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Tara Jones Fish Medicaid rates in NC are set by the state with federal approval. Medicaid in NC is about to go through a major overhaul as it goes to a managed care model rather than a few for service model. Medicaid is an 18 Billion $ a year business in NC. It is going to be very interesting to see how it plays out with expansion. BTW, NC provides all 17 or 18 optional services available under Medicaid. That s why other states put their residents on buses with one-way tickets and send them here to live… And get healthcare. Lori Walston that is very interesting. The point remains that any health system could say no to any rate negotiation. How will that be viewed when those people being denied are specifically low income by qualification? I’m pretty sure of two things, the state plan is going to pay more than Medicaid in rates and secondly not one single hospital system will boycott the expansion of Medicaid even though it will pay less and serve close to the same amount of people we are talking about with the state health plan. That is why I find this to be challenging to find any fault with Folwell and what he is asking.
The patient does not pay $30 for a Tylenol. It may say that on the statement but that’s prior to insurance. It’s inflated because the hospital will get nothing for the patients who cannot pay for that Tylenol but the actual cost to the patient with insurance is not $30. This is where the misunderstandings lie. If you do not have a background in how hospital billing and insurance reimbursement and are getting facts from news articles that may be biased (not saying you are but just in general) it can be very deceiving. I have a Master’s degree in nursing, and much of that is still way over my head.
Vidant is not going to respond to the ads because it just fuels the fire, I guess very similar to how I am now in my attempts to clarify how things are from the healthcare perspective, but I feel I am getting nowhere. So I will bow out respectful. I do believe you are in the minority in your opinion on this matter, but I hope for everyone’s sake there is a resolution.