Saturday, February 20, 2010

A favorable report on containing health care costs

Rdan at Angry Bear digests the Maryland plan for managing health care costs:

One answer might be Maryland’s solution, a regulatory commission of seven governor-appointed-commissioners serving 4 year terms and having the responsibility of setting appropriate rates for hospital inpatient, outpatient, and emergency department care to manage its rising healthcare costs by limiting payment to the minimum amount necessary to cover hospital operating expenses, and requiring all payers (both private insurers and Medicare) to adhere to the rates set. This regulatory commission is nothing new for Maryland and has been in place for years. At one time, 30 other states regulated hospital rates only to have them fall by the wayside in the late seventies and earlier eighties with the deregulatory movement.
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So what’s in it for Maryland hospitals? Hospitals are reimbursed at a higher rate for treating those who are uninsured and result in being charity cases; Medicaid and Medicare accept the Commission’s pricing and pays Maryland hospitals at the same rate as private insurance. The standardization of pricing goes a long way towards eliminating operations in the red; offers greater financial stability for hospitals as variation caused by the economy is minimized; prevents leveraging by insurance or hospitals and creates comfortable operating margins; lowers hospital administration costs with standardized pricing by eliminating insurance payout variation; and creates transparency for hospitals and patients on pricing.

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