Friday, February 17, 2017

Week 2

My second week was great and far more hands on than my first week. I began by sitting down with my mentor and learning about Banner Medical Group’s income statements and determining how to cut costs for the month of March in order to meet the budget. I learned a lot about the source of Banner’s revenue and its many inefficiencies. Insurance groups such as Blue Cross Blue Shield and Medicare negotiate contracts with the hospital so that they only have to pay a fraction of what they are billed. We hear every day how healthcare costs and insurance premiums are rising and how America is by far the most overpriced country when it comes to paying the price of being healthy. What we don’t hear, though, is the story behind all of it. The current medical billing process is highly outdated and puts large nonprofit hospitals at a disadvantage. The laws restricting these organizations allows insurance companies and customers to manipulate hospitals’ lack of freedom to get more money from them. Hospitals see an average of 10% reimbursement for the services that they provide. Medical care in America is the most expensive of any first world country, but this is partially as a result of hospitals increasing prices with the expectation that they will only receive a small portion of what they bill.
Later I learned about the specific quality metrics that Banner looks for in order to implement a system of quality based medical care. These break down into customer metrics, or how satisfied the customer is and operating metrics or how healthy the customers are after visiting the hospital. The most important of these are the likelihood of the patient to recommend the hospital to others and the patient readmission rate. Banner has implemented specific action plans in order to encourage its employees to meet a high criteria for both of these metrics. Unfortunately, when I tried to determine what specific actions were taken, I could not find them anywhere on the web. Moreover, I do not yet have access to the Banner intranet where this information can be found, but I promise to tell you as soon as I can.

I learned a lot this week, and I’m excited to learn much more. Finance is very new to me, but I already love it. I’m excited to see where it takes me in the years to come.  

12 comments:

  1. I'm glad to read that you are enjoying your project, Manu. It sounds like you are getting some great experience in finance. I can't wait to read more about your project.

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  2. It's interesting to hear that the billing process, like many other things, is inefficient and outdated, and that hospitals suffer just as much from steep prices as the hospitalized. why do you think that we haven't reformed the billing process? Is it more laziness on our part or lobbying from insurance companies that can take advantage of it?

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  3. It is very interesting to hear about how the insurance companies interact with hospitals. I have a few questions about why America has not reformed this process. In basically all other first world countries, there is universal health care, why does America not have it? Would it be too much of a burden on doctors, hospitals, etc. or have we just decided against it due to how politics work. Also why has no one focused on the fact that insurance companies are doing this because as a result of what insurance companies are doing, medical bills are much higher which is bad. Your research has been really exciting! I hope to learn more on your next update!

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  4. Hi Manu, Really nice blog again just like the last one. You seem like you have done lot of research from Banner Health. My question is, is Banner Health the only hospital that tried to reduce the medical bills for their patients? Why I am asking is because high medical bills is really bad and especially for the people that can't pay that amount of money. So as you said Banner Health is trying to fix that by looking at the satisfaction of their patients, is there any other hospitals that tried changing the medical bill issue or no?

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  5. Hey Manu, I think it's great that your experience has gotten much more hands-on. I think you'll be able to delve more into finance and enjoy it a lot more. So do you believe that if hospitals charged less, they would have the same productivity? What do you think would happen if hospitals lowered prices yet increased reimbursement? What would happen to the amount of money they'd be making? Also, are insurance groups paying hospitals less with the intent of making more profit? Reading about your research is really exciting. Can't wait for more updates!

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  6. Hey Manu! Another fascinating blog post, as always. It's sad to see that not even hospitals are safe from outdated, even obsolete billing processes. With this much billing clutter at hospitals affecting their finances, the impact on patients can't be positive! Do you think there should be a complete overhaul, or rather a revision of, the current billing process for hospitals as businesses, for patients of the hospitals (with a system such as universal healthcare), or both (or neither). And would the cost of a billing revision fall on the hospitals, or the government?

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  7. Hey Manu, I'm glad to hear that you have been learning a lot about the connection between medicine and finance. What is the criteria that an insurance company assess for the payment charged to a patient?

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  9. Great blog post! You seem to be implying that the insurance groups are at fault. Insurance companies seemed to have changed their policies to adapt to Obamacare. How do you think the last few years under Obamacare has changed the system from the time before Obamacare? How do you think the proposed repeal of Obamacare will affect the status quo?

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  10. Hey Manu,
    I'm glad to hear you are enjoying finance. How do you think the current billing system should change if it is so inefficient? And also, how specifically do insurance companies take advantage of hospitals? Thanks!

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  12. It's good to hear more about your project. It sounds fun and I hope you continue to do the work you enjoy!

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