By Julie Wasserman
Stop shopping discounts. Using a claims’ repricing to find an extra few discount points is not strategic, nor is it consultative. A monkey could throw some numbers on a spreadsheet and call it a day.
Carrier discounts are worthless because the discount itself is based on a completely ridiculous number. Hospitals are charging up to 800% over actual costs. (See below for the Top 25 states*) These figures are based on self-reported data, but it’s so obnoxious it almost seems like I made it up.
Then you have the carriers wielding their Discount Sword. Duh duh duh… here we come, to save the daaaayyyy… Maybe they’ve been able to negotiate a 50% discount, or perhaps even more, but that still leaves the plan sponsor to pay up to 375% of Medicare. That’s not deal, that’s a scam. (See the Top 25 States by cost as a percentage of Medicare).
This one-two punch is how hospitals get richer and carriers get fatter, and it’s time to take them both to the slaughterhouse. To make a real dent in spend you have to go after the source, and you do that with RBP. It’s bold, it’s aggressive and it works.
In a recent conversation about RBP a CFO said to me, “That’s an aggressive strategy, you have to really be feeling the pain to make that kind of move”. What’s your pain threshold? What’s your limit on the Pain Scale? Let’s talk when that smile turns into a frown. 😊 🫤 😐 🙁 😡
*Data pulled from NASHPs 2023 Hospital Cost Tool (HCT)
