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Monday, January 25, 2010

Here's to Your Health VI

Speaking of healthcare reform, there's a showdown in New York between Continuum Health Partners--a hospital chain that includes such presitigious facilities as Beth Israel Medical Center and St. Luke's-Roosevelt Hospital Center--and UnitedHealthcare, a giant insurance conglomerates ("Insurer Steps up Fight to Control Health Care Cost"). The major sticking point in contract negotiations seems to be UnitedHealthcare's requirement that hospitals notify the insurer within 24 hours of admitting a patient. Should the hospitals fail to do this, they may be charged a penalty of up to 50% of the claim.

The insurer claims that expedient notification will allow it to "improve the quality of care and cut costs by allowing case managers to jump in right away"--and presumably stop greedy doctors from performing frivolous procedures like emergency appendectomies.

But seriously, folks, let's give UnitedHealthcare the benefit of the doubt--let's say they are truly committed to cutting costs (which may be true--we imagine they've saved billions just by leaving the space out of the name UnitedHealthcare). Let's further assume that 24-hour notification will allow the company to cut costs without sacrificing patient care. If all this is true, then what's the big deal?

Hospital executives claim that 50% is an exorbitant penalty for a relatively minor inconvenience. We agree, but it seems an easy enough penalty to avoid. Hospital executives claim that 24 hours is too short a timeframe to mandate. We fail to see why.

We confess to a severely limited knowledge of computers, but how hard is it to program a computer to send an automatic notification to UnitedHealthcare whenever one of their clients is admitted? Visa is alerted immediately whenever we buy a pack of Chiclets; how complicated would it be to install similar programming at major hospitals? Heck, if UnitedHealthcare is so concerned about cost-cutting, they could even help pay for the upgrades.

We expect someone to get back to us immediately, either to explain the serious flaw in our logic (and no cynical comments about how insurers aren't really interested in patient care either!) or to thank us for solving yet another of the world's intractable problems.

1 comment:

  1. No jokes, no nothin'. It MAY be a misperception on my part, but it seems that whenever some sleazy, underhanded, even borderline illegal, misuse of medical insurance is noted in tyhe press, the word (s?) UnitedHealthCare pops up SOMEWHERE in the story... and not in a positive way. It's one of the reasons SOME of us turned down AARP's plan. I don't know why Unitedetc. made this demand but, trust me, it ain't good for the patient.