Quote of the Day

“[The problem of provider market power] is especially true for the emergency rooms where you want to have no more than Medicare plus 150%. Now, ER care can run 400% to 1,000% Medicare; it is all over the place…. Hospitals are saying, ‘give me a 300% markup for all your patients that you send to me or out-of-network will be 500% to 600% [over Medicare] for the ER. So that means big systems have huge leverage because of the ER. For out of network, it’s free rein and insurers slink away from the negotiating table.”

— Robert Murray, president of the management consulting firm Global Health Payment, LLC, told AIS’s Health Plan Week.