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Doctors: Expand Medicaid

Local health care providers urge governor to agree

April 5, 2013

He had a meeting, but he still doesn’t have a decision. Go....

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MerryMary

Apr-05-13 9:37 AM

Medicaid is a very bureaucratic system that restricts services and payments. Why would the doctors and other entities want more of it.

Regarding the statement that WGH provides $5.8 million a year of charity, I refer you to the Time article about healthcare costs. ***********time****/time/magazine/article/0,9171,2136864,00.html The way hospitals have a list price, which has nothing to do with costs, but they accept a set, lower price from Medicare and Medicaid. So the $5.8 million is probaly list price may have only really cost them out of pocket and/or incremental costs of $50-500K. Read the Time article

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Brazil

Apr-05-13 11:22 AM

The amount WGH claims or for that matter any hospital claims as charity care provision is a grossly inflated amount that no one actually pays and that bears no relationship to hospital costs. You can discern that by looking at any insurance claim and the hospital accepted writeoff based on the particular contract.

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Carlton

Apr-06-13 8:31 AM

Brazil, you would be right if everyone was insured. The billed amount is generally 2 or more times what medicare will pay for a service. This allows the full insurance payment to be captured. An insurance may pay 1.5 times medicare rates. If only 1.2 times medicare was billed, some revenue would be lost. (This higher payment is how private insurances and their customers are helping fund federal programs by keeping providers in the black btw) Insurance companies through their contracts are able to adjust payments to what they authorize. Now take the uninsured patient. They are billed the same high amount ( By law everyone has to get the same charge ) and don't have a contract allowing them to reduce the fee. What is unpaid or (if the hospital is willing) reduced is legitimate charity since they could legally pursue all avenues of collection on the uninsured patient. Sadly, some people ARE stuck with the full amount.

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