, 8 tweets, 4 min read Read on Twitter
#Ohio hospitals charge about 241% of Medicare rates to private insurers.

Let's look into this a bit...
Some argue transparency will help. If consumers are informed, they can shop.

Research has documented how this does not work: 1) khn.org/news/as-hospit…

2) jamanetwork.com/journals/jama/…
Providers often argue they HAVE to increase prices because Medicare doesn't pay enough to cover their costs.

But high spending is an outgrowth of a few factors, including prices for labor and goods, Rx and DME, and admin:

Well what about mergers? In most economic contexts, the scale that comes from consolidation mean lower prices. There's lots of M&A with hospitals, so we should be getting lower prices, right?

OK, but what about the patient? Shouldn't they bare some of the responsibility here? Shouldn't they better utilize services?

Well, we don't spend much on social services (social determinants): well.blogs.nytimes.com/2013/11/21/spe…
We also don't utilize services more than other countries and some countries (like Japan) use much more tech, so that's not the issue either: ajmc.com/newsroom/healt…
And we've already been increasing cost-sharing for patients across the board. That isn't affecting price: healthsystemtracker.org/brief/increase…
To recap:
1) prices are illogical (healthaffairs.org/doi/10.1377/hl…)
2) transparency doesn't work
3) utilization and "skin in the game" isn't going to solve this problem
4) scale isn't going to solve this problem

This issue does not start/end w/PBMs, they're just an example.
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