[sunnyatlast]

Originally Posted by dbussone

This is an interesting article from the Kaiser Foundation. I was aware of this methodology when I was still working, but the article discusses outcome expectations. I've included the link below

Radical Approach To Huge Hospital Bills: Set Your Own Price | Kaiser Health News

EXCELLENT!

This is what should be happening in the healthcare marketplace. Put the consumer and payer in the driver's seat, not some other monstrous federal/state bureaucracy spending other people's money.

"Huffines first worked with ELAP on charges for an employee’s back surgery. The worker had spent three days in a Dallas hospital. The bill was $600,000, Hartter said.

Like many businesses, the dealership pays worker health costs directly. At the time it was working with a claims administrator that set up a traditional, “preferred provider” network with agreed hospital discounts.

The administrator looked at the bill and said, “‘Don’t worry. By the time we apply the discounts and everything else it’ll be down to about $300,000,’” Hartter recalled. “I said, ‘What’s the difference? That doesn’t make me feel any better.’”

Instead he had ELAP analyze the bill. The firm estimated costs for the treatment based on the hospital’s financial reports filed with Medicare. Then it added a cushion so the hospital could make a modest profit.

“We wrote a check to the hospital for $28,900 and we never heard from them again,” Hartter said.

Now Huffines and ELAP, which launched this service in 2007 and has been growing since, treat every big hospital bill the same way. The result has saved so much money that what the dealership and workers contribute for health costs stayed unchanged for six years while benefits remained the same, Hartter said....."