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Blue Shield of California has suspended its
relationship with UCLA Medical Center, one of the state's top hospitals, in a dispute over
the cost of treating patients there. It's a disturbing sign of things to come
in the healthcare industry, as insurers become increasingly resistant to the
cost increases that they routinely passed along in previous years. Although the
standoff is hard on the patients who've lost access to UCLA, Blue Shield is
right about one thing: The healthcare industry is on an unsustainable path, and
every segment must start focusing on cost control.
…Hospitals costs have risen particularly rapidly, with the average
daily fee for a bed in an acute-care ward more than tripling since 2000. UCLA's
reimbursements from Blue Shield have almost doubled in the last five years
alone, the insurer says. That's partly
because the university has been shifting onto Blue Shield some of the expense
of treating patients with Medicare, Medi-Cal or no insurance. But it's a trend
that even University of California officials acknowledge cannot continue.
…UC health officials say they've gotten the message; that's why they created the Center for Healthcare Quality and Innovation in October 2010 to find ways to deliver more effective healthcare services and to control costs. The university system and Blue Shield also have agreed on a new approach at UC San Francisco Medical Center that shares the financial risk of providing care for certain policyholders, holding cost increases at or below the rate of inflation. The question is how to bring that focus on efficiency and value to UCLA and the rest of the UC system. Here's hoping the two sides find an answer soon.
…UC health officials say they've gotten the message; that's why they created the Center for Healthcare Quality and Innovation in October 2010 to find ways to deliver more effective healthcare services and to control costs. The university system and Blue Shield also have agreed on a new approach at UC San Francisco Medical Center that shares the financial risk of providing care for certain policyholders, holding cost increases at or below the rate of inflation. The question is how to bring that focus on efficiency and value to UCLA and the rest of the UC system. Here's hoping the two sides find an answer soon.
Full editorial at http://www.latimes.com/news/opinion/opinionla/la-ed-blueshield-20120213,0,3668965.story
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In short, a key problem – according to the editorial itself –
is an external one reflecting the cost shifting that goes on in the current
system of national health which requires providers to care for the non-insured
and to make up for government programs that provide less than full
reimbursement.
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*“Burying the lede” is a common stylistic error in
journalism. To bury a lede (rhymes with “bead”) is to hide the most important
information within a news story instead of putting it up front where readers
can find it immediately. Source: http://www.avwrites.com/?p=15
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Meanwhile, our
best advice is not to get sick:
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