patient. In other words, they found that as the proportion of baccalaureate-degree registered nurses increased in hospitals, patient deaths decreased. These studies demonstrate that lower levels of patient mortality are associated with the nurses’ education levels."
(Emphasis mine.)
Quote:
Originally Posted by RegQ
Of course you'd say that but let me tell you something. There are many profession that are more mentally and physically taxing that pay far less. Oh and some of those professions save lives like EMTs.
Quote:
Originally Posted by RegQ
With all due respect, it is high compared to the salaries in most other professions, most notably EMTs who are just as critical a role in the care of trauma patients.
It's obvious you are not well versed in what various health professionals do, nor do you have any idea what the training/education requirements are.
Quote:
Originally Posted by asitshouldbe
RN's are extremely overpaid, of course they will never admit it, along with anyone else who makes a decent salary. Nobody would willingly say "yes, I'm overpaid" , however, they are overpaid. The hospital administration did this to themselves, when they got rid over the lower paid LPN and insisted that all patients have an RN. Hospitals once ran very efficiently with one RN per shift, per area. This was called the shift nurse or head nurse. Now they have an RN assigned to every patient but they also have a CNA or MA assigned with each nurse, the CNA, MA does the majority of the work for a fraction of the pay. The RN's outright laugh about how easy they have it, while making the huge paycheck. Administration needs to bring back the one RN per shift, per area and reinstate the LPN or increase responsibilities for the CNA, MA. This will be help bring health care costs down.
My replies above are in response here, too.
Furthermore, there is a reason a CNA would be assigned to a unit or, in some facilities, to one or two particular nurses. Let me give you a couple of examples why. At any given time on any given hospital unit, multiple patient call lights go on in a single nurse's district. One patient just had hip replacement surgery and is now finished with the bedpan s/he is painfully sitting on and needs someone to get him/her right off it. Another patient began vomiting, or started having chest pain (or any other pain), or trouble breathing. One nurse only has two hands and two feet. To which patient should the nurse attend? Obviously the patient having trouble breathing, in pain or vomiting. What happens to the patient still sitting on the bedpan? Should that patient have to wait perhaps 20 minutes, until the nurse becomes free? (It can easily take that long or even much longer to assess the patient in pain, check orders, get medication for that patient if appropriate medication for that situation had already been ordered, administer the medication, document what just happened, etc. Or, the nurse may have to place a call to the physician, give him/her all the details about the patient's current condition, including the nurse's assessment of the patient at that time, obtain orders from the physician, document those orders so they are legal and valid, get the copy of the order off to the pharmacy, call the pharmacy to say the medicine is needed "stat", etc.) Take this one step further. Perhaps the physician is reluctant to give the orders via telephone or gives orders which are inappropriate for the situation. The nurse then has to contact the Charge RN, who may then have to contact the Nursing Supervisor (of the entire hospital). If appropriate orders still aren't obtained, the Nursing Supervisor will have to go over the physician's head and contact the physician's supervisor (i.e. Chief of Surgery) and then if appropriate orders haven't been received, the Nursing Supervisor would then have to contact the Medical Director of the entire hospital. Who is staying with this very ill patient in the meanwhile? Who is caring for the nurse's other patients in the meanwhile? Of course, the earth keeps turning throughout all this, meaning a family member is on the phone, calling for an update of their loved one's condition, another patient's physician is on the unit and needs the nurse to assist with something...
Do you really have any idea of what RN's do, particularly BSN's? Who do you think REALLY takes care of patients? Doctors?? CNA's?? Doctors aren't there around-the-clock and must rely on a nurse's assessment of a patient's condition when they are not at the bedside. The patient who is suddenly having trouble breathing... is that patient wheezing or is fluid building up in their lungs? (The cause and treatment for each differs.) Not only does the RN need to listen to the patient's lungs, the RN must know what it is that s/he is hearing and has to assess the severity of what s/he is hearing, because the orders she obtains from the physican will be based upon what the nurse tells the physician she is assessing. Is that patient having an allergic reaction? Do they itch? Do they have hives? Is their tongue swelling??? Are they starting to drown from fluid in their lungs from sudden congestive heart failure? The patient who is vomiting... is it from the disease process they were admitted for? Is their blood pressure dropping? Are they suddenly having a cardiac event???
LPNs do not have the scientific knowledge base nor are they allowed by law to assess a patient, as an RN can. An RN with an associates degree does not have the same knowledge base as an RN with a bachelor's degree, either. This is why patient outcomes are better when hospitals staff with BSNs.
You are grossly misinformed. There is a direct link to better patient outcomes from care rendered by an RN with a BSN, compared with an RN with an associates degree.
From JAMA (Journal of the American Medical Association). 2003;290:1617-1623:
"Context Growing evidence suggests that nurse staffing affects the quality of care in hospitals, but little is known about whether the educational composition of registered nurses (RNs) in hospitals is related to patient outcomes."
(A study was done on surgical patients. Details, methodology, sample size, etc. are cited in the Journal.)
"Conclusion In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates."
(Emphasis mine.)
An article in the American Association of Colleges of Nursing entitled, "The Impact of Education On Nursing Practice", cited:
"In a study released in the May 2008 issue of the Journal of Nursing Administration, Dr. Linda Aiken and her colleagues confirmed the findings from her landmark 2003 study which show a strong link between RN education level and patient outcomes. Titled “Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes,” these leading nurse researchers found that every 10% increase in the proportion of BSN nurses on the hospital staff was associated with a 4% decrease in the risk of death."
"Several studies have demonstrated an inverse relationship between the proportion of BSN nurses and mortality of the hospitalized patient. In other words, they found that as the proportion of baccalaureate-degree registered nurses increased in hospitals, patient deaths decreased. These studies demonstrate that lower levels of patient mortality are associated with the nurses’ education levels."
(Emphasis mine.)
It's obvious you are not well versed in what various health professionals do, nor do you have any idea what the training/education requirements are.
My replies above are in response here, too.
Furthermore, there is a reason a CNA would be assigned to a unit or, in some facilities, to one or two particular nurses. Let me give you a couple of examples why. At any given time on any given hospital unit, multiple patient call lights go on in a single nurse's district. One patient just had hip replacement surgery and is now finished with the bedpan s/he is painfully sitting on and needs someone to get him/her right off it. Another patient began vomiting, or started having chest pain (or any other pain), or trouble breathing. One nurse only has two hands and two feet. To which patient should the nurse attend? Obviously the patient having trouble breathing, in pain or vomiting. What happens to the patient still sitting on the bedpan? Should that patient have to wait perhaps 20 minutes, until the nurse becomes free? (It can easily take that long or even much longer to assess the patient in pain, check orders, get medication for that patient if appropriate medication for that situation had already been ordered, administer the medication, document what just happened, etc. Or, the nurse may have to place a call to the physician, give him/her all the details about the patient's current condition, including the nurse's assessment of the patient at that time, obtain orders from the physician, document those orders so they are legal and valid, get the copy of the order off to the pharmacy, call the pharmacy to say the medicine is needed "stat", etc.) Take this one step further. Perhaps the physician is reluctant to give the orders via telephone or gives orders which are inappropriate for the situation. The nurse then has to contact the Charge RN, who may then have to contact the Nursing Supervisor (of the entire hospital). If appropriate orders still aren't obtained, the Nursing Supervisor will have to go over the physician's head and contact the physician's supervisor (i.e. Chief of Surgery) and then if appropriate orders haven't been received, the Nursing Supervisor would then have to contact the Medical Director of the entire hospital. Who is staying with this very ill patient in the meanwhile? Who is caring for the nurse's other patients in the meanwhile? Of course, the earth keeps turning throughout all this, meaning a family member is on the phone, calling for an update of their loved one's condition, another patient's physician is on the unit and needs the nurse to assist with something...
Do you really have any idea of what RN's do, particularly BSN's? Who do you think REALLY takes care of patients? Doctors?? CNA's?? Doctors aren't there around-the-clock and must rely on a nurse's assessment of a patient's condition when they are not at the bedside. The patient who is suddenly having trouble breathing... is that patient wheezing or is fluid building up in their lungs? (The cause and treatment for each differs.) Is that patient having an allergic reaction? Do they itch? Do they have hives? Is their tongue swelling??? Are they starting to drown from fluid in their lungs from sudden congestive heart failure? The patient who is vomiting... is it from the disease process they were admitted for? Is their blood pressure dropping? Are they suddenly having a cardiac event???
LPNs do not have the scientific knowledge base nor are they allowed by law to assess a patient, as an RN can. An RN with an associates degree does not have the same knowledge base as an RN with a bachelor's degree, either. This is why patient outcomes are better when hospitals staff with BSNs.
Most on here aren't even talking about Rn's with Associate degrees.
They actually want hospitals to start hiring Lpn's with one charge Rn.
They want hospitals to get rid of expensive Rn's and put Lpn's in their place,because they think aa Lpn can do all the things an Rn can do without the extra expense(Rn pay)
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