Global payment. “Global payment” involves only the human and her physician. There is no insurance company. The human hands over a check to the physician, upfront, before he renders any service. Think “nose job”.
“That'll be $19,000 please.”
“Here you go, doctor.”
[doctor deposits check; bank lets him know it cleared *CHA-CHING*]
“Please step right this way.”
submitted by drdoom(1206), 2020-01-01T09:58:13Z
Bundled payments. A human desires a Brazilian butt lift. The human’s health insurance company, NuLife, offers $12,000 to any system that performs this procedure as well as the post-op care. Acme Hospital System accepts the contract. Acme’s salaried employees (surgeon, anesthesiologist, nurses, rehab folks) perform the procedure and post-op care. Acme receives a check for $12,000 from NuLife.
At the end of the month, Acme Hospital System realizes total costs for the Brazilian butt lift were closer to $16,000, due to discarded collagen butt stuffer implant (surgeon dropped it on floor, whoops) and complications during post-op care. NuLife replies, “Too bad. I gotta contract RIGHT HERE that says you accepted bundled payment in the amount of $12k. We owe you nothing more and you will have to shoulder the loss.”
Afterward, Acme Hospital System decides to send bill in the amount of $4,000 to human, in the hopes she’ll pay what her insurance company wouldn’t.
Welcome to the greatest show on Earth, the American medical system.