The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Rheuminations: New Rules for Rheumatologists

Rheuminations: New Rules for Rheumatologists

April 1, 2013 • By Simon M. Helfgott, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

You Might Also Like
  • Medicare Incident-to Billing Rules, Pitfalls
  • Rheuminations: Why the Obesity Epidemic Should Matter to Rheumatologists
  • Rheuminations: Rheumatologists Seek Better Understanding of Fibrosing Disorders
Explore This Issue
April 2013
Also By This Author
  • Why Rheumatologists Should Focus on Patients’ Cardiovascular Health
Simon M. Helfgott, MD
Simon M. Helfgott, MD

The late night comedian Bill Maher ends his weekly shows with a segment called, “New Rules.”1 These consist of a series of Maher’s opinions and commentaries on current events—some erudite, others caustic or a tad obscene. Though they are written to generate laughter, many of these rules belie a deeper analysis of some complex issues. In homage to Maher, here is my version of some new rules for our ever-changing world of healthcare.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

New Rule: Let’s Get Rid of Hospital Sticker Shock

New Rules For Rheumatologists
Is it time to institute a Monroney sticker for medical costs and cap hospital executive salaries?

Have you ever tried to decipher a medical bill? It might be easier to break the encryption codes used by the Allies during World War II. Using sleight of hand and some clever math (where numbers can be added but never subtracted), hospitals deliberately obscure the true cost of tests and procedures. With the anticipated major redesign of healthcare delivery, it is time for hospitals to wake up to the realities of the 21st century. Comparing prices for medical procedures is impossible because there is no transparency about cost. As Professor Uwe Reinhardt, a noted healthcare economist at Princeton University in New Jersey, observed, the pricing of hospital services is best described as “chaos behind a veil of secrecy.” Descriptors are often inaccurate and the charges can be mind boggling. For example, I have seen up to four separate charges listed for a single corticosteroid joint injection, including the professional fee, a facility fee, a technical charge, and the medication cost. A recent cover story in Time magazine depicts many egregious examples of price gouging in painstaking detail.2

Researchers from the University of Iowa in Iowa City highlighted the difficulty encountered when patients attempt to compare hospital charges for procedures.3 Using a standardized script, they surveyed more than 100 hospitals nationally and requested from each hospital the lowest complete “bundled price” (hospital cost plus physician fees) for an elective total hip arthroplasty for a 62-year-old, otherwise healthy woman. In this scenario, the patient did not have health insurance but had the means to pay costs out of pocket and was seeking the lowest complete price for the procedure. The question seemed fair enough. Isn’t this the way we shop for cars, computers, and cell phones? Shouldn’t medical shopping be the same? Get several price quotes, investigate those facilities that seem most capable of providing quality care, and book an appointment to meet with the team. You are probably not surprised to learn that the authors struggled to get price information for the procedure and what they observed was an 11-fold variation in the prices that were quoted. They ranged from a low of $11,000 to over $125,000! By comparison, Medicare and other large insurance payers usually pay hospitals between $10,000 and $25,000 for primary joint-replacement surgery.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 4 5 | Single Page

Filed Under: Practice Management, Rheuminations Tagged With: costs, Practice Management, salariesIssue: April 2013

You Might Also Like:
  • Medicare Incident-to Billing Rules, Pitfalls
  • Rheuminations: Why the Obesity Epidemic Should Matter to Rheumatologists
  • Rheuminations: Rheumatologists Seek Better Understanding of Fibrosing Disorders
  • HIPAA Privacy Rules Bring New Enforcement Guidelines

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.