EPISODE · Apr 28, 2021 · 30 MIN
Episode 1: 6 Degrees (Part 1)
from Healthcare Solutions · host Jean VanNoppen
Join Cristy with Scott Ray and Heath Potter in understanding current healthcare transparency, hospital negotiations, and reference-based pricing.Timestamps:00:00 Intro00:39 2020? See ya, wouldn't wanna be ya!01:25 Intro to 6 Degrees, Scott Ray and Health Potter02:37 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 www.custombenefits.work
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What this episode covers
To kick off Season 2, this conversation between Cristy Gupton, Scott Ray, and Heath Potter hovers around the current environment in healthcare transparency, negotiating with hospitals, and establishing a fair price. Employers today are at a tipping point, COVID ripped the rug out from everyone...except the big insurance companies and others who operate under the cover of secrecy and opacity. It's time for employers to stand up and demand to be treated fairly. Referenced Based Pricing is the tool that allowed that conversation to start. So, let's keep the conversation going.
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Episode 1: 6 Degrees (Part 1)
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