Dramatically influence drug prices by positive action – Drug maker admitted their price point was too high. But rather than lower the price they chose to share the profits with the provider in return for market share. This means that patients still have to cover their $2200 a month copay and that Medicare still pays the full amount.
Out-of-Network Bills for In-Network Health Care – The robo-call from the physicians’ billing service had the intended effect: I panicked. It sounded like a collection agency. I almost paid what it asked. When there’s a difference between the charge and the insurance reimbursement, and a health care provider tries to collect the difference from the patient — that is balance billing. Critics call it a huge problem.
Asymptomatic Carotid Ultrasonography Jumps, and With it, More Endarterectomies and Stenting – Physician self-interest may be a factor in the shift toward use of carotid artery ultrasonography to identify patients for vascular interventions. Diagnostic radiologists and self-referring cardiologists, vascular surgeons, and interventional radiologists may have benefitted financially from the procedures.
Curbing hospital readmission rates
New Efforts to Close Hospitals’ Revolving Doors – Hospitals are dispatching nurses, transportation, culturally specific diet tips, free medications and even bathroom scales to patients deemed at risk of relapsing. Readmission rates have decreased, in some months by as much as half.
Hospitals Face Pressure to Avert Readmissions – With nearly one in five Medicare patients returning to the hospital within a month — about two million people a year — readmissions cost the government more than $17 billion annually.
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