Hospitals Prioritizing People Getting Elective Procedures Over Emergency Patients Because They’re More Financially Attractive
A new analysis shows that hospitals earn about $700 more on each elective admission than on each patient admitted through the emergency department. Other news on health care costs and the industry focuses on value-based efforts, mergers and acquisitions, and a court clash between insurance giants.
The Washington Post:
Sorry, ER Patients. People With Elective Procedures Get The Hospital Beds First.
In a medical emergency, you may have a surprisingly difficult time finding a bed in a hospital. This is because elective admissions — that is, patients whose hospital stays have been scheduled in advance — take priority over emergencies. Such a preference for elective admissions might be unexpected, as emergency patients are, by definition, emergencies. But elective patients have attributes that make them financially attractive. They arrive promptly in the morning; they are well-insured; and they undergo invasive procedures that represent a significant revenue stream for hospitals. (Klasco and Wolfe, 2/24)
As Value-Based Efforts Lag, Push For Price Regulation Gains Momentum
For many years, the battle cry of healthcare cost warriors was, “Eliminate all those wasteful services.” More recently that evolved to, “Pay providers based on value rather than volume.” But there were always those who insisted the real problem was, “It's the high prices, stupid.” Now policymakers and experts who favor attacking price increases have gained momentum, with both congressional Democrats and the Trump administration pushing price-setting proposals. (Meyer, 2/23)
M&A No Longer Health Systems' Top Growth Strategy
Members of Modern Healthcare's CEO Power Panel say mergers and acquisitions may be losing their allure for health system leaders. Only three of the 24 health system CEOs who took the survey said M&A will be their primary growth strategy in 2019. Ben Isgur, the leader of PwC's Health Research Institute, said big mergers can be followed by years of integration and inward focus, which could explain why systems might keep a low profile this year. The survey results also show finances may slide in 2019, but CEOs insist it's happening for good reason. (Bannow, 2/23)
Anthem, Cigna Joust For Billions In Court Clash Over Failed Deal
There’s no dispute that a $48.9 billion merger announced in 2015 between health insurers Anthem Inc. and Cigna Corp. imploded two years later over antitrust concerns. Now, the question is whether one owes the other billions for the deal’s failure. A Delaware judge will start the process of deciding that pricey dispute Monday in a trial of dueling lawsuits by Anthem and Cigna over the merger meltdown. (Feeley and McLaughlin, 2/23)