Comment by BugsJustFindMe
3 days ago
The trouble with this cascades as follows:
1) I don't know what Medicaid pays.
2) I don't know that what Medicaid pays is a just price until we define what a just price is on its own merits. Maybe Medicaid pays more than they should.
3) What Medicaid pays could change at any time for any reason unless what Medicaid pays is based itself on some metrics that define otherwise, in which case let's just look at those metrics directly, yes?
4) If Medicaid decides to pay more, is that the new line?
1. Unlike private insurance, this is publicly available.
2. If anything, it's a bit stingy. The negotiating power of government (and the predictability of it) helps keep reimbursements down here.
3. I mean, that's how they're set. They analyze how long and how much a particular procedure should take/cost.
4. Sure.
And the more predictable process. Private insurers (especially UHC) are notorious for changing up the minutiae of the claims process in order to increase the proportion of claims they deny. There's a cost associated with having to maintain a huge staff just to hassle with for-profit insurance companies.