And it's a little more than a little possible that we're seeing a kind of death-throes thing in the for-profit American healthcare scheme as Americans are increasingly fed up with the combination of rising costs and stagnant wages, while the owner class pursues space travel as a hobby.
Pandemic fuels activity in health care's billing industry
Money is flowing heavily into the business of medical billing as hospitals and doctors — whose revenues were disrupted by the coronavirus — focus on maximizing every dollar they can collect from patients and insurers.
The big picture:
The rise and even existence of the billing industry is the result of a fragmented system that is designed around multiple types of insurance plans and a system that has increasingly forced patients to shoulder more of the costs of their care.
The state of play:
- Companies involved with billing and collections, called "revenue cycle management" in industry jargon, increasingly advertise themselves to health care providers as one-stop shops for all things involving payments.
- They verify patients' insurance, help hospitals update their pricing lists, code the medical claims that are sent to insurers and government programs, fight with insurers over denials, and collect payments from patients before and after they get care.
Driving the news:
- The pandemic drastically shrank revenue among hospitals and other providers, and although that drop was relatively short-lived, it spurred even more revenue cycle activity.
- Ensemble Health Partners filed to go public last week. The company pitched investors by saying, "Coding standards are constantly evolving ... it is often difficult for providers to adapt to these changes on a timely basis."
- UnitedHealth Group is attempting to buy Change Healthcare for $8 billion, although the Federal Trade Commission has asked for more information.
- The publicly traded R1 RCM has spent $800 million since 2018 to buy three separate revenue cycle firms. R1 changed its name in 2017, from Accretive Health, after the company settled allegations that it hounded patients for payment in emergency rooms.
- Private equity firms have always had interest in revenue cycle, and own large stakes in Ensemble and R1. Welsh, Carson, Anderson & Stowe recently acquired Argos Health, and four different companies merged to form CorroHealth, which is backed by the Carlyle Group.
- There are so many other revenue cycle deals within the past year.
- Lawsuits against patients over medical bills aren't the only controversial industry tactic. Submitting bills for more expensive services than were actually provided, a practice called upcoding, have generated bigger concerns.
- One hospital executive told David Seltz, the head of Massachusetts' health policy agency, that his system has hired more people to work exclusively on coding.
- "The more [people] you hired, the more revenue you could generate," Seltz said, according to Modern Healthcare. "His analysis was that there was no peak."
- Hospitals aren't just clients of revenue cycle firms. They also are investors in some cases.
- R1 is part-owned by hospital systems Ascension and Intermountain, and Ensemble is part-owned by Catholic hospital system Bon Secours Mercy Health. Those tax-exempt systems serve as both owners and major clients, which means they benefit twice from any payments that are collected.
- Tenet Healthcare recently sold five of its hospitals, and stipulated those hospitals had to continue using Tenet's revenue cycle firm, Conifer Health Solutions. HCA Healthcare also owns one of the country's largest billing firms, Parallon.
The revenue cycle frenzy is a result of "providers trying to win as much revenue as possible," said Ge Bai, a health policy and accounting professor at Johns Hopkins. But that's also meant "patients are more and more being treated as a revenue-generating product."
And there it is - even the Press Poodles are starting to get it:
Patients are the products.
Insurance companies are the customers.
And that's right in line with the other shitty things we're beginning to recognize about business-as-usual here in USAmerica Inc.
It's like with Facebook: an awful lot of people have been walking around thinking everything's peachy while The Lizard King is busy ignoring - or facilitating - a royal fucking of the serfs.
Companies have to sell something to stay alive - nothing good happens for any company until somebody sells something. So if it's not apparent what a company is actually selling, then it's practically a sure thing that what they're selling is you.
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| About 215M (65%) have gotten at least 1 dose |
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