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  #11  
Old 05-06-2016, 01:05 PM
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Originally Posted by Dr T Non-Fan View Post
Re the bolded: Perhaps the insurer could handle this, as it is in its best interest to keep its costs down as well.
I think they're called "case managers," but they are only used in high ROI situations.
So, who wants to buy my idea of small-case managers?
There are plenty of small case management companies. The focus is usually cancer and other expensive diseases. They help patients search for effective treatment.

Although they can certainly use your actuarial knowledge.
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  #12  
Old 05-06-2016, 02:09 PM
Dr T Non-Fan Dr T Non-Fan is offline
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There are plenty of small case management companies. The focus is usually cancer and other expensive diseases. They help patients search for effective treatment.

Although they can certainly use your actuarial knowledge.
Thank you for the compliment. (I think -- checking my sarcastometer...)

I was referring to the size of the case, not the size of the company.
ER, for example, would be a tough place to negotiate, with life on the line and such, and the hospitals do exploit this. (I.e., that makes them "evil.")

But, for, say, greenman's MRI, where he has time to shop on price, a small-case manager (note the hyphen) could be a valuable assistant. (Would require volume to sustain business and some sort of fee schedule.)
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  #13  
Old 05-06-2016, 05:11 PM
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Any insurance company should have some sort of maternity case management program to try and make sure the pregnancy makes it to full term and to help reduce costs in any way. We definitely do.
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  #14  
Old 05-06-2016, 05:42 PM
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Any insurance company should have some sort of maternity case management program to try and make sure the pregnancy makes it to full term and to help reduce costs in any way. We definitely do.
Honestly, why do you choose health insurance when you are voting for Bernie?
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Old 05-06-2016, 06:41 PM
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Any insurance company should have some sort of maternity case management program to try and make sure the pregnancy makes it to full term and to help reduce costs in any way. We definitely do.
These programs exist, and they're the best anyone's figured out so far. That being said, it never seems like care-management programs pass the simplicity test for good product design. Experts in the industry can navigate these without issue, but laymen who aren't used to a massive bureaucracy will have a lot of trouble.

Also, just out of curiosity, I decided to look at my health insurance company's website and see if I could price-shop for an MRI. It's easy to absolutely pick apart this website for design flaws, but once you factor in how much information has to be integrated, it's actually pretty good. Anyways, while I can find in network providers close to me, I can't find any kind of prices on the site. The booking tool is actually pretty well designed in general, but this is a pretty crucial piece of information to be missing for a well-defined procedure.
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  #16  
Old 05-06-2016, 10:16 PM
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Maternity management programs don't do shit and have embarrassingly low participation - even when incentives are offered.
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  #17  
Old 05-06-2016, 10:42 PM
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There's going to be a 25 - 50% difference just depending on whether you get a c-section or not. If you've already had one, most doctors don't do VBACs, so you can at least know you're getting another. . . but the variance on c-section deliveries is really high.

The geographic difference in costs to deliver babies is also very high.
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  #18  
Old 05-07-2016, 02:03 AM
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For those of you who has access to healthaffairs.org

http://content.healthaffairs.org/content/35/5/923

You need to pay for the access.
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  #19  
Old 05-08-2016, 03:21 PM
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Exactly. People would probably intentionally choose higher priced services believing price is tied to quality. I mean, would you put your kid under the knife of the cheapest surgeon in town?

And to your first point, no they couldn't. Some plans have a single copay per admit, some are copays per day perhaps up to a max, and some are % of allowed (and probably half a dozen others I don't even know about, plus combinations of those three). Hospitals don't keep all that information to be able to apply it for you, they don't know where you are in your deductible etc. It could be fairly misleading if they did.
You're a hospital apologist. Hospitals could look up the cost under your health plan, many do already. It's called a computer. Complicated? Just plug it into the insurer's program. EVERY SINGLE HOSPITAL I HAVE BEEN AT FOR THE LAST FIVE YEARS KNEW WHERE I WAS AT WITH MY DEDUCTIBLE.

As to putting your kid under the knife of the cheapest surgeon, no maybe people won't do that, but they will avoid the expensive ones. People buy the less expensive cars and less expensive food since they know they don't want to use up their money for a marginal increase in safety.

So quit apologizing for the hospitals. The simple fact is they benefit from not telling you the price in advance. They just care about the money.
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  #20  
Old 05-08-2016, 03:51 PM
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Actually, it's the insurance companies that have full information on your insurance plan and your deductible. The hospitals just bill the insurance company to find out this information before they send you a bill.

So why don't the insurance people provide the info? It seems to me like that is the place to put the transparency.
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