Episode 7: Doug Aldeen--Connecting Employers to Providers (Part 1)
Manage episode 313694745 series 3282256
Cristy Gupton and Doug Aldeen have a great discussion about fiduciary duty and how the new transparency law is going to make it easier for those charged with that task to honor their duty.
Timestamps:
00:00 Introduction
02:20 Doug Aldeen's background
03:28 So, what is the price?
04:30 If you're uninsured or underinsured you need to be asking for your hospital's Financial Assistance Policy
05:50 Quizzify's emergency consent is a gift to all people who might need emergent care...thank you, Al Lewis!
07:14 If you're being asked to sign something in the ER you must advocate for yourself or there's no turning back
08:00 No judge in the country would disagree with paying a fair price for ER services
09:11 Mark Watson of Union County, NC--a true fiduciary. Go back and listen to this episode https://www.custombenefits.work/news/2019/3/28-episode-6-t955b-362c7
10:18 Leon Wisniewski of Health Cost Labs, he's publishing hospital pricing online.
10:50 Information seeing the light of day means fiduciaries can't sit on their hands much longer
11:33 ERISA--the 2 faced law of convenience for health plan fiduciaries
13:00 Hey fiduciary! Start today!
13:46 "Turbocharging"...what's that?
14:55 Coming out of COVID, self-preservation efforts should lead CFOs to start looking at their health plans as ground zero
15:30 The transparency bill...should we get excited or roll our eyes?
16:10 The fine is no biggie, that's why eye-rolling might commence
16:40 But if hospitals really thumb their nose at it, will it jeopardize their Medicare status?
17:50 In light of value-based payments from Medicare, why do hospitals work so hard to get better payments from Medicare if it doesn't cover the costs?
18:43 So, does Medicare actually cover the costs or not? 7-9% margin in the aggregate.
19:30 Medicare Payment to Cost Report
21:21 Can't we all just get along? Willing buyers and willing sellers in mutually beneficial exchange. I could get behind that.
22:05 Employers come to the table...that's what starts the conversation.
22:30 Having some market intelligence when you come to the table at least gets the conversation started.
23:10 DPC rose from the underground during COVID, see also this video from Custom Benefits Solutions
23:55 First patients in the door are usually uninsured
24:23 Referrals are going to need to happen at some point
24:47 Never say "what do you charge"
25:08 Instead say "what would you accept if I pay cash"
25:55 A quasi-contract seed was planted right then
26:31 Employers can benefit from this arrangement without having to do all the work
26:52 The contracts are pretty straight forward especially when there are 2 willing partners
27:30 This is why being an independent doctor is so important
28:21 The ACA gave hospitals the license to steal
28:40 DPC is the smartest cost-containment strategy and if you start with it first it leads to many other innovations
29:00 Thank you! #letsfixhealthcare, www.custombenefits.work.
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