Hospital Agrees to Cost-Plus 12%

A Texas hospital has signed a direct contract with a local employer and has agreed to accept cost-plus 12% as payment in full for services rendered. Specialty items, such as implants, will be paid based upon the hospital’s invoice from the manufacturer, plus a 12% margin.  There are no outlier (gotcha) provisions.  Certain in-hospital services will be reimbursed at 80% of RBRVS (20% below Medicare rates).

This is a very encouraging sign that hospitals will negotiate in good faith for the benefit of their customers.