Friday, November 16, 2012

Video Analysis: Are Healthcare Costs Out of Control?

We recently discovered the following video on The video details a few facts about healthcare costs that most consumers would probably find surprising.

Of course, the high costs of healthcare are nothing new for those of us in the industry. The question that everyone is clamoring to answer is: why? presents a few examples of gross over-pricing in the video, but none is more black-and-white than that of a “complex bilateral sinus procedure.” The procedure was priced at a major hospital, as well as the Oklahoma Surgery Center. The cost difference ends up at just over $27,000, but the patient would never see that bill, and never think to question the markup. Reason explains:
The Integris bill for the same nasal procedure went to Blue Cross of Oklahoma, so the patient had no compelling reason to question its outrageous markups. They included a $360 charge for a steroid called dexamethasone, which can be purchased wholesale for just 75 cents. Or the three charges totaling $630 for a painkiller called fentanyl citrate, which all together cost the hospital about $1.50.
Integris insists that some prices are raised to cover the cost of pro bono procedures, but Reason’s conclusion is that hospitals are intentionally marking up charges for insurance companies and government agencies to pay, knowing that no one is checking the numbers. It’s a shocking and somewhat believable argument, but is it true? Tell us your opinions in the comments section below!

Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at

No comments:

Post a Comment