LRGH Billing

[Slickcraft]

From today's LDS, LRGH bills at 3.16 times estimated cost of services, highest of sampled area hospitals.

LACONIA — According to the data released earlier this month by the federal Centers for Medicare and Medicaid Services (CMS), billed charges for selected common services at Lakes Region General Hospital (LRGH) are relatively high compared to those stated by a sample of other hospitals in the state.
For the first time, CMS published the posted charges, together with the Medicare reimbursements, of some 3,300 hospitals across the country for the 100 most frequently billed in-patient services, which represent about 60-percent of all Medicare billings. The fiscal year 2011 data shows wide disparities in charges among hospitals for treating the same condition. For example, Bloomberg News found that the price of treating pneumonia and pleurisy, the most common of the 100 services, ranges from $5,093 to $124,051 while for the treatment of psychoses, which displayed the greatest discrepancies, the most expensive hospital charges $144,523, 52 times more than the least expensive.
Medicare reimbursement rates, which reflect what CMS calculates is a reasonable payment for a particular service, represent approximately 90-percent of the actual estimated hospital costs for providing those services. But, on average, they also represent only about a quarter of the amounts hospitals actually bill for. And they vary much less from hospital to hospital than the hospitals' own published rates.
In taking a closer look at the data regarding LRGH, The Daily Sun picked treatments for five of the 100 services — chronic obstructive pulmonary ideas (COPD), simple pneumonia and pleurisy, heart failure and shock , major joint replacement and kidney and urinary tract infections, each corresponding to medical conditions frequently treated at the hospital. The charges and payments for these treatments at LRGH were compared to the data reported for five other New Hampshire hospitals — Frisbie Memorial Hospital in Rochester, Wentworth-Douglass Hospital in Dover, Cheshire Medical Center in Keene, Concord Hospital in Concord and Portsmouth Regional Hospital in Portsmouth. (See chart, p. 12)
As a multiple of Medicare payments, LRGH scored the highest among the nonprofit hospitals at 3.26 selected for comparison. That is, the hospitals published rates — "chargemasters", they are called — are an average of 3.26 times the Medicare reimbursement rates. Wentworth-Douglass followed closely at 3.24. They were the only hospitals in the group with multiples of more than three. Cheshire Medical Center, with a multiple of two, ranked the lowest.
Portsmouth Regional Hospital, which is owned by Hospital Corporation of America and the only for-profit hospital in the group, ranked the highest of the six with charges 4.14 times more than payments, Moreover, Portsmouth charged the most for four of the five treatments focused on, with major joint replacement the lone exception. The data indicated that for-profit hospitals accorded the highest multiples throughout the country.
Among the nonprofit hospitals, LRGH charged the most for three of the five treatments — COPD, pneumonia and pleurisy and kidney and urinary tract infections — and not much less than Wentworth-Douglass for a fourth — heart failure and shock.
Henry Lipman, senior vice-president for financial strategy and external relations at LRGH, said that pricing reflects the character of the population the hospital serves and treatment the hospital provides. More than 60-percent of the in-patients served at LRGH are enrolled in Medicare, the greatest share of any of the 13 largest hospital in the state.
Lipman said that that of the three hospitals in the state that receive a specific base rate for Medicare patients, LRGH receives the lowest rate. Likewise, the hospital serves a relatively large population enrolled in Medicaid, the federal program for the poor. The higher charges, Lipman explained, reflect the shifting of costs to privately insured patients to offset the difference between the cost of treating those enrolled in Medicare and Medicaid and the reimbursements received.
At the same time, Lipman noted that LRGH mix of patients includes a relatively high proportion with chronic and recurrent conditions that do not lend themselves to procedural solutions but require continual monitoring, care and treatment. These so-called "medical cases," he said are generally more costly than conditions that can be treated and reversed by surgical procedures.
On the other hand, Lipman said that to retain the most profitable services, both for in-patients and out-patients, they must be priced competitively. Among the five selected treatments, major joint replacement is an example of this competitive pricing. Only Cheshire Medical charges less for the procedure than LRGH among the six hospitals.
In releasing the data, CMS said that it intended to bring a measure of clarity to what Ron Pollack, executive director of Families USA, an advocacy group, called "the craziest of crazy quilts." Some commentators have been quick to stress that very few patients pay the posted charges of hospitals. Insurers bargain discounted rates while most hospitals, including LRGH, offer financial assistance or provide charitable care, to uninsured and needy patients.
However, others claim that hospitals use the posted charges to strengthen their bargaining position with the insurance companies and sustain income at discounted rates and, by charging few the full rate, inflate the value of the charitable and uncompensated care they provide.

[Happy Gourmand]

Imagine a banana in a supermarket. It costs $1 for those paying with Visa, $3 for those paying with MasterCard, and $32 for those paying with cash. You can't sign up for Visa until you're 65, and you can only get a MasterCard if you have a nice employer or a decent income. Worse, customers have no idea that such price discrepancy exists. They don't even know how much they'll pay for the banana until long after they've eaten it.

That would be absurd. No one would put up with it.

But it's how our health care system works.

[Billy Bob]

These are the issues that Obama care will finely be dealing with . Just have to get it going

[winnipiseogee]

Originally Posted by The Phantom Gourmand

Imagine a banana in a supermarket. It costs $1 for those paying with Visa, $3 for those paying with MasterCard, and $32 for those paying with cash. You can't sign up for Visa until you're 65, and you can only get a MasterCard if you have a nice employer or a decent income. Worse, customers have no idea that such price discrepancy exists. They don't even know how much they'll pay for the banana until long after they've eaten it.

That would be absurd. No one would put up with it.

But it's how our health care system works.

You are right but you are forgetting one important part - 25% of the people get their bananas for free!!!! If everyone just paid the same price we could all buy our bananas for $4!!! Wouldn't it be nice if everyone paid for what they got and got what they paid for!

[secondcurve]

Originally Posted by Billy Bob

These are the issues that Obama care will finely be dealing with . Just have to get it going

If only your statement were true.

I'm actually looking forward to Obama Care at this point because I'm certain its implementation will guaranty the Republicans significant gains in the 2014 midterms.

[RailroadJoe]

to BillyBob Huh

[songkrai]

I had to be admitted to a hospital for a somewhat common issue - 30 years ago. Started in Emergency Room then admitted. That hospital was a not for profit or non-profit hospital.
I received two bills.
One from doctor.
One from hospital.

Recently, I had to be admitted to a hospital for same issue.
Everything just about the same.

This last time I received 17 bills.
Many of the hospitals are now private for profit corporations.
Each and every entity inside the hospital is now owned by a for profit company.
Emergency Room - one company.
Lab in Emergency Room - another company.
X-Ray in Emergency Room - another company.
Pharmacy in Emergency Room - another company.
Once admitted - Exact same lab work - another private company.
Food service another company.
Sheets/laurdry another company.
Doctors in hospital another company.
Specialists in hospital another company.
X-Rays another company.
Pharmacy another company.
And many others.
Even the hospital billing was contracted out.
I received a bill for the billing.

I later went back to obtain a copy of the bill. The billing company seemed amazed that someone would actually ask for a copy of the bill.
10 point font about 9 pages.
Fifty cents per page.

[tis]

Isn't that just ridiculous. And insurance covers certain companies or labs or whatever, so you darn well better make sure you go to the right company or you will have to pay the bill yourself. Or as they say, it goes toward your deductible. (I still call that having to pay it.)

[mcdude]

From yesterday's Laconia Sun. They have taken five procedures and listed the cost at LRGH, Frisbee in Rochester, Portsmouth, Concord, Dover and Keene Hospitals. Huge discrepancy in what you are charged....

To see the chart, click on the link, click on "Click here to read" (in the middle of the newspaper pic) and then scroll to p. 11.

http://issuu.com/dailysun/docs/lds5-23-13

Here's one example; Major Joint replacement

LRGH - $18,600
Frisbee - $11,500
Dover - $14,400
Keene - $12, 000
Portsmouth - $20,800
Concord - $15,900

Wouldn't it be nice if everyone could pay for what they needed?

[tis]

It's funny you should post that. We were just discussing that at work the other day. Isn't it amazing that there can be such a difference in prices??!

[Happy Gourmand]

Originally Posted by mcdude

From yesterday's Laconia Sun. They have taken five procedures and listed the cost at LRGH, Frisbee in Rochester, Portsmouth, Concord, Dover and Keene Hospitals. Huge discrepancy in what you are charged....

To see the chart, click on the link, click on "Click here to read" (in the middle of the newspaper pic) and then scroll to p. 11.

http://issuu.com/dailysun/docs/lds5-23-13

Here's one example; Major Joint replacement

LRGH - $18,600
Frisbee - $11,500
Dover - $14,400
Keene - $12, 000
Portsmouth - $20,800
Concord - $15,900

Wouldn't it be nice if everyone could pay for what they needed?

Could all this attention to all the disparity in medical costs be the beginning of some finally much needed health care reform?
I personally feel that it is not only necessary, but the result would be much lower health care costs for all. It's time for the health care industry to come clean and stop ripping us off.

[AB_Monterey]

Originally Posted by Billy Bob

These are the issues that Obama care will finely be dealing with . Just have to get it going

My agent is telling me that the expectation is that premiums will go up AT LEAST 40% on 1/1/2014.

That's not "finely" (sic)

[Happy Gourmand]

The Unions don't seem to like some of the latest developments with Obamacare.

http://www.washingtonpost.com/blogs/...te-shock-here/

[ITD]

Originally Posted by The Phantom Gourmand

Could all this attention to all the disparity in medical costs be the beginning of some finally much needed health care reform?
I personally feel that it is not only necessary, but the result would be much lower health care costs for all. It's time for the health care industry to come clean and stop ripping us off.

Health care reform is done, the problem is fixed, what is wrong with you people?

[BroadHopper]

Originally Posted by The Phantom Gourmand

Could all this attention to all the disparity in medical costs be the beginning of some finally much needed health care reform?
I personally feel that it is not only necessary, but the result would be much lower health care costs for all. It's time for the health care industry to come clean and stop ripping us off.

It's not the health care system that is ripping us off, It is Obamacare!

[RailroadJoe]

Health care costs are like shopping for groceries. Different prices at Market Basket, Shaws, Walmart and Hanniford, even the same store at different towns.

[fatlazyless]

....say-hey....it's too expensive to get sick...it's just a whole lot cheaper to stay healthy....especially if you have no health insurance!

As Wolfeboro summer guy, Mitt Romney, said last October: "If you need medical care, then you should go to the emergency room!"

...here in central New Hampshire....it seems like people do not get anywhere near the opportunity to walk as much as in a city like New York or Boston. People depend on their car for going anywhere, and their only walking activity may just be walking from their car, through a store parking lot, and into the store.

...here's hoping the www.wowtrail.org will get built out to nine miles of Winnipesaukee waterfront walking and bicycling paved trail, and create a new walking-pedaling go-to, scenic exercise area for both locals and visiters...

[LakeSnake]

Originally Posted by BroadHopper

It's not the health care system that is ripping us off, It is Obamacare!

Since our leaders in Washington did not take the time to understand the Obamacare proposal prior to enacting it into law I strongly suggest that anyone over the age of 20 take the time look into, read up on, talk to people that have lived under a governement run helathcare system (social medical care) such as Russia, Canada, etc. Also there are several abbriged versions of Obamacare out on the internet to make that readable as well.

I have talked to several from Russia and you really won't belive what you are hearing.

If the current trend continues I hope I die before I get old (if I havent already- gotten old that is)

[P-3 Guy]

Originally Posted by LakeSnake

Since our leaders in Washington did not take the time to understand the Obamacare proposal prior to enacting it into law I strongly suggest that anyone over the age of 20 take the time look into, read up on, talk to people that have lived under a governement run helathcare system (social medical care) such as Russia, Canada, etc.

There's no need to find a Russian or Canadian to talk to. If you want to know what it's like to "live under a governement run healthcare system," just ask any American who's age 65 or older.

[tis]

We have friends in Canada and they have to buy private health care. Otherwise they would not get good care at all.

[jrc]

We all drive different cars, we all eat different food, we all live in different houses, why would we all expect to get exactly the same healthcare at exactly the same cost?

We should have safety net health insurance for the people unable to work, the rest of us should get the best care we want and can afford.

[secondcurve]

Originally Posted by mcdude

From yesterday's Laconia Sun. They have taken five procedures and listed the cost at LRGH, Frisbee in Rochester, Portsmouth, Concord, Dover and Keene Hospitals. Huge discrepancy in what you are charged....

To see the chart, click on the link, click on "Click here to read" (in the middle of the newspaper pic) and then scroll to p. 11.

http://issuu.com/dailysun/docs/lds5-23-13

Here's one example; Major Joint replacement

LRGH - $18,600
Frisbee - $11,500
Dover - $14,400
Keene - $12, 000
Portsmouth - $20,800
Concord - $15,900

Wouldn't it be nice if everyone could pay for what they needed?

I wonder if the outcomes at each hospital might be different, too?

[NoBozo]

Originally Posted by secondcurve

I wonder if the outcomes at each hospital might be different, too?

Not to mention..one patient weighs in at 350# and has diabetes, high blood pressure and a heart murmur, and the second patient weighs 125# and in otherwise good health...except she smokes. Extreme cases..yes..but it goes to show there can be a lot of combinations and variables that can run up the bill. NB

[ITD]

Originally Posted by secondcurve

I wonder if the outcomes at each hospital might be different, too?

And when I see lists of final numbers like this with out a detail list of what is exactly being billed I get suspicious. Different hospitals bill services differently, for example one hospital may bill for hospitalists, while another doesn't and the hospitalists bill on their own. This is typical low info voter bait, just a small, probably mis-representative, piece of info on which huge decisions are made.

[fatlazyless]

B M I tax: http://en.wikipedia.org/wiki/Body_mass_index; anyone with a BMI that's #25 or greater will get slapped with a BMI tax of $250/month, a fat tax, to help pay for single-payer health care (period!)!

It's either shape up, or ship out!

Lose the fat, and vote Democrat!

[Rusty]

Originally Posted by mcdude

From yesterday's Laconia Sun. They have taken five procedures and listed the cost at LRGH, Frisbee in Rochester, Portsmouth, Concord, Dover and Keene Hospitals. Huge discrepancy in what you are charged....

To see the chart, click on the link, click on "Click here to read" (in the middle of the newspaper pic) and then scroll to p. 11.

http://issuu.com/dailysun/docs/lds5-23-13

Here's one example; Major Joint replacement

LRGH - $18,600
Frisbee - $11,500
Dover - $14,400
Keene - $12, 000
Portsmouth - $20,800
Concord - $15,900

Wouldn't it be nice if everyone could pay for what they needed?

The dollar numbers are not for "Major Joint replacement" as you have stated.
According to what I see in the chart, the dollar numbers that you posted are for Kidney & urinary tract infections.
Also When I go to the chart it is on page 12 and not page 11.

The dollar numbers on the chart are "average charge" so we don't know what the high and low dollar values are. It's too bad that our government had to release these very deceiving dollar numbers.

[RailroadJoe]

My BMI (just calculated) is 33. Guess I'm in for a shock.

[NoBozo]

I had had a Abdominal Aeortic Anuresum. It was "fixed" at Newport Hospital (RI). Five months later I had a problem. I went back in and the same doctor decided I needed a "Stent".

I was on the table and Awake while he was doing the procedure. The nurse was having problems with the "Flouroscope" (A kind of live Xray). The machine was overheating. So the doctor told her to turn it OFF..and he would then tell her to turn it ON..to keep the machine cool. OFF..Then ON. He was following the path of the catheter he was feeding into my body.

----------------------------------

Later: We (Blue Cross) got a bill for $8,000 for "durable medical devices"..or something like that. The hospital was charging Blue Cross for the FAILURE of THEIR machine. My wife called Blue Cross to tell them this charge was not logical. Blue Cross PAID the bill anyway.

Five months later I had More problems...but that is another story. Mass General Hospital in Boston saved my life...with the Fourth intervention. That was 15 years ago. Mass General didn't have much to work with..hamburger.. two previous hospitals had screwed it up. Happy to still be here now. NB

PS: Not looking for sympathy..just commenting....

[RailroadJoe]

NoBozo The smartest thing you did was to go to Mass General. I had my thermo nuclear scan done there over 30 years ago. They stated instead of open heart surgery, I could take medicine and watch my diet. I am still here , still have heart problems but no open heart. They are the greatest hospital around in my estimation.

[Chaselady]

MGH, as in "Man's Greatest Hospital". I spent my career there,and am proud to say it is the best. I was also a patient there. They made my open heart surgery seem like a walk in the park. It's not important who charges the most, it is who has the most experience.

[jetlag100]

I was hospitalized at LRGH for 7 days over a year ago. All bills were paid, I thought. About a month ago I received a bill that said I owed them 545$, but if I payed now it would only be 130$ Felt like I was on "Let's Make a Deal"

[ApS]

Originally Posted by jetlag100

I was hospitalized at LRGH for 7 days over a year ago. All bills were paid, I thought. About a month ago I received a bill that said I owed them 545$, but if I paid now it would only be 130$ Felt like I was on "Let's Make a Deal"

Could be!



Are they "dealing" to avoid LRGH lawyers' collection-fees?

[magicrobotmonkey]

Originally Posted by jetlag100

I was hospitalized at LRGH for 7 days over a year ago. All bills were paid, I thought. About a month ago I received a bill that said I owed them 545$, but if I payed now it would only be 130$ Felt like I was on "Let's Make a Deal"

I got a $1000 bill from LRGH for our hospital stay for my son's birth about a week after his 2nd birthday. I called them up and they said they *lost* it...? And they had never submitted it to my insurance. I was no longer with that insurance company *and* they no longer operated in NH. You can imagine the exciting hours I spent on the phone getting that worked out. LRGH's billing dept. is terrible. We've had three ultrasounds with our currently pregnancy and so far I have received 5 separate bills that say just "Ultrasound" all for different amounts.

I will say that regarding Obamacare, I don't know if it's the right answer or not, but I'll give him credit for trying. The system cannot last how it is now. As a business owner I can attest that having the provide healthcare for employees is like an anchor around your neck.

[tis]

I don't think many of them bill right. Huggins seems to have the hardest time coding things. I think the whole system got terrible when they started this coding.

[magicrobotmonkey]

Originally Posted by tis

I don't think many of them bill right. Huggins seems to have the hardest time coding things. I think the whole system got terrible when they started this coding.

I agree. We tried to find out how much one of those ultrasounds was going to cost us out of pocket before it was performed and neither the hospital our our insurance company could tell us.