Yeah, the state investigators wander all around it while the executives offer up lame ass excuses!
"Insurer details its unequal payments; Harvard Pilgrim lists hospital, doctor fees; State to open hearing on health care costs" by Liz Kowalczyk, Globe Staff | March 16, 2010
Newly released documents from a major insurer detail how certain hospitals and doctors are paid dramatically more than others for the same types of services, sometimes as much as three times higher.
Yeah, everyone knows why, and has for a long time!
This is election year bulls***, isn't it?
The vast inequalities emerged in documents filed by Harvard Pilgrim Health Care Inc., the second largest health insurer in Massachusetts, before the start today of state hearings investigating why health care costs are rising so rapidly....
As if no one knows!
The hospitals that commanded the highest fees for inpatient care in 2008 include powerhouses like Children’s Hospital Boston, Dana-Farber Cancer Institute, and the major Partners Healthcare hospitals, Massachusetts General and Brigham and Women’s, according to the insurer.
But smaller community hospitals also landed near the top of the list: tiny Nantucket Cottage Hospital, Fairview Hospital in Great Barrington, as well as South Shore Hospital in Weymouth, and Berkshire Medical Center in Pittsfield. For outpatient care, Martha’s Vineyard Hospital, Cooley Dickinson Hospital in Northampton, and Sturdy Memorial Hospital in Attleboro received fees similar to some of Boston’s large teaching hospitals, the insurer’s testimony showed.
Yeah, right, it's the community hospitals causing all the problems.
Un-flipping-real!
While community hospitals in isolated areas can command high fees for specific services, their impact on over all health care costs is small.
Then why is the agenda-pushing paper making a big deal out of it while pretending that Partners shit pile in the room doesn't stink?
Fairview Hospital ranked somewhat higher than the Brigham on its fees for outpatient care, for example. But Harvard Pilgrim paid the Western Massachusetts hospital, which is part of the Berkshire Medical Center network, just $153,421 in 2008 for care provided to its members. It paid the Brigham $129 million, almost twice as much as it paid the hospital in 2004, the earliest year for which Harvard Pilgrim provided testimony. Payments to many other providers also rose dramatically over those years.
Quite a disparity in payments, huh?
You know, I'm sick of being dumped on by Boston and the Globe.
Time to SECEDE, Western Massachusetts!
Executives at higher-paid hospitals said there are many legitimate reasons for their fees, including treating sicker patients....
I don't want to hear it.
Rick Weisblatt, senior vice president for health services at Harvard Pilgrim, said the payments show that while some large Boston teaching hospitals command higher fees because of their brand-name status and advanced care, smaller community hospitals can exercise market clout too, particularly when they have a geographic monopoly.
Yeah, you are paying for a NAME but it is the community hospital that is causing all the problems because they are the only one in the region.
Pfffft!
“They use that to leverage higher reimbursement,’’ he said. “The employers in that community generally want that hospital in the network. And the hospitals are not shy about threatening termination.’’
Really?
That's taking care of you, citizens!
The disparities in fees paid to physicians’ groups are just as great, and sometimes greater, the insurer said, with doctors affiliated with Children’s Hospital, Partners Healthcare, and Harvard Vanguard Medical Associates commanding the highest fees.
Well, we KNOW who the PRICE-GOUGING TROUBLEMAKERS are!
Harvard Pilgrim’s testimony mirrors the results of a yearlong investigation by Attorney General Martha Coakley’s office, which found that the highest pay goes to the providers with the most clout and not as a reward to those hospitals and medical practices that provide the highest-quality care. The attorney general’s report looked at payment rates from all large insurers. Unlike Harvard Pilgrim’s testimony, Coakley’s preliminary report did not identify providers by name.
Related: The Massachusetts Model: The AG's Amnesia
The Massachusetts Model: Nursing Home Will Make You Nuts
So when can we put her worthless ass in one?
A 2008 Globe Spotlight Team series focused on the Boston market found that a small number of hospitals such as Mass. General and the Brigham typically are paid 15 percent to 60 percent more for essentially the same work as other hospitals, even though the quality is not superior. It said the fees paid the Partners hospitals were helping to drive up health costs in Eastern Massachusetts, something critics have called the “Partners effect’’ but that Partners disputes.
Yes, it amazes me how the Globe minimizes their award-winning report.
Yup, EVERYONE KNOWS what the PROBLEM is and yet they act like they do not.
Other insurers that filed testimony with the state this month originally did not include their relative payment rates to providers. But after another request from the state, Blue Cross and Blue Shield of Massachusetts and Tufts Health Plan filed additional information in the past few days that similarly showed wide disparities in payment rates.
Related: The Massachusetts Model: What to Expect
Yeah, wait until they stiff Congress.
State regulators say the price of care should be based on quality and the actual cost of treatments, not on market power....
That's why WE NEED SINGLE-PAYER!!
In a written statement, Partners defended fees paid to its hospitals, saying the Brigham and Mass. General “care for the sickest patients, treat the most complex diseases, support research discovery and community health programs while subsidizing a broad range of other services which are not fully reimbursed, such as psychiatry and mental health.’’
Yeah, whatever, I just don't want to hear their rationalizations or excuses anymore.
Berkshire Medical Center and Fairview Hospital do not have contracts with Harvard Pilgrim, said Darlene Rodowicz, their parent company’s chief financial officer, so they mostly treat members who need urgent and emergency care, which could make the hospitals look more expensive.
“Our margin is less than 1 percent,’’ she said. “If we were abusing our market clout, we’d have huge margins.’’
Yeah, they are bankrupting the system, my little stink clinic out here.
Likewise, Craig Melin, chief executive of Cooley Dickinson, said market power is not why his hospital is ranked by Harvard Pilgrim as having the second highest fees for outpatient care. The hospital, he said, aims for a 3 percent margin in its negotiations with insurers, because of low payments from the federal Medicare insurance program and because it must subsidize physician practices in order to convince doctors to practice in the area.
Yup, and the feds are going to cut Medicare and Medicaid to make the national model work.
Well, at least the crap coverage will come in handy after the reaming, taxpayers!
Dr. JudyAnn Bigby, secretary of the Executive Office of Health and Human Services, is leading the effort to develop a new payment system for providers and said while hospitals have legitimate explanations for some of the inequalities, the differences probably should not be so large....
Related: The Massachusetts Model: Doctors' Diet
Anything with the word "global" in it just sounds wrong.
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See if you can sit through this testimony:
A top executive from Partners HealthCare, the large hospital and physician network that has been blamed by some for helping to push up health care costs, said yesterday the organization realizes it’s too costly and is working to become less expensive.
Sigh.
I think I need that health plan; I'm starting to feel ill off the smell.
But Thomas Glynn, chief operating officer for Partners, testified under oath at a state hearing that while prices charged by better-paid hospitals and doctors have contributed to rising health care costs, they don’t have as big of a role as state regulators have suggested.
Attorney General Martha Coakley recently found after a yearlong investigation that the escalating prices charged by the providers with the most market clout, including Partners’ hospitals Massachusetts General and Brigham and Women’s, are a main driver of the state’s spiraling health care costs.
Glynn said other factors, such as residents’ growing use of medical services, particularly as the population ages, are also important.
Yeah, it is ALL YOUR FAULT for GETTING HURT or SICK, patients!
And, he said 18 percent of the amount Partners charges Blue Cross and Blue Shield of Massachusetts, the state’s largest insurer, is to make up for inadequate payments from the government Medicare and Medicaid programs.
And THOSE are getting CUT by ObamaCare!!!
You are F***ed, Bay-Stater!
Now you know why you are a getting a "global payment" -- as if that will take care of everything? -- and a COVERAGE CAP!
Still, he said Partners is working to trim expenses by better managing the care of very sick patients to reduce hospital stays and by freezing salaries for some employees.
“Do we have a cost problem? Yes. Are we working on it? Yes. Are we working on it hard enough? No.’’ he said.
Glynn’s remarks came on the second day of Patrick administration hearings investigating why health care costs are rising so rapidly and to propose solutions.
As if they didn't already know!
Hospital and insurance executives answered questions from health care specialists, who were conducting the hearings with state officials, focused on the wide disparity Coakley’s staff found in how much insurers pay providers for essentially the same medical services.
While Partners hospitals are some of the highest paid by private insurers, Lawrence General Hospital is among the worst paid. Dianne Anderson, the president of the hospital, said that since just 25 percent of her patients have private insurance coverage, she has little market clout.
“It’s inexcusable that our hospital and physicians would be paid significantly lower for the same services,’’ she said. “It doesn’t make sense. We’re not asking to be paid as high as Partners. Maybe just Winchester [hospital].’’
Winchester Hospital president Dale Lodge also testified.
Andrew Dreyfus, executive vice president of health care services for Blue Cross, said the organization does “not have the market power to eliminate the disparities’’ on its own. “They are very troubling and they need to change. How do we do that? We work very hard to get the best rates we can.’’
But he said employers have not been interested in buying insurance coverage with limited networks of hospitals and doctors, which could force providers to compete by lowering prices.
Nancy Kane, a professor of management and associate dean for educational programs at the Harvard School of Public Health, said new research shows that hospitals that don’t have the market leverage to charge high prices from private insurers have been able to survive on, and even profit from, Medicare payments.
Which is WHY WE NEED a UNIVERSAL, SINGLE-PAYER PLAN like the REST of the INDUSTRIALIZED WORLD, readers!
She said this suggests that the ability to make up for low government payments by charging extra to private insurers may make hospitals less efficient.
And boost that bottom line, don't forget that!
“When you can get more money from the private sector you spend to that level,’’ she said. “It’s not clear to me that shifting costs is a good excuse’’ for higher prices.
Oh, that is the SOLUTION?
To SHIFT COSTS to YOU?!!!
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Still with me, readers?
"Hospital chief urges more cost oversight; Wants increased monitoring by state regulators" by Liz Kowalczyk, Globe Staff | March 20, 2010
State regulators should more closely oversee hospital costs, including setting prices, limiting new programs that make money for hospitals but drive up overall costs, and even sitting in on contract negotiations with insurers, Paul Levy, chief executive of Beth Israel Deaconess Medical Center, said yesterday.
Oh, you mean, like what they should be doing?
On the final day of Patrick administration hearings into the state’s escalating health care costs, hospital chief executives suggested a range of solutions but did not reach agreement on what to do first....
So don't expect anything to be done except a cap for you (and if you don't use it all? Back into the corporate treasury, 'eh?).
Levy said Massachusetts teaching hospitals have too many solid organ transplant programs, considering the relatively small number of patients who need transplant surgery....
Oh, no, readers! Not an organ-running ring in Boston at Beth Israel!
Hospital executives who testified agreed that, long-term, the state should scrap the current fee-for-service system, which pays hospitals and doctors a negotiated fee for each procedure and test and is widely seen as encouraging unnecessary care. Instead, they said, paying groups of providers a per-patient annual fee, called a global payment, to cover all a patient’s medical care would save money and lead to more coordinated care....
Again, WHAT if something BIG and UNEXPECTED happens?
You are F***ED, aren't you?
Dr. Gary Gottlieb — chief executive of Partners HealthCare, which includes some of the best paid hospitals in the state, Massachusetts General and Brigham and Women’s — said global payments ‘’allow for the least amount of patient choice’’ because providers have a financial incentive to keep patients within their network.
Oh, another Partners puke -- like we have one now!
“We would all have to prepare the public to accept some limitation of choice,’’ he said.
But with a HIGHER PREMIUM and DEDUCTIBLES!!!
Gottlieb said one reason his hospitals charge high fees is that they must make up for under-payments from the government Medicare and Medicaid programs.
WhereTF are your taxes going, America -- other than into bankers, politicians, and war-profiteering pockets?
Ellen Zane — chief executive of Tufts New England Medical Center, one of the lowest-paid teaching hospitals — said the state has to solve the wide disparity in payments to hospitals for providing essentially the same care before moving to global payments or “we will bake in the current market inequities and will have done nothing to control costs.’’
And that is what is going to happen, too.
That's the way they passed this bankrupting monstrosity.
They put the cost question in the future so Ted Kennedy could trump health care success in Washington.
Kinda strange him dying just before his health care jewel became tarnished, huh?
Ralph de la Torre, chief executive of Caritas Christi Health Care, said one option is to charge highly paid providers a sort of “luxury tax’’ that is then given to low-paid providers to help them build infrastructure.
Good luck with that one against all the campaign kickbacks flowing up the hill.
Several executives suggested that a culture change needs to occur among Massachusetts residents, who want complete choice of providers and low out-of-pocket costs for care.
Sigh!!!
Yup, GET READY to be PROPAGANDIZED and fed a PLATE of SHIT, Bay-Staters!!
Yeah, the culture needs to be changed, all right.
Start lining up, f***ers!
Assistant Attorney General Thomas O’Brien, however, suggested that it is providers, who engage in heavy advertising and aggressive expansion, that need to change. “It’s business; it’s big business,’’ he said. “Does there need to be a cultural shift on the part of providers?’’
Oh, no, not one their part. They aren't going to eat s***.
Yeah, the use of health care dollars for ADVERTISING is REALLY MAKING ME FEEL BETTER!
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A former employee was charged in federal court yesterday with embezzling more than $1 million from Beth Israel Deaconess Medical Center by allegedly depositing into his own accounts checks made out to the Harvard-affiliated Boston teaching hospital and by obtaining fraudulent refunds for hearing aids and other items.
Federal and local law enforcement officials said Richard P. Webb, 42, of Boston, who had worked as a practice assistant in the Ear, Nose and Throat Department, was charged with one count of health care theft and embezzlement.
Between January 2006 and April 2009, Webb allegedly took $1,054,712 by stealing checks others had written for services and goods, and by obtaining fraudulent refunds, according to a document outlining the charges.
It said he forged signatures and deposited funds into accounts he controlled.
If convicted, Webb faces up to 10 years in prison, to be followed by three years of supervised release, restitution, forfeiture of the money he allegedly stole, and a fine of more than $2.1 million.
In an agreement filed with the court, Webb agreed to waive indictment and plead guilty to the charge, according to the prosecutors.
The case was investigated by the FBI and the Boston Police Department. It is being prosecuted by the US attorney’s office in Boston.WhereTF is the state's attorney general?
WTF?!!!!!!!
What are we paying her for?
To tag along and issue reports on things after all the work has been done?
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