Hospitals argue that Medicare and Medicaid under-reimburse, relative to the true costs, and higher reimbursements from private payors are necessary to cover the shortfall. How do you deal with push-back from hospitals on this issue, recognizing that you have no leverage with Medicare or Medicaid to increase reimbursements?

Using the information and examples from the Bitter Pill article, outline a strategy the company could use, driven through the ASO and potentially in conjunction with other large employers in the region, to
1.) Induce hospitals in the region to list actual costs for their services, rather than starting with inflated Chargemaster prices
2.) Align payments from your client to hospitals based on actual costs, rather than some pre-negotiated fraction of those costs
3.) Limit the ability of hospitals to inflate their statements of actual costs
4.) Hospitals argue that Medicare and Medicaid under-reimburse, relative to the true costs, and higher reimbursements from private payors are necessary to cover the shortfall. How do you deal with push-back from hospitals on this issue, recognizing that you have no leverage with Medicare or Medicaid to increase reimbursements?

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