California!!

[Meister]

Great. Not only was obamacare responsible for millions of Americans losing their health plans, now we're looking at the very real possibility of hospitals shutting down.

The only feasible solution would be to repeal obamacare before anymore damage is done.

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

That's like saying the Earth is the reason for sunsets.

 

[Greenbeard]

The increased revenues are because they are getting more patients that use Medical, not because they are getting more money per patient.

Sutter Auburn is receiving more money per inpatient case than they were prior to the Hospital Value-Based Purchasing program.

Hospitals get paid by Medicare under the inpatient prospective payment system, which assigns a certain dollar amount to every inpatient case they see.

Under the value-based purchasing program, each of those dollar amounts gets multiplied by a (small) adjustment factor whose value depends on the quality of the care the hospital provides. So for FY13, everything Sutter Auburn billed Medicare was multiplied by a factor of 1.004078237 (or, as KHN said, each of their payments was increased by 0.41%). They're a relatively high performer, so all of their reimbursements got a little bump.

 

[Quantum Windbag]

The increased revenues are because they are getting more patients that use Medical, not because they are getting more money per patient.

Sutter Auburn is receiving more money per inpatient case than they were prior to the Hospital Value-Based Purchasing program.

Hospitals get paid by Medicare under the inpatient prospective payment system, which assigns a certain dollar amount to every inpatient case they see.

Under the value-based purchasing program, each of those dollar amounts gets multiplied by a (small) adjustment factor whose value depends on the quality of the care the hospital provides. So for FY13, everything Sutter Auburn billed Medicare was multiplied by a factor of 1.004078237 (or, as KHN said, each of their payments was increased by 0.41%). They're a relatively high performer, so all of their reimbursements got a little bump.

They get a cut, then they get a bonus that partially makes up for the cut, and you want me to believe this means they make more money. Is that the same logic that demands that I think of spending more money as a cut in spending? I am just asking because I am really confused how cuts can be raises, but spending more is a cut.

 

[Greenbeard]

They get a cut, then they get a bonus that partially makes up for the cut, and you want me to believe this means they make more money.

This isn't rocket science. Multiplying numbers by a number greater than one makes them bigger. High-performing hospitals receive incentive payments that raise every payment they get above what they'd be getting if they weren't rewarded for quality. Those hospitals have adjustment factors greater than one (as I said, Sutter Auburn's was 1.004078237 in its first year). Or as the IPPS rule pointed out:

A hospital may earn a value-based incentive payment percentage that is greater than the applicable percent, which would result in that hospital receiving a value-based incentive payment adjustment factor that is greater than one and a higher base operating DRG payment amount for each discharge than it would have received in the absence of the Hospital VBP Program.

This is the situation in which Sutter Auburn finds itself. They make more money per inpatient case than they would in the absence of the value-based purchasing program. Because they're an example of high-value service delivery. Good on them.

Again, not rocket science.

 

[MeBelle]

Ahhh, just another part of the ACA that is unknown by many.

Why it should be unknown at this point I have no idea. Medicare has started tying some payments to the quality of care provided. That's a huge shift in an industry that's based largely on everyone being unaccountable.

I know about the quality of care system.

I also know what comes before it, after it and how easily payment can be denied.

 

[OnePercenter]

Great. Not only was obamacare responsible for millions of Americans losing their health plans, now we're looking at the very real possibility of hospitals shutting down.

The only feasible solution would be to repeal obamacare before anymore damage is done.

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

Insurance companies were forced to cancel health plans because of obamacare. The president should have checked with the insurance companies before he made a promise that he couldn't keep. Some of those folks who lost their health plans are still not covered.

Insurance companies could have easily modified existing plans to conform, but they (insurance companies) made that choice for their customers.

 

[OnePercenter]

Great. Not only was obamacare responsible for millions of Americans losing their health plans, now we're looking at the very real possibility of hospitals shutting down.

The only feasible solution would be to repeal obamacare before anymore damage is done.

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

Even Obama backed off that one.

Great. Not only was obamacare responsible for millions of Americans losing their health plans, now we're looking at the very real possibility of hospitals shutting down.

The only feasible solution would be to repeal obamacare before anymore damage is done.

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

That's like saying the Earth is the reason for sunsets.

To blame it on ACA would be admitting the ACA is an actual insurance company.

 

[william the wie]

ACA will be blamed for all deaths attributed to narrow networks and reduced numbers of ERs. Right or wrong that is where undecided voters will attribute the blame.

 

[OnePercenter]

ACA will be blamed for all deaths attributed to narrow networks and reduced numbers of ERs. Right or wrong that is where undecided voters will attribute the blame.

Idiots will blame ACA.

 

[dblack]

ACA will be blamed for all deaths attributed to narrow networks and reduced numbers of ERs. Right or wrong that is where undecided voters will attribute the blame.

True enough. A lot of people really hate ACA, and will look for anything they can find to justify its repeal. Think it's a good idea to ignore that?

 

[william the wie]

ACA will be blamed for all deaths attributed to narrow networks and reduced numbers of ERs. Right or wrong that is where undecided voters will attribute the blame.

True enough. A lot of people really hate ACA, and will look for anything they can find to justify its repeal. Think it's a good idea to ignore that?

Apparently that is the D talking point.

 

[dblack]

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

Insurance companies were forced to cancel health plans because of obamacare. The president should have checked with the insurance companies before he made a promise that he couldn't keep. Some of those folks who lost their health plans are still not covered.

Insurance companies could have easily modified existing plans to conform, but they (insurance companies) made that choice for their customers.

Off course. They could also agree to donate all their profits to charity. But they don't, because their primary responsibility is to generate profits for their stockholders. This is the core conceit of ACA; that insurance companies will take all the bennies granted to them by government, and use them to please their now captive customers. Yeah, right.

 

[Meister]

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

Even Obama backed off that one.

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

That's like saying the Earth is the reason for sunsets.

To blame it on ACA would be admitting the ACA is an actual insurance company.

If not for the ACA, the insurance companies wouldn't have changed their policies. It isn't rocket science.

 

[OnePercenter]

Even Obama backed off that one.

That's like saying the Earth is the reason for sunsets.

To blame it on ACA would be admitting the ACA is an actual insurance company.

If not for the ACA, the insurance companies wouldn't have changed their policies. It isn't rocket science.

If the insurance companies didn't have trash policies they wouldn't have to update them.

 

[OnePercenter]

Insurance companies were forced to cancel health plans because of obamacare. The president should have checked with the insurance companies before he made a promise that he couldn't keep. Some of those folks who lost their health plans are still not covered.

Insurance companies could have easily modified existing plans to conform, but they (insurance companies) made that choice for their customers.

Off course. They could also agree to donate all their profits to charity. But they don't, because their primary responsibility is to generate profits for their stockholders. This is the core conceit of ACA; that insurance companies will take all the bennies granted to them by government, and use them to please their now captive customers. Yeah, right.

So the primary responsibility of an insurance company is to generate profits for their stockholders?

 

[Meister]

To blame it on ACA would be admitting the ACA is an actual insurance company.

If not for the ACA, the insurance companies wouldn't have changed their policies. It isn't rocket science.

If the insurance companies didn't have trash policies they wouldn't have to update them.

I know you recieved your talking points, but....they weren't trash policies....no matter what the democrat politicians say.

 

[Quantum Windbag]

They get a cut, then they get a bonus that partially makes up for the cut, and you want me to believe this means they make more money.

This isn't rocket science. Multiplying numbers by a number greater than one makes them bigger. High-performing hospitals receive incentive payments that raise every payment they get above what they'd be getting if they weren't rewarded for quality. Those hospitals have adjustment factors greater than one (as I said, Sutter Auburn's was 1.004078237 in its first year). Or as the IPPS rule pointed out:

A hospital may earn a value-based incentive payment percentage that is greater than the applicable percent, which would result in that hospital receiving a value-based incentive payment adjustment factor that is greater than one and a higher base operating DRG payment amount for each discharge than it would have received in the absence of the Hospital VBP Program.

This is the situation in which Sutter Auburn finds itself. They make more money per inpatient case than they would in the absence of the value-based purchasing program. Because they're an example of high-value service delivery. Good on them.

Again, not rocket science.

Still missing the point.

 

[Quantum Windbag]

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

Insurance companies were forced to cancel health plans because of obamacare. The president should have checked with the insurance companies before he made a promise that he couldn't keep. Some of those folks who lost their health plans are still not covered.

Insurance companies could have easily modified existing plans to conform, but they (insurance companies) made that choice for their customers.

Damn, that was funny.

The regulations written by HHS prohibited them from modifying plans to confirm with the new coverage. The very act of making them complaint forced them to cancel the policies because that is what the program was designed to accomplish. Everyone with an IQ above the freezing point of helium understand this, which is why you are the only Obamazombie in history to still be making this absurd claim.

 

[Quantum Windbag]

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

Even Obama backed off that one.

Insurance companies are the reason Americans are getting their healthcare changed to other policies.

That's like saying the Earth is the reason for sunsets.

To blame it on ACA would be admitting the ACA is an actual insurance company.

What?

 

[dblack]

Insurance companies could have easily modified existing plans to conform, but they (insurance companies) made that choice for their customers.

Off course. They could also agree to donate all their profits to charity. But they don't, because their primary responsibility is to generate profits for their stockholders. This is the core conceit of ACA; that insurance companies will take all the bennies granted to them by government, and use them to please their now captive customers. Yeah, right.

So the primary responsibility of an insurance company is to generate profits for their stockholders?

Yeah.... ? Is this as novel concept to you?