Updates on Nursing Home Safety, Hospital Pricing Rules
Two recent pieces of journalism are worth a close read.
The New York Times published a devastating indictment of how nursing homes have gamed government quality rules to mask low staffing and care levels and still qualify for top government ratings. The headline was tough to stomach over breakfast:
Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public
As I recently posted, it’s never been more important to do your homework in choosing a nursing home for yourself or a loved one. The Times story provides troubling specifics on what happens when people depend on flawed government ratings systems, which is the case with Medicare’s Nursing Home Compare tool.
The second story I want to share comes from Healthcare Dive. It took a close look at five hospitals around the country and how they are complying with new Medicare rules that took effect January 1. They require hospitals to publicly post the prices they’ve negotiated with different health insurers for many common health procedures:
Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
As I recently wrote, “The government’s price transparency rules would require health insurers to provide consumers with ‘personalized out-of-pocket cost information, and the underlying negotiated rates, for all covered health care items and services, including prescription drugs, through an internet-based self-service tool and in paper form upon request.’
The Healthcare Dive story found enormous variations in the prices hospitals negotiated with participating health insurers for identical procedures. Many hospitals have not yet complied with the new rules, and even many that did so have made it hard to find the information or easily compare the different charges.
This will get easier over time, providing consumers with a powerful set of new healthcare shopping tools. In the meantime, self-insured employer health plans and insurance companies will be poring over the new data and looking for ways they can reduce the charges paid on behalf of the individuals covered by their plans.