She tried to make sense of the charges, she said, but couldn't, and ultimately gave up. The contrast between the paperwork from my birth 46 years ago and the volume of confusing bills we get today raises the question: What happened to the hospital bill? Billing has evolved continually over the last century, but rising costs and changes in insurance reimbursement during the s — still central themes in today's healthcare market — take center stage in this story.
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National healthcare spending rose sharply during the s, and inflated hospital charges were a major cause. Hospitals submitted bills for services based on their stated costs, and both private insurers and the government simply paid up. During that period, charges became almost entirely divorced from costs," a problem that persists today, said Tomas Getzen, executive director of Philadelphia-based International Health Economics Assn.
In an effort to control costs, Medicare changed the way it paid for healthcare starting in Instead of reimbursing hospitals for individual line items, it paid predetermined flat fees for groups of services and procedures, such as treating heart failure. This requires hospitals to match every treatment and procedure to one of tens of thousands of codes used to bill insurers.
The more procedures and codes that hospitals can justify on the bill, the higher their payment. Or why a hospital bill is often many pages long.
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Gundling, vice president with the Healthcare Financial Management Assn. Although patients have historically been an afterthought, that is starting to change. Experts point to several trends that could limit the growth of the bills that hospitals send you in the future. New payment models are being tested as a way to improve quality and hold down healthcare costs.
These include reimbursing doctors and hospitals based partly on the safety, success and effectiveness of care delivered, rather than by volume.
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Some new forms of pricing may lead to simpler billing for patients. That's possible by lumping together all charges associated with knee replacement or heart surgery, for example, often including pre- and post-hospital care.
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Patients who choose providers who have agreed to these simplified arrangements typically save money and avoid billing hassles. There has been a dramatic shift to high-deductible health plans, both for people who get insurance at work and those who buy coverage on their own. Please note that LTC Consumer and its representatives do not give financial planning, tax or legal advice. You are encouraged to consult with your tax advisor or attorney concerning your own situation. Some involve paying for premiums with tax-free money or deducting premiums on your taxes.
Consider these four tax-friendly ways to pay your LTCI premiums.
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The amount you can withdraw is based on your age up to annual IRS limits. If your employer offers a high deductible health plan with HSA, consider your options. HSAs can be a great way to save for current and future eligible health care expenses, including a portion of LTCI premiums now and into retirement.
You may qualify to deduct a portion of your LTCI premiums as a tax-deductible medical expense. The same age-based limits apply to these deductions as they do for Health Savings Account withdraws.
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Keep in mind, if you already took a tax-free withdrawal from your HSA to pay LTCI premiums, you cannot deduct the same expense as medical expenses. For more information, review IRS Publication If you have an annuity, you can transfer money tax-free to pay for LTCI premiums or transfer funds to another annuity with an LTC rider. This transfer is referred to as a exchange.
