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HUGE Shrine Hospital News!

JBD

Premium Member
Before anyone goes crazy, this is too specific to be limited to just the Shrine Section. It is also General, in that it will probably be a discussion by many and people may ask us about it

http://www.modernhealthcare.com/article/20110112/NEWS/301129982/1024

Shriners set to start billing insurers

Shriners Hospitals for Children, Tampa, Fla., will begin to bill insurance for the first time in its history after the plan won clearance from HHS' office of the inspector general.

Six of the health system's 20 U.S. children's hospitals are prepared to begin insurance billing and another four are expected to be ready in February, said Douglas Maxwell, chairman, president and CEO of Shriners Hospitals. Rising medical costs and the 2008 stock market plunge—which wiped $3 billion from the hospitals' assets that year—prompted the shift in payment policy, Maxwell said. For the year ended in December 2008, the most recent publicly available data, the Shriners Hospitals lost $575 million after its investment income plummeted. In 2009, the health system considered closing six hospitals but instead chose to seek insurance revenue, Maxwell said.

Maxwell confirmed that the Shriners Hospitals was the unnamed children's hospital network seeking an advisory opinion for a plan to bill insurers, but charge patients nothing, as well as offer subsidized housing and transportation to needy patients and caregivers. The inspector general's office said authorities would not move to sanction the Shriners Hospitals (PDF) under anti-kickback and civil monetary penalty laws.​
 

Benton

Premium Member
Hopefully this will help stabilize the hospitals' financial situation. They do a lot of great work, but it sure would be a shame to see them go under because of increasing medical costs.
 

cemab4y

Premium Member
I am delighted, that the Shrine hospital system, is getting a reality check. I believe that this change, will result in better care for the children, and still insure that no child is turned away.
 

Dave in Waco

Premium Member
I don't see a problem with this, since it is still keeping with the tradition that the patients themselves are not being charged. And technically speaking, if someone has insurance, they should be paying medicial costs, that's why we have it. I don't really see it as a tool for them to provide better care, since from what I've heard, they already provide top notch care, but I can it as making sure the hospitals stay stable and perhaps even an expansion of the system to be more available to provide that care.
 

JohnnyFlotsam

Premium Member
I wonder how they will deal with the deductible and (sometimes very stringent) co-pay requirements. Some insurance companies are very fussy about such things, prohibiting care providers from using discounts and other creative ways of shielding patient's from those out-of-pocket expenses.
 

Benton

Premium Member
I wondered the same thing Johnny. Maybe they get some kind of exemption as a charitable organization?
 

JTM

"Just in case"
Premium Member
i suppose it's better than shutting down, but this is a bad day.
 

Bill Lins

Moderating Staff
Staff Member
I wonder how they will deal with the deductible and (sometimes very stringent) co-pay requirements. Some insurance companies are very fussy about such things, prohibiting care providers from using discounts and other creative ways of shielding patient's from those out-of-pocket expenses.

I doubt that too many insurers would want to take the PR hit & backlash that would come their way should they give the Shriners a hard time over this.
 

JohnnyFlotsam

Premium Member
I doubt that too many insurers would want to take the PR hit & backlash that would come their way should they give the Shriners a hard time over this.
I hope you're right, but I don't see medical insurance companies much worried about PR these days.
I'm hoping that The Shrine finds a way to cover those out-of-pocket expenses in a way that doesn't run afoul of the insurance companies rules. A separate financial entity, perhaps, that could gift those payments for those that needed it.
 

fairbanks1363pm

Registered User
I will find out and ask some questions. Im sure the shrine will do what is best for the kids. I have been told by several people that the shrine system stretches a dollar further than anyone. It is a shame on how masonic organizations have taken such a pounding throgh rough times
 
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