Hospitals seek price hikes to offset rising nursing costs - WSJ

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Amid surging nursing expenses, some hospital chains are looking to introduce hefty increases to treatment costs that could lead to higher premiums for employers and workers, The Wall Street Journal reported on Sunday.

HCA Healthcare Inc. (NYSE:HCA) and Universal Health Services Inc. (UHS) are said to be among hospital operators requesting higher payments from payors. Neither firm did not specify the level of the price hikes they seek, The Journal said.

However, people familiar with the talks say that some healthcare providers are seeking a 7.5% – 15% increase in their prices compared to the 4% to 6% price increases that hospitals typically seek.

Meanwhile, insurer and employer groups are pushing back as they point out that the priciest hospital operators, which are usually paid more than five times the rates paid by Medicare, can absorb the costs without price hikes.

The requests for price increases come as hospital operators are grappling with rising nursing expenses. According to Premier Inc., a healthcare data analytics firm, the average annual base pay for hospital nurses climbed to $86,674 in March, from $79,172 in June 2021.

The shares of HCA Healthcare (HCA) crashed after the company’s 1Q 2022 earnings last month as the company, which operates one of the largest hospital chains in the U.S. set its full year guidance below Street forecasts amid surging labor costs.

Hospital prices are typically set under long-term contracts with insurers and employers. With some discussions on new contracts unlikely to start until 2024, the delay will soften next year's health expenditure for some employers. However, some hospitals are said to be seeking contract renewals ahead of the schedule to add price hikes.

Hospitals in talks with health insurer Anthem (ANTM) are requesting a few to double-digit percentage point price increases over the historic rates, Bryony Winn, president of the company’s contracting operations said.

Commenting on the cost inflation of healthcare providers, Sarah London, Chief Executive of rival managed care provider, Centene (CNC) said at the recent earnings call: “The fact that our rates are contracted creates a buffer on that but obviously aware of the potential future impact.”

Comments

[SuperPac]

The predicament facing the health-care matrix in the US is unresolvable under the current dispensation (nevermind the political party in power, both parties are the same). Like every other social process, its logjammed and gridlocked. You would think there should be revolutionary social fracturing in America but degeneracy is widespread and that won't happen.

[Simon Chatham]

Then, there's up-coding. That involves a physician or provider deciding that a procedure is more severe than initially diagnosed, and thus requires more expensive remediation. A chest cold becomes a "severe" upper respiratory infection, and generates a bigger payout.

A skilled coding expert can make a lot of money...

[munhoi]

@Simon Chatham physicians are most likely trained to upcode to get better reimbursement for all procedures. borderline fraudulent coding IMHO trained to upcode severity and discharge diagnosis to assure the max reimb is obtained , drg upcoding you name it , its costing taxpayers a bundle

[munhoi]

hospitals clinics doctors healthcare professionals depend on people to get sick to make them rich HMOs depend on the opposite to make them rich
Ive never missed a day of work in my life nor even been in a hospital bed and havent had a need to even have a primary doctor visit in over 4 years, why I jog 7 days a week for over 50 years , stay healthy no vices and started eating healthy 5 years ago, the high costs of health care are in part more people getting sick ie poor health but mostly because of the coporate practice of medicine to enrich all healthcare providers and its associated involved entities the middlemen created to suck money out to fhe system for their benefits

the healthcare system is still broken because like the drug industry too many lobbyist for every profession every provider is there to protect their enrichment

[munhoi]

heres how bad corporate practice of medicine has done to dentists:

I went to a larger group dentists practice paid a higher premium - I got right from the start pressure to pay for so called paredontal disease diagnosis , they didnt even want to schedule the plain dental cleaning without doing all the extras to so called preventative paredontal preventation add ons , so every cleaning trip I ended up paying extra on top of the premium that is supposed to cover all reventative care, I switched to a single dental doctor practice ( not many around) I paid alot less in premiums for the coverage, got a deep cleaning from it without any add ons no out of pocket walked out after getting all 4 quadrants done , not a dime out of pocket or co pay state of the art both business systems and equipment

thats how the corporate practice of medicine has done to the dental business , you end up paying 3 times for one with less services per above , lucky I found that single dentist practicing not affiliated with any dental corporation or group of affiliated dentists

the whole corporate practice of medicine increases costs thru many middleman groups taking a slice of the increased costs and profits and the patient is the one that suffers

layers of middleman needing a bigger slice of the pie is how it works

[rsykes73]

@munhoi this is fair. As large healthcare systems buy up smaller entities, the level of bureaucracy and the slew of administrators who consume revenue without making significant contributions, balloons. Meanwhile, those of us who actually provide direct care, and produce revenue face increasingly heavier work loads - only one of a number of reasons why the country is facing the largest nursing shortage in history.

[Tita748]

I love how they always blame the nurses but never question the salary of the CEO or CFO. How about they stop being cheap and hire more nurses so they don’t burn out. If they did a better job with their staff, nurses wouldn’t be leaving the profession in droves. How about write an article about that?

[munhoi]

@Tita748 thousands of nurses only one CEO and one CFO , good CEOs and CFOs are hard to find , problem with hospitals they think a nurse adminstrator or doctor should be running the hospital , I assure you those two always end up sinking most hospitals to the financial ground having clinicians without good mgmt always never works out well IMHO

[brian saltzer]

@munhoi have you ever seen what a nurse goes through on a daily 12hr shift. Missed breaks, most if the time we wirk through our unpaid lunch break because no one is there to cover us. Unsafe staffing, malpractice or negligence, burn out, belligerent patients. They treat you as if it is a 5 star hotel and you are there to cater to them. Violence, assault, dementia confused pts. Bloodborne, airborne,droplet and contact precautions. We do the dirty work, cleaning up feces, urine, wound care, blood, emesis, mucous....just to name a few. Everything falls on the nurse, it's our responsibility to assess, diagnosis, plan outcomes, interventions and evaluate the results. We look at lab values, orders, chart review history, signs and symptoms all while missing our breaks on our feet most of the shift. We advocate for our pts, we are the first and last line of defense on patient care. Would you like to shadow me and be my helper for a day, could you handle all that. Comfort and provide emotional support and encouragement, education. And than comes the family members who harass us to no end. Have you ever held 3 to 5 peoples hand in a night, during a pandemic and watch them breathe there last breath

[kata]

@brian saltzer

I think you should find a different profession, this one doesn’t sound like it suits you at all. There are 11 million open jobs in this country. No better time to find a job that will make you happier. Good luck.

[Blowback2]

‘….seek price hikes’’. My first real laugh of the day. In other news: ABA seeks to rein-in bs law suits.’….

[rambler1]

Judging by my health insurance premiums inflation has been running 10-15% annually for at least the last 15 years. But, apparently these figures have been ignored in the CPI

[CS15]

Now would be the perfect time to start eating right and exercising to avoid having to goto the hospital in the first place.

[quakerpop]

@CS15 just don't twist your ankle while jogging!

[munhoi]

@quakerpop just wear ankle sleeves like I do and all other athletes

[munhoi]

@CS15 in your teens, marry a dietician, the jogging you can start at youth to end of life, the eating right may not happen until your 40s when the light bulb of invincibility wanes and lack of immortality forces you to take the less meat for greens, no soda less sugar , less fat diet

[CS15]

Maybe they shouldn't of fired the ones who didn't want to get the shot.

[mrbuseco]

Go to the Philippines, Thailand, Mexico or if you speak the languages China, Kazakhstan for medical procedures. You'll get a vacation out of it as well.

[kata]

@mrbuseco , or they keep you for spare parts, rofl

[mrbuseco]

Baloney. They are seeking a replacement for losing the free money they were getting by claiming infections and deaths by covid-19. Big fraud and gorging at the public trough. If any politicians are on these boards please do something.

[TruthSpeaks]

Funny, the title says it's nursing costs that are causing hospitals to seek higher prices. Let's get real for a minute. This is a nice attempt to blame nurses for the price hikes... during Nurse's week too. Nurses don't make that much compared to the executives who are running hospitals. We understand that revenue is an issue and covid caused the facade to be removed. It also showed the problems of an inefficiently run, crumbling system.

Reimbursement from payers is what drives prices. Insurance/CMS doesn't pay as much so the costs get passed down the line. Nurses are asking for higher wages because we are being treated as replaceable. WE ARE NOT. Yes, nursing is he bulk of the labor costs in hospitals---often 60-80% of the labor costs...because you can't run a hospital or care facility with out us. Reality check, in my 30 years at bedside, our salary increase is often less than 1% per year. Yes, 1%, maybe 2% if I'm lucky. And veteran nurses like myself are capped at certain rates. Veteran nurses often make less per hour than the newer nurses coming in, who are less experienced.

Our Healthcare workers workday tasks to meet ever increasing reimbursement requirements have been/are increasing exponentially. And if the boxes aren't ticked off correctly, we get blamed. You get an infection, we get blamed. Your food is cold, we get blamed. Those surveys are tied to CMS/insurance reimbursements. As a bedside nurse, I don't make that much compared to the CEO, CFO and Directors of departments, a of whom get bonuses for being under budget.

The costs of performing CPR to save your life are about $10, 000-15,000. Most of that cost goes to the physicians (who "ran the code"--teaching hospitals the residents do this if nurse doesn't, often it's the nurse until a doc gets there) the pharmacy (to pay for the meds given) and to pay for equipment replacement. We get $20. That's possibly half their hourly wage, if they're lucky. We saved your life, we can't charge extra for that. And if you die, we get blamed that too.

There is a critical nursing shortage. Many of the newer nurses realize what they are worth. The veterans, like me, do too. Since healthcare has been running like a corporate business, and nurses have been expected to do so much more with so little, there aren't enough of us anymore. The cost of nursing is going up. It's supply and demand.

Ypu want change, let's look at the true costs of our crumbling healthcare system that focuses on treatment instead of prevention. Treatments like more medications that may or may not work bc pharmaceutical companies gotta make money too. But that is a whole other topic.

[mrbuseco]

@TruthSpeaks But the reward for letting a patient die and blaming covid is $39,000 The hospitals have an incentive to kill you by bad or no treatment.

[Mgreencvg]

@TruthSpeaks Nursing costs have skyrocketed. At the hospital my wife works at they fired all the unvaccinated nurses. They lost 30 in just the labor and delivery dept. alone. There are not enough nurses to replace the ones they fired, so they bring in "travelling" nurses, i.e. contractors. They typically cost 3 times what a full time employee does.

My wife spent 6 months working vast amounts of overtime to help cover the shortage, which of course was at time and a half, minimum. To get people to work almost double their normal hours they had to offer huge bonuses beyond the overtime.

The full time nurses are burned out from working almost twice their normal hours for close to a year and now the hospital has a majority of contractors in her department. The hospital has seen it nursing labor costs go up millions of dollars per year.

The vaccine mandates created a massive artificial nursing shortage and healthcare consumers are going to pay through the nose for it. This isn't the fault of the nurses, it was an unintended consequence of the government demanding vast numbers of nurses be fired if they didn't want to get the vaccine.

[Road-runner]

@TruthSpeaks Thank you for being a nurse! I hope you can pull your salary up. The nurses (especially, those at the bedside in hospitals) deserve more.

[Mr.BuyHighSellLow]

Complete joke. Healthcare in america is a racket

[TruthSpeaks]

@Mr.BuyHighSellLow yep.

[MoneyPig]

I have learned, that rent seeking hospitals make up fake prices and consumers get stuck paying rent seeking "insurance" companies to get access to real prices. Real prices are cash prices one might pay in a third country for the same service.

And, hospitals and doctors run side rackets to inflate those real prices. Hospitals assign customers to doctors that do not accept the customer's insurance and doctors send customers to the emergency room for routine tests.

To keep this going, political groups collect rent from doctors, hospitals and insurance companies. Each collects their rent and the average American pays more for health insurance than all other taxes combined. Check your W2 at tax time.

And the service Americans receive makes most of them angry people. So what bull is this article, hospitals raising prices, what prices?

[user IS75]

My company who is a self insurer strongly discourages it's employees from visiting hospitals. If I am to visit it due to a less than a life threatening event my co-pay is like 60%of the bill. Naturally I will avoid going to a hospital unless i m dying
The last couple of times i visited a hospital around 10-12 yers ago, in one case i got a bill for $ 200 from a doctor whom my PA was talking to , hopefully about my condition , for exactly 3 minutes.
Another time, I got $1200 bill for waiting in line for 2 hours and talking to a doctor for 5 min. to all fairness I was laying down during those hours since I couldn't keep vertical because of a terrible vertigo.
Can't even imagine what cost of the hospitalization is now...
I respect doctors and nurses and their work but middle class can't afford their services any longer even with a pretty decent private insurance.

[LeadAlpha]

@user IS75 I don’t respect them anymore. They’ve become just another overhyped self promoting spoiled entitled class.

[Texas Red]

I wonder if the VAX mandate contributed to this issue? Surely not.

[TDAN10]

@Texas Red it absolutely did not. ALL politicians lie! Including the ones pretending to make vaccine mandates villainous. I live in Florida and promise you Ron DeSantis made a shit ton of money on MATs. Even had stations in city parks to administer it. Funny thing is people who didn't want the experimental Vax gladly accepted the experimental antibody treatments. The love of money is what has driven America to the low estate it is.

[Texas Red]

@TDAN10 I know personally two registered nurses that were forced out of their positions due to the vax mandate. Many workers in healthcare and outside of healthcare were "cancelled" due to the mandate. Now, guess what, labor shortage.

[TheVerbalsensei]

Take a look at the Director, VP and hospital President salary and bonuses, like any organization. Big dollars being spend on these individuals. Save millions in any organization, by cutting here.
I know never will happen, the workers will be paid less, their benefit costs will rise as well as the patients costs.

Bruce Hornsby told us “that’s just the way it is, something’s will never change.”

[BuckingTrends]

Over the last 15+ years or so, *most* doctors & nursing staff that I have encountered have run the gamut from underwhelming to complete failures.

Better to be, *in part at least*, your own healthcare provider/advocate these days.....to the extent possible of course.

And don't get me started on dancing nurses.

[kata]

@BuckingTrends reminds me of some of the last and best advice my long time doc gave me before he quit. He said exercise, eat right and don’t get sick, lol

[brian saltzer]

@BuckingTrends I would love for you to be my nurse assistant for a day, you wouldnt make it past my initial or assessment pass before you quit

[Diesel]

Why not? Since everyone and their uncle is raising prices of everything, they might as well join the party.

[cash]

Biden can teach the hospital administrators a lesson by targeting the most egregious and cutting them off of all reimbursements.

The others will follow in line 🙂