Costs Are A Function Of What We Agree To Pay

J. Patrick Rooney is the Godfather of Cost Plus Insurance. Rooney acknowledged that hospitals may need to charge more than Medicare will pay, but contended that authoritative research showed that Medicare plus 25 percent is the reasonable amount for hospitals to charge.  J Patrick Rooney (1927 – 2008)

We now know many PPO contracts, even after significant “discounts”, reimburse 260%, 400% or more of Medicare allowable. Our medical costs continue to escalate  because we continue to agree to pay our health claims through secretive managed care contracts we cannot see.

Cost Plus / Reference Based Pricing provides a common sense approach. The golden age of managed care (PPO’s) has passed.

Below are 26 articles which will give the reader a good understanding of the issues surrounding health care costs and possible common sense solutions:

Reference Based Pricing Gains 10% Market Share……. Balance Billing & Provider Pushback……. Cost Plus Insurance To Make Offer To Hospitals?……. Selling Fear & Cost Plus Insurance……. Cost Plus / Medicare Benchmarking Continues To Gain Market Acceptance – Are PPO’s Facing Extinction?……. How Do You Evaluate Cost Plus Insurance Through Competing TPA’s?……. Milliman Analysis Of Cost Plus vs PPO Plan……. A TPA Divorce Can Be Revealing – How Many Mistresses Were There?……. Are You Paying Competitive Fees For Your Cost Plus Plan?……. Selecting a Third Party Administrator……. Guess Who’s Coming For Dinner?……. Hospitals Dismiss Significance Of Chargemaster Prices?……. You Can’t Fix What You Don’t See……. A Wave Change In Insurance Payment Models: Cost Plus, Not Bills ……. Reference Based Pricing, Individual Responsibility & Willing Providers……. Xerox, Eastman Kodak and Cost Plus Insurance……. How Some Cost Plus Health Plans Are Structured……. Cost Plus Audit – Legal Indemnification Fees Getting You Down?……. Supreme Court Ratifies Cost Plus Health Insurance……. Bill O’Reilley Opines on Cost Plus……. AMPS Achieves 100% Growth in 2012 – Touts Cost Plus Model……. Insurance Plan Pits Hospitals vs. Employers……. Medicare Based Pricing for Smart Payors……. Federal Judge Rules In Favor of Cost Plus Insurance……. Managed Care Under Siege…… Health Care Strategies for Texas Political Subdivisions…….

Once we rid ourselves of traditional thinking we can get on with creating the future” – James Bertrand

“Costs are a function of what we agree to pay” – Bill Rusteberg

www.CostPlusInsurance.com

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