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Hospitalist Recommends A Way Out Of Medicare And Medicaid

Ask yourself this question:  Would you pay 20-30% less in insurance premiums if it meant you were locked into one hospital system for your health care?  I would.  That’s  what one hospital system in Massachusetts is offering to provide.  It is, essentially, a concierge hospital plan.   You or your employer will pay a set premium, which the hospital is offering at a 20-30% discount, and you get all your health care needs in their system, only going to a competing hospital system if they are unable to provide your necessary services.

What a great idea.  In fact, it’s an idea I have thought about previously for Happy’s hospital.  Why shouldn’t Happy’s hospital offer direct premiums to large and small business employers in our city in exchange for reduced pricing?  I’d sign up.  My health insurance premiums cost over $12,000 a year.  In the eight years of my practice, I’ve probably sent over $100,000 to health insurance companies and realized less than $10,000 in expenses.

It’s a concept who’s time has come.  In fact, direct concierge hospital plans also offer patients and their employers the opportunity for tiered pricing for special amenities  (flat screen television service, pet therapy dog service, dialysis spa, designer ostomy covers, wine vending machines, free soda machines, gourmet cookies, closer parking,  door-to-door service, and 24 hour special access to their physicians and nursing staff).

No more worries about not getting paid for heart failure 30 day readmissions. Nobody’s keeping track with concierge hospital plans unless the employers demand it.  That is  who these hospitals are accountable to because they are the ones paying the bills.

You are an employer and you  want your employees to have more amenities during their hospital stays?  You can purchase the premium amenity plan for a few dollars more.  You want the doctor to come back and talk to you and your family a second time in the same day?  No problem.  You’ve signed up for the all access hospital pass.  Your doctor gets paid more for the service they are providing and you and your family get the extra service you’re paying for.

The vast majority of one’s health care in major cities can be provided in full service hospitals that have all the medical technology your illness could desire.  Instead of sending your $20,000 a year in family premiums to  an insurance company for you and your family’s healthy lifestyles, send it all to your local hospital and let them use it to improve their amenities and customer service should you ever need to get admitted.  If your hospital is non profit they might even send you a partial refund at the end of the year as a way of saying thank you for staying healthy.    Let’s take it one step further.  The time has come to use this concierge hospital plan model and its higher operating margins to exit the bankrupt Medicare and Medicaid National Banks and with that all their ridiculous unfunded mandates and unproven quality initiatives.  No more EMTALA.  Sorry patient faking a seizure in ER.  You’re going to have to go to a hospital that takes your Medicaid.    Imagine the reduction in administrative costs that would be realized by exiting government health care.  Sorry Medicare.  Sorry Medicaid.  You folks are going to have to find another hospital to get admitted to.  Cut your daily census by 85% and increase your income at the same time.  Now that’s a smart business solution.

Instead of having the government force quality onto hospitals, hospitals should have to compete with each other for direct concierge hospital plan dollars and force quality on to themselves through transparency.  Medicare and Medicaid are demanding hospitals do more with less.  I say it’s time for hospitals to do more with more competition and it’s not CMS dollars they should be competing for.  Those concepts are dead. They cannot survive.  Hospitals should be competing for  private money from employers looking for the best quality health care dollar.  It’s WIN-WIN for the hospital and it’s WIN-WIN for the employers and it’s WIN-WIN for the patient.

The only loser is the Medicare and Medicaid patient.  For those patients, I recommend they contact their Congressman and complain that nobody will take their insurance anymore. Hint.  It’s because they pay less than the cost of doing business.  And when that happens, every business will eventually go bankrupt unless they change their business model.  That’s exactly what these concierge hospital plans offer.  The perfect exit strategy.

*This blog post was originally published at The Happy Hospitalist*

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