A Brownsville hospital is reported to have soaked an insured patient thousands of dollars for an emergency room visit recently. A brief visit to the emergency room produced billed charges in excess of $4,000. Thankfully the insured had the “Caring Card”, BCBS of Texas insurance. Billed chargesof more than $4,000 were discounted down to about $2,300.
Maybe the problem is regional – http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande
A brief 45 minute emergency room visit at a local Brownsville hospital for only $2,300. Sounds reasonable?
Molly Mulebriar and her team will submit their full detailed and documented report in a few days.
Could this be an example of egregious hospital cost gouging? Do PPO’s really negotiate good deals for us or do they owe a duty of loyalty with the providers they sign up? And, if what BCBS salesmen tell us, that they have the best pricing of any competitior in the market, how much would this emergency room bill had been under HealthSmart, Texas True Choice, Aetna, PHCS, United HealthCare, or any number of other PPO networks?
Could this be the reason the Brownsville Independent School District’s group health plan is costing the taxpayers over $40,000,000 per year? Does the BISD administration really know what kind of pricing Texas True Choice has negotiated with area providers upon the taxpayers behalf? Did the Brownsville medical community cut their costs to BISD through the Texas True Choice network as compared to the costs negotiated by HealthSmart the year before? (See http://blog.riskmanagers.us/?p=4143).
Editor’s Note: PPO’s negotiate provider pricing behind the curtain and will refuse to disclose the terms of their contracts with consumers. Medical providers will not disclose the contents of the contracts either. So no one other than the PPO networks and the providers know the true cost of health care – yet they expect consumers to pay without question. Almost all PPO contracts prohibit the consumer from auditing their medical bills. PPO contracts are Contracts of Adhesion. Brownsville ISD is spending over $40,000,000 per year on medical bills for their employees. This could be cut in half without reducing benefits. It has been done before and can be done in Brownsville. What is stopping the BISD from taking control over their raging healthc are costs?
