4 ms·

> But the bulk of their revenue comes from medicaid/medicare patients so prices basically round down to those reimbursement rates. This is totally wrong. Priva

> But the bulk of their revenue comes from medicaid/medicare patients so prices basically round down to those reimbursement rates. This is totally wrong. Private insurers reimburse several times what Medicare does. In fact, they're literally required by law to pay more. Medicare prices are so low that providers can't sustain themselves on Medicare reimbursements alone; the government provides a special subsidy to providers who see a lot of Medicare patients because otherwise they'd operate at a loss.

sjg007 9y ago
>This is totally wrong. Private insurers reimburse several times what Medicare does. In fact, they're literally required by law to pay more. That's not true. http://money.cnn.com/2014/04/21/news/economy/medicare-doctors/index.html http://money.cnn.com/2014/04/21/news/economy/medicare-doctor... And check out table 1 in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/
- chimeracoder 9y ago
  > That's not true. http://money.cnn.com/2014/04/21/news/economy/medicare-doctor.. http://money.cnn.com/2014/04/21/news/economy/medicare-doctor.... And check out table 1 in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/ Both of the links you provide corroborate what I said. Mass-market media tends to do a terrible job with reporting nuanced details like the medical billing process (or computer security), but even this watered-down CNN overview notes: > The differences can be stark. Private insurers allow an average of $1,226 for low-back disc surgery, while Medicare will only permit $654, for instance. And the gap can grow wider depending on where the patient is. In New York, insurers allow $1,352 for a gall bladder removal, compared to $580 for Medicare. Some services are more comparable. For office visits by established patients, for instance, Medicare will allow 92% of what insurers do. As for Table 1 in the paper you linked, every single city listed there receives less from Medicare than the black-box FAIR estimates. In the case of San Francisco, Medicare basically pays 33% of what the private insurers are estimated to pay. And that's just tracking Level 3 office visits, which is where the Medicare shortfall is generally the smallest (generalized and routine care).

sjg007 9y ago

>This is totally wrong. Private insurers reimburse several times what Medicare does. In fact, they're literally required by law to pay more. That's not true. http://money.cnn.com/2014/04/21/news/economy/medicare-doctors/index.html http://money.cnn.com/2014/04/21/news/economy/medicare-doctor... And check out table 1 in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/

chimeracoder 9y ago
> That's not true. http://money.cnn.com/2014/04/21/news/economy/medicare-doctor.. http://money.cnn.com/2014/04/21/news/economy/medicare-doctor.... And check out table 1 in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375010/ Both of the links you provide corroborate what I said. Mass-market media tends to do a terrible job with reporting nuanced details like the medical billing process (or computer security), but even this watered-down CNN overview notes: > The differences can be stark. Private insurers allow an average of $1,226 for low-back disc surgery, while Medicare will only permit $654, for instance. And the gap can grow wider depending on where the patient is. In New York, insurers allow $1,352 for a gall bladder removal, compared to $580 for Medicare. Some services are more comparable. For office visits by established patients, for instance, Medicare will allow 92% of what insurers do. As for Table 1 in the paper you linked, every single city listed there receives less from Medicare than the black-box FAIR estimates. In the case of San Francisco, Medicare basically pays 33% of what the private insurers are estimated to pay. And that's just tracking Level 3 office visits, which is where the Medicare shortfall is generally the smallest (generalized and routine care).