DiVita Submitted Charges "OVER" the Top!!

[Rerun]

They know!  They have it down to the alcohol wipe!  They just don't want us to know.  They can make the broad statement "we lose money on Medicare Patients" when the CEO makes MILLIONS.  Now, when the majority of your patients pay via Medicare, how can the CEO make millions every stinking year...?

I just want Truth In Billing.  I think they should make a profit of maybe 10%... but not 200% off sick people and Medicare....

Read March 4 Time Magazine.  Why Medical Costs are Killing Us.  Here is a blip:

http://www.time.com/time/video/player/0,32068,2178453595001_2136781,00.html

[rocker]

The link given by BlueKat did not work for me, but it's easy to find "an article" to say anything.  It reminds me of Hollywood accounting - sometimes people on a movie are given a contract with a cut of the profits - but somehow the movie never actually makes a profit!  Somewhere I saw a list of the top money-making movies where the studios claimed they lost money on them.  Movies that cost a hundred million to make and brought in over a billion.

DaVita and Fresenius a couple years ago were making a combined four billion in profit per year.  You'd have to cut a lot more than bundle price to eliminate that.  But I agree, this is why you get a gauze and tape for your catheter and not a tegaderm.  It's profit profit profit.  These companies are controlled by MBAs, not doctors.

As for whoever said it was the government profiting from high dialysis prices - that makes no sense at all to me.

[Simon Dog]

As to "lose money on medicare patients" - there are two ways to calculate the "profit" on a patient.  One is the "incremental profit" - how much more (or less) does the company make as a result of a medicare patient coming in for treatment.  The other is the fully burdened cost which includes overhead, corporate salaries, etc.    It is quite possible that the incremental profit from medicare patients is positive, but the fully burdened cost is negative.  BUT, since the overhead must be paid even in the absence of medicare patients, it make sense to treat them .... and good PR to belly ache about "doing it at a loss".   If it was *really* a loss on an incremental basis, I doubt the clinics would keep putting up with it.

But I agree, this is why you get a gauze and tape for your catheter and not a tegaderm.

Don't even think about trying to get a biopatch to go with that Tegaderm.

And why they start you with a 160 filter and keep you there if it's "good enough" even if a 180 or (shudder) a 200 would give you better clearance.   Fresenius won't let docs prescribe anyone a 200 unless it goes before their cost control committee to make sure a cheaper filter is not "adquate" (not "best for the patient" but "adequate").

[Bill Peckham]

As to "lose money on medicare patients" - there are two ways to calculate the "profit" on a patient.  One is the "incremental profit" - how much more (or less) does the company make as a result of a medicare patient coming in for treatment.  The other is the fully burdened cost which includes overhead, corporate salaries, etc.    It is quite possible that the incremental profit from medicare patients is positive, but the fully burdened cost is negative.  BUT, since the overhead must be paid even in the absence of medicare patients, it make sense to treat them .... and good PR to belly ache about "doing it at a loss".   If it was *really* a loss on an incremental basis, I doubt the clinics would keep putting up with it.

This is true but there is so much more that is wrong with this we-lose-money argument. For one the expanded bundle rate is based on Medicare's assuumption that after the bundle average per treatment EPO use would decline from 5,800 m/u to about 5,200. The value of the bundle is based on the idea that each treatment the unit will provide on average $50 worth of EPO. As it turned out the units are providing less than 3,000 on average, less than $30 of EPO instead of $50 - there's $20 worth of gravy right there. Consider also that by treating Medicare patients they get to feast on Private Payers. Losing $10/per Medicare treatment? Then if 10% of your census is private pay you'd need to charge private payers $100 more for it all to work out ... uh yeah the units are doing fine.