Anthem Won ' t Pay for Outpatient MRIs and CT Scans in Hospitals

This article brought to mind a previous post discussing the price advantage that surgicenters have over hospitals in terms of total knee replacements and the price war than was now being waged over these patients (see:Tug of War between Hospitals and Surgicenters for Knee Replacements). It's a story similar to the price tags for imaging costs raised above. For decades, hospital executives have turned to the labs, radiology, and certain highly remunerative surgical procedures to generate revenue to offset the cost of critical care, for example, with its high labor input and higher costs. In this previous note, I suggested in that note that the surgicenters may be cherry-pickling younger and more robust patients in order to operate on them in an outpatient setting with few complications. All types of ambulatory patients, or course, can be seen in a free-standing imaging centers.So how can hospitals survive in the face of insurance companies and CMS taking steps to provide more competition for high-margin tests, procedures, and operations? First of all, hospitals do need some financial protection because they will never be able to compete with highly specialized providers. However, it seems to me that hospital executives need to understand that they can't be the costliest providers in all categories. They also need to take more steps to wring out expenses, particularly labor costs, across the board. Smaller hospitals may not have the managerial expertise or oportunity to...
Source: Lab Soft News - Category: Laboratory Medicine Authors: Tags: Clinical Lab Testing Cost of Healthcare Healthcare Business Hospital Executive Management Hospital Financial Source Type: blogs