A review of WebMD’s analysis of 33 procedures at Bay area hospitals found that those with the highest costs are seldom top-rated for quality, according to Humana’s member Web site. WebMD ranks hospitals’ quality performance using mortality rates and other data such as major complications. The Tribune reviewed data for hospital inpatients in 2005.
Are you surprised to see how much costs vary from one hospital to the next? Do you see a link between price and quality when it comes to medical procedures? Share your thoughts here.
What may be more surprising, though, is that paying high prices does not guarantee the best treatment.
Case in point: Even though bypass surgery costs considerably more at Brandon, the other two hospitals received higher scores for effectiveness from WebMD Quality Services, which analyzes hospital-patient data and sells the analysis to Humana and other health insurers.
A review of WebMD’s analysis of 33 procedures at Bay area hospitals found that those with the highest costs are seldom top-rated for quality, according to Humana’s member Web site. WebMD ranks hospitals’ quality performance using mortality rates and other data such as major complications. The Tribune reviewed data for hospital inpatients in 2005.
Humana, which has 200,000 commercial health plan members in the Bay area, plans to expand access to its cost and quality database nationwide Oct. 1. Doctors’ payment information will be available online in October, and their effectiveness ratings will be available in 2008.
It will be coupled with an advertising campaign. The message: “In the very complex world of health care, cost and quality don’t always go together,” said Tom James, physician adviser at Humana headquarters in Louisville, Ky.
To prove it, the company is making public what it pays for health care - not what a hospital lists as its charges, but the real cost, which typically is secret. Prices in the database include the total payment from Humana and patients to doctors and hospitals. Humana executives say they hope members and employers who pay most of the cost of coverage will review the data and see the price differences.
“It’s all about power to the consumer,” said Wadida Murib-Holmes, director of special projects for Humana.
I can’t wait!!! Hip Hip Hooray, we can now comparison shop!!!!
Now if people would just get on board with universal health care!!!! Maybe doctors would get back to the business of truly caring about thier patients instead of making the most money as fast as they can.
My contention is if health care were universal rather than money oriented then the people that really want to become doctors to help humanity would be the only ones being doctors. The people that are in it to be rich, would be somewhere else, lol.
What may be more surprising, though, is that paying high prices does not guarantee the best treatment.
Case in point: Even though bypass surgery costs considerably more at Brandon, the other two hospitals received higher scores for effectiveness from WebMD Quality Services, which analyzes hospital-patient data and sells the analysis to Humana and other health insurers.
A review of WebMD’s analysis of 33 procedures at Bay area hospitals found that those with the highest costs are seldom top-rated for quality, according to Humana’s member Web site. WebMD ranks hospitals’ quality performance using mortality rates and other data such as major complications. The Tribune reviewed data for hospital inpatients in 2005.
Humana, which has 200,000 commercial health plan members in the Bay area, plans to expand access to its cost and quality database nationwide Oct. 1. Doctors’ payment information will be available online in October, and their effectiveness ratings will be available in 2008.
It will be coupled with an advertising campaign. The message: “In the very complex world of health care, cost and quality don’t always go together,” said Tom James, physician adviser at Humana headquarters in Louisville, Ky.
To prove it, the company is making public what it pays for health care - not what a hospital lists as its charges, but the real cost, which typically is secret. Prices in the database include the total payment from Humana and patients to doctors and hospitals. Humana executives say they hope members and employers who pay most of the cost of coverage will review the data and see the price differences.
“It’s all about power to the consumer,” said Wadida Murib-Holmes, director of special projects for Humana.
I can’t wait!!! Hip Hip Hooray, we can now comparison shop!!!!
Now if people would just get on board with universal health care!!!! Maybe doctors would get back to the business of truly caring about thier patients instead of making the most money as fast as they can.
My contention is if health care were universal rather than money oriented then the people that really want to become doctors to help humanity would be the only ones being doctors. The people that are in it to be rich, would be somewhere else, lol.
LJ-
You have quite an imagination. First off, why is it wrong to make money? Being a doctor takes about 250K in student loans. It’s human nature to want to provide for your family and most doctors deserve to make what they make. It’s the Insurance, drug companies and the lawyers that are making the real money. You have sports figures and CEO’s that make millions and can’t hold a candle to the intelligence level of Most doctors....and its the most important job in the world, yet you want them to work for peanuts? If universal health care happens, you will see many med students switch careers and you will start losing the real talent. Look at our school systems, we want our teachers to be more educated and trained...yet we pay them 35K to start and top out at 65K in 30 years. That is why most of the talented teacher move on to other jobs that pay more. What you are suggesting is a road to horrible health care.
Also most doctors have to go to school 8-10 years and then do 2 years residency before they can go on their own. Ever start a new business with new business loans and on top of that student loan payments....most are mid to late thirties before they start making money. Sure make a universal health care and pay a doc as GS-14 and see how many good doctors want to save lives.
I agree you have a point there. Forgive me for getting carried away with my Utopian-rose colored glasses.
Musta been stuck in a parallel dimension somewhere, heh.
but......my time is just as valuable as a doctors time, so maybe they should only make the appointments in their offices they can keep, and if they are detained as many of them are...why make the other patients wait? They could go out to the waiting room and tell the patients, ask them if they would like to reschedule rather than SITTING FOR HOURS AND HOURS....
I agree you have a point there. Forgive me for getting carried away with my Utopian-rose colored glasses.
Musta been stuck in a parallel dimension somewhere, heh.
LJ-
I know where you are coming from on this one. I wish I knew what the answer was to provide a cheaper health care to all American’s. Unfortunately is not universal health care, but I do have a suggestion. As I believe Shakespeare said.....First thing we need to do is KILL all the lawyers.....
I think that would fix most of our problems. Then LJ you won’t have a need for rose colored sunglasses....
Well, I don’t advocate the killing of anyone. Maybe we could just have them placed in the parallel dimension, which would be pure hell for them since in this dimension there is no crime....hence they would have to learn to be “doctors” .
Then we could bring them back to this dimension and there would be a total excess of doctors and everyone would have a personal physician, isn’t life grand? lol.
There can be a middle ground, where physicians are FAIRLY reimbursed for their training/time and patients receive the care they deserve at a reasonable cost. And it starts with taking away contingency fees for lawyers.
Just watch the nuisance suits dry up & the malpractice rates go down when you make people have to actually THINK (and pays some kind of retainer) before they sue.
Then get the health care costs down by forcing drug companies to charge reasonable prices for their drugs. And before anyone points to cost of research, how about looking at the price of ADVERTISING these companies shell out to get everyone to use their new designer drug. (Which was probably just as good as the old designer drug, but the patent was expiring, so they had to “invent” something “new” to justify the outrageous pricing to the consumer.)
Likewise hospitals do not need to charge $5.00 to a patient for an aspirin when it only costs them $.002 to buy it…
Universal health care can be affordable if it user fees are instituted based on income, frequency of use, and need. But not at the prices the HMOs (et al) are charging!
who decides what is ‘fair’? LJ is a pretty good example of the fallacy of that way of thinking. You aren’t paying for a Doctors ‘time’, you are paying for their expertise. The training and knowledge they have acquired and with which they put to use to diagnose and treat the problem you present them with.
Why would a nurse (RN), for instance, make so much more than a nurses aid or tech -when the tech or aid will typically put in far more manual effort during the same shift? The RN isn’t ‘working HARDER’ than the CNA or tech (and I should know, having spent time as a patient care tech while attaining my nursing degree), but the pay is far from similar.
There was a time when there were folks who were TV repair men (much like plumbers) and they would come to your house. They were NOT inexpensive. They didn’t break a sweat, but earned more than the average working stiff.
Same thing. You were paying for their knowledge and their ability to apply it.
You take away the monetary incentive, and many folks will not put forth the extra effort required to attain the degrees and expertise to work in the varied fields of medicine (or anything else). Few people do things simply to better humanity. That ‘ideal’ -while noble, does not put food on the table, put clothes on the kids, or pay for their education.
who decides what is ‘fair’? LJ is a pretty good example of the fallacy of that way of thinking. You aren’t paying for a Doctors ‘time’, you are paying for their expertise. The training and knowledge they have acquired and with which they put to use to diagnose and treat the problem you present them with.
Why would a nurse (RN), for instance, make so much more than a nurses aid or tech -when the tech or aid will typically put in far more manual effort during the same shift? The RN isn’t ‘working HARDER’ than the CNA or tech (and I should know, having spent time as a patient care tech while attaining my nursing degree), but the pay is far from similar.
There was a time when there were folks who were TV repair men (much like plumbers) and they would come to your house. They were NOT inexpensive. They didn’t break a sweat, but earned more than the average working stiff.
Same thing. You were paying for their knowledge and their ability to apply it.
You take away the monetary incentive, and many folks will not put forth the extra effort required to attain the degrees and expertise to work in the varied fields of medicine (or anything else). Few people do things simply to better humanity. That ‘ideal’ -while noble, does not put food on the table, put clothes on the kids, or pay for their education.
I have no problem with paying physicians & other health care professionals a wage commensurate with their expertise. However, I do have a problem with the exorbitant amount of money some of them feel their time is worth or the fact that they try to maximize their time/profit by booking patients too close together to give them proper service. (Which inevitably leads to overly-long patient wait times.) Medical treatment is not an assembly line!
Just how many Mercedes Benz does a doctor need? Or investment projects to lose money so they can write it off on their taxes? I’m not so altruistic to think that physicians shouldn’t make a good living. But where do you draw the line between “good” and “obscene”?
Like most things in life, YOU are completely free to decide NOT to use a particular doctor, hospital, insurance service or any other service if you feel they make too much money.
How many of ANYTHING does ANYONE need? Again, what you think is ‘obscene’ is your opinion only. Personally, I know MOST docs don’t make rediculous salaries -the ones that do, good for them. Doctors are by far, not the main reason our healthcare is so expensive. Not even close to being the reason.
I think many here miss a vital link in the problem chain. The cost of being in the healing business has gone through the ceiling. Used to be the doc’s office was on the first floor of his home, and maybe he had a nurse working for him, not any more. Have you seen the staff they have these days? One or two people who do nothing but fight with the insurance companies to get the office paid (my sister-in-law does that for a living, only she is so good at she works on percentage) another person who fights with insurance companies to get OK’s for tests, drugs, or specialists. Then there is a nurse or two. mal-practise insurance is through the ceiling because people sue at the drop of a hat. Hard fact is some people die despite the absolute best care. And this sue sue sue mentality results in a lot of unnecessary tests and procedures just to cover the docs back side, because if the one time he doesn’t order one, some one gets sicker or dies and he’s in the sh!t house. Of course if Doctors would do a little in house policing it would help, instead of covering.
There was also a time when people accepted as true that every outcome may not be optimal. But I recall reading somewhere that our country had the highest per-capita ratio of lawyers compared with any other industrialized nation in the world.
I know what you mean, Dusty. Until a few months ago, I was a critical care RN. NOW I have a new position (lateral transfer, but actually end up making a little more money than my critical care job because THAT job was a 36hr week job, this one is a 40hr week -2 14hr and 1 12h shift. Of course, I still pick up some overtime working with the neuro-lab a half-day or so a week. What can I tell ya? I’m one of the greedy types that a certain user here loves to hate. I expect to get paid for my efforts.
Anyway, my new job is precisely what you were talking about. ALL I do is try to make our cases meet the requirements set forth by the insurance companies so that the hospital gets paid. And I have to say that the requirements vary from company to company, and they will fail you and refuse to pay if they can. But in a nutshell, my job is to get the insurance companies to pay us. I’m in ER Case Management. I only handle emergency room cases.
I expect to keep this job for about a year, then probably get back into critical care, or possibly go to the transplant floor -met a tranplant RN and she really liked that kind of work, and after talking with her, it looks like it would be interesting -I’m glad I work in such a diverse field.
