Hospital news: Reimbursement caps mean some Calif. facilities reduce surgery prices

The program saved $5.5 million over two years, the study found. News outlets covered developments in the industry. 

Los Angeles Times: Hospitals Cut Some Surgery Prices After CalPERS Caps Reimbursements
When the California Public Employees' Retirement System told its Anthem Blue Cross members it would pay only up to $30,000 for a knee or hip replacement surgery, some patients shopped around for a cheaper hospital. What may be more surprising is that about 40 higher-priced hospitals in the state cut their surgery prices significantly to avoid losing patients. That response accounted for about 85 percent of the $5.5 million CalPERS saved over two years, researchers at UC Berkeley found, with the rest of the savings coming from patients opting for lower-cost hospitals (Terhune, 6/23).

Bloomberg: Surgery Cost Caps Save Pension Funds Without Hurting Health
The nation's largest pension fund and health insurer WellPoint Inc. cut medical costs 19 percent by capping the price of some surgeries, in the latest sign payers are taking a tougher line against rising hospital claims. ... Hospital charges have come under renewed scrutiny as the government seeks to increase the number of insured Americans under President Barack Obama's 2010 health-care law. Cost capping, which steers consumers away from high-priced providers that don't produce better outcomes, is gaining currency among employers grappling with the wide variation in hospital expenses, said Kenneth Goulet, a WellPoint executive vice-president. (Nussbaum, 6/24).

In the meantime, some doctors in Texas are not allowed to deliver babies at one hospital unless they've completed a three-year residency program, prompting legal action --

The Texas Tribune/The New York Times: A Policy Keeps Some Texas Doctors From the Delivery Room
But Dr. [Jeff] Alling no longer has a place to deliver babies in the county. The community hospital in Bridgeport that he helped found in 2008 merged its obstetrics unit with the Wise Regional Health System in Decatur in March. That hospital, where Dr. Alling delivered babies before he left for Bridgeport, instituted a policy in 2009 that allowed physicians to deliver babies only if they had undergone a three-year residency program specializing in obstetrics and gynecology. ... As a result, Dr. Alling and three other family physicians were denied obstetrics privileges at Wise Regional and are in legal mediation with the hospital. They estimate that 50 to 100 pregnant patients, the majority of whom live in rural areas and are covered by Medicaid, have been affected by Wise Regional's refusal to grant them obstetrics privileges (Aaronson, 6/22).

Kaiser Health News looks at hospital food and the health law --

Kaiser Health News: Better Hospital Food Brought To You By The Federal Health Law 
When Lauren Heath learned she had to spend an extra day in Rex Hospital after delivering her baby girl in May, she wasn't complaining. "It means I get three more, really good meals," said Heath, 29, of Wake Forest, N.C. ... Rex, part of the University of North Carolina Health System, is one of a growing number of hospitals nationwide that are tossing out their fryers and adopting hotel-style &quotroom service&quot where patients can order food anytime from a large menu.  Many are also setting up gardens to grow their own vegetables, inviting local farmers to sell produce in their lobbies and turning food presentations into works of art -- even when made puree style" (Galewitz, 6/24).

And costs are examined as hospitals hire doctors --

Tampa Bay Times: As Hospitals Hire Doctors, Costs Rise, Medicare Report Finds
As they buy up physician practices, hospitals promise to streamline patient care and cut costs. But just the opposite is happening, warns a federal Medicare advisory panel. The same services cost the government's Medicare program much more when performed on an outpatient basis at a hospital, rather than at a doctor's office. A common type of echocardiogram can be done in a doctor's office for $188. But for the same procedure in a hospital setting, the total payment is $453, reported the Medicare Payment Advisory Commission (Stein, 6/23).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.



The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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