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Episode 1: 6 Degrees (Part 1)
Manage episode 313694751 series 3282256
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Join Cristy with Scott Ray and Heath Potter in understanding current healthcare transparency, hospital negotiations, and reference-based pricing.
Timestamps:
00:00 Intro
00:39 2020? See ya, wouldn't wanna be ya!
01:25 Intro to 6 Degrees, Scott Ray and Health Potter
02:37 Better for Less $$? Sign me up!
02:57 Medicare Rate Sausage? How is it made?
04:08 So, hospitals CAN cover their costs with Medicare reimbursement rates? Huh, that's not what they've been telling us.
05:18 And there's a wide variation in costs between hospitals nationwide.
06:14 So, if Medicare doesn't cover a hospital's reported costs you have to ask the obvious question...WHY?
07:50 The short answer is due to lack of transparency and lack of competition.
08:34 It's counterintuitive but higher quality costs less in healthcare.
09:20 It took RBP (reference-based pricing) to start the conversation around quality and fair pricing.
10:23 Back in the day, hospital's first knee-jerk reaction was to fight transparency. Wait, that's still happening today.
10:56 Now, if you don't present a PPO network card then you're considered cash pay. Which frankly helps employers pay a fair price.
11:22 Hey Mr. Hospital? Ever heard of the free market? It still exists.
12:22 Transparency alone is not the total solution.
13:26 FL Case Study.
18:24 In NC, people are getting "heated" over this discussion.
19:42 Balance billing isn't exclusive to RBP plans. What do you think a deductible and coinsurance is? Duh!
21:43 What happens when an employee has an accident? How does RBP work then?
21:58 First of all, don't forget about EMTALA. You can't be turned away at an ER.
22:39 If we have to, we'll show you the data to shame you into being fair.
23:17 But once in a blue moon you have to stand up to the bullies...with the help of 6 Degrees.
23:51 Even hospital VIPs admit their gross billed charges are meaningless numbers.
24:38 Smart plans are done with this.
25:00 2020 was supposed to be the year employers pushed back. I don't wanna talk about 2020.
26:32 Don't forget about quality. Is your broker using MediVi?
26:55 Proactive vs. Reactive.
27:26 Employees need to go on the same "learning journey" that the decision-makers went on.
28:29 Employers need to be transparent with their employees too. Just tell them the cold hard truth about the healthcare system.
29:48 See you next time! #letsfixhealthcare
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