Offcall.com
@offcall.com
Improving the wealth and well-being of physicians.
You can listen to @glaucomflecken.bsky.social @lglaucomflecken.bsky.social 's podcast Knock Knock Hi: glaucomflecken.com/podcast/ here!
Podcast - Glaucomflecken
Knock Knock, Hi! “Knock Knock, Hi! with the Glaucomfleckens” dives into the highs, lows, and WTFs of healthcare. Whether you’re in the medical field, live with a healthcare worker, or broke your arm o...
glaucomflecken.com
December 19, 2024 at 3:20 PM
You can listen to @glaucomflecken.bsky.social @lglaucomflecken.bsky.social 's podcast Knock Knock Hi: glaucomflecken.com/podcast/ here!
Mark's thread with his replies here on Bluesky! bsky.app/profile/mcub...
If you want to understand why healthcare pricing is horrific, the first thing to know is that our system puts 100% of the credit risk for deductibles, copays and co-insurance on hospitals and doctors. That's insane.
We have turned them into Sub Prime Lenders 🧵
We have turned them into Sub Prime Lenders 🧵
December 14, 2024 at 4:25 PM
Mark's thread with his replies here on Bluesky! bsky.app/profile/mcub...
Payors do this? Insurers do that.
Doctors do this? Pharma does that.
The rules of the game clash with the values of our people—and this friction leaves everyone, from patients to providers, deeply unhappy with what we’ve built.
Doctors do this? Pharma does that.
The rules of the game clash with the values of our people—and this friction leaves everyone, from patients to providers, deeply unhappy with what we’ve built.
December 14, 2024 at 4:25 PM
Payors do this? Insurers do that.
Doctors do this? Pharma does that.
The rules of the game clash with the values of our people—and this friction leaves everyone, from patients to providers, deeply unhappy with what we’ve built.
Doctors do this? Pharma does that.
The rules of the game clash with the values of our people—and this friction leaves everyone, from patients to providers, deeply unhappy with what we’ve built.
🤒 Patients Lose Twice: Patients face inflated bills they can’t pay, leading to bankruptcies. Meanwhile, cash prices are often cheaper than insured prices, making the system feel completely 𝗿𝗶𝗴𝗴𝗲𝗱.
December 14, 2024 at 4:25 PM
🤒 Patients Lose Twice: Patients face inflated bills they can’t pay, leading to bankruptcies. Meanwhile, cash prices are often cheaper than insured prices, making the system feel completely 𝗿𝗶𝗴𝗴𝗲𝗱.
🏦 Insurance Companies Benefit: Thanks to the Affordable Care Act (ACA), insurers must spend 85% of premiums on healthcare costs. Higher hospital prices mean insurers can justify higher premiums—and take a larger profit.
(85% of $10,000 is more than 85% of $2,000)
(85% of $10,000 is more than 85% of $2,000)
December 14, 2024 at 4:25 PM
🏦 Insurance Companies Benefit: Thanks to the Affordable Care Act (ACA), insurers must spend 85% of premiums on healthcare costs. Higher hospital prices mean insurers can justify higher premiums—and take a larger profit.
(85% of $10,000 is more than 85% of $2,000)
(85% of $10,000 is more than 85% of $2,000)
Then Cuban exposes the vicious cycle between payors and hospitals:
🏥 Hospitals Inflate Prices: To offset unpaid bills, hospitals charge inflated prices to insurers who they know will pay. An MRI might cost $450 for cash-pay patients, but if billed to insurance? $2,000.
🏥 Hospitals Inflate Prices: To offset unpaid bills, hospitals charge inflated prices to insurers who they know will pay. An MRI might cost $450 for cash-pay patients, but if billed to insurance? $2,000.
December 14, 2024 at 4:25 PM
Then Cuban exposes the vicious cycle between payors and hospitals:
🏥 Hospitals Inflate Prices: To offset unpaid bills, hospitals charge inflated prices to insurers who they know will pay. An MRI might cost $450 for cash-pay patients, but if billed to insurance? $2,000.
🏥 Hospitals Inflate Prices: To offset unpaid bills, hospitals charge inflated prices to insurers who they know will pay. An MRI might cost $450 for cash-pay patients, but if billed to insurance? $2,000.
Much of this comes from EMTALA, the ER law that says the ER will see you no matter what.
But EMTALA is an “unfunded mandate” — meaning if the patient can't pay, too bad. And how do hospitals balance their books if a third of the time their services are essentially free? 𝗧𝗵𝗲𝘆 𝗷𝗮𝗰𝗸 𝘂𝗽 𝗽𝗿𝗶𝗰𝗲𝘀.
But EMTALA is an “unfunded mandate” — meaning if the patient can't pay, too bad. And how do hospitals balance their books if a third of the time their services are essentially free? 𝗧𝗵𝗲𝘆 𝗷𝗮𝗰𝗸 𝘂𝗽 𝗽𝗿𝗶𝗰𝗲𝘀.
December 14, 2024 at 4:25 PM
Much of this comes from EMTALA, the ER law that says the ER will see you no matter what.
But EMTALA is an “unfunded mandate” — meaning if the patient can't pay, too bad. And how do hospitals balance their books if a third of the time their services are essentially free? 𝗧𝗵𝗲𝘆 𝗷𝗮𝗰𝗸 𝘂𝗽 𝗽𝗿𝗶𝗰𝗲𝘀.
But EMTALA is an “unfunded mandate” — meaning if the patient can't pay, too bad. And how do hospitals balance their books if a third of the time their services are essentially free? 𝗧𝗵𝗲𝘆 𝗷𝗮𝗰𝗸 𝘂𝗽 𝗽𝗿𝗶𝗰𝗲𝘀.
So glad physicians are finally speaking up about this
December 12, 2024 at 11:29 PM
So glad physicians are finally speaking up about this
$371 billion in profits since ACA passed
Over 40% of that went to UnitedHealth Group
jacobin.com/2024/12/heal...
Over 40% of that went to UnitedHealth Group
jacobin.com/2024/12/heal...
Health Insurers’ Profits Are Reaching New Heights
The top five health insurers have raked in over $371 billion in profits since ACA passed. Over 40% of that went to the parent company of CEO Brian Thompson’s UnitedHealthcare, UnitedHealth Group — whi...
jacobin.com
December 12, 2024 at 6:12 PM
$371 billion in profits since ACA passed
Over 40% of that went to UnitedHealth Group
jacobin.com/2024/12/heal...
Over 40% of that went to UnitedHealth Group
jacobin.com/2024/12/heal...
In other words: doctors do the right thing and deliver the services, care, and procedures to patients, and then we hope that we'll get paid for them.
United literally says this in their documentation — but then will not guarantee any payment.
United literally says this in their documentation — but then will not guarantee any payment.
December 11, 2024 at 4:27 PM
In other words: doctors do the right thing and deliver the services, care, and procedures to patients, and then we hope that we'll get paid for them.
United literally says this in their documentation — but then will not guarantee any payment.
United literally says this in their documentation — but then will not guarantee any payment.
