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Why Is It Important to Understand the Gap Between Employer and Medicare Payments?
Public payers underpay for medical services and you can hardly challenge hospitals. However, there is no relationship between a hospital’s prices charged to commercial payers and its volume of Medicare patients. There is never a good time to take on hospital prices, but the task is essential if the nation ever gets a grip on healthcare…
Embracing Transparency and Fiscal Responsibility: The Quest for Medicare-inspired Pricing Strategy
Major business organizations tend to use a self-funded, Medicare-based insurance plan. If you ask them what factors propelled them to transition out of their insurance plan, you’ll get to know they turned to what is known as “reference-based pricing” after seeing double-digit rate increases with each renewal of their carrier’s plan. This scenario is frustrating…
Steps to Use Medicare Pricer Tools to Calculate Potential Medical Expenses
Navigating the maze of healthcare costs can feel overwhelming for many due to factors like regional differences, provider rates, and the type of care provided that add layers of complexity. Fortunately, there is hope in the form of Medicare pricer tools, which can greatly simplify this process. These tools are specifically designed for TPAs, PPOs,…