Healthcare cost and policy

The hospital industry's annual Medicare underpayment claim

Originally posted by

It’s almost Summer time, which means that it’s almost time for the American Hospital Association to start shouting about how Medicare doesn’t pay enough to cover services. They’ll say that to justify ripping off commercially insured patients.

As a reminder, the argument that Medicare reimbursements are insufficient is misleading.

Preston Alexander (in his excellent newsletter) put the NASHP | National Academy for State Health Policy data into a handy chart to show the operating profit 4,546 hospitals.

Medicaid operating profit
($20,481,466,509)
Medicare operating profit
$2,594,558,689
Commercial operating profit
$235,114,349,968
Total operating profit
$192,805,538,119

Hospitals at large are profitable on Medicare services. Medicaid under reimburses, but we commercial patients are being fleeced.

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Originally posted on LinkedIn, where the discussion and source links live in the comments.

About the author

Chris Vanderwolk is Director of Compliance and Innovation at OneDigital | Kistler Tiffany Benefits General Agency, where he helps brokers and employers navigate the regulatory complexity of employee benefits. An ERISA attorney with more than 19 years in the benefits industry, he specializes in translating what the law actually requires into language people can use.

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