Kevin Stone 🐋

self-aware and always judgmental Father of the three Stone girls #StoneSororityHouse

[Kevin Stone 🐋 @5KStone]

@BrianBroadus @tovash10 Cowboy best case - Bosa 1, Docston 2, Prescott 3, DJ White 4, Smallwood 5, fast ILB in 6 & 7. Objections?

[Kevin Stone 🐋 @5KStone]

@VarleyRachel @mcuban If local hospitals push back the big 3 threaten to keep the hospitals or systems out of network on their local employer plans.

[Mark Cuban @mcuban]

The greatest problem in healthcare ? Hospitals, even market dominant hospitals, won’t walk away from the big ins companies that underpay, late pay, clawback, deny claims, waste their time in denial appeals, and require them to pay up to 8 pct of revenue to RCM consultants so they think they are getting what they are owed.

Here is the crazy part. The ins companies ARE NOT THE ONES ACTUALLY PAYING THEM on commercial plans. Employers are.

60 pct of employees get their insurance from their self insured employers. The ins carrier is just a middleman that pretends to add value.

All the clinical “value” they add, the hospital could do better, for both medical and pharmacy.

Most hospitals have no idea whether they make or lose money with their big ins contracts. They are just afraid to lose patient flow.

But. They actually know which companies their patients are coming from. They actually know or can find out, how much more the employers are paying the ins company, than what the ins company pays them (the spread, just like in pharmacy )

And to make it worse, those ins companies negotiate their rates as a discount from the “charge master “, which is like WAC in pharmacy. Just a made up list price.

Because the hospitals are afraid or too uninformed to walk away from these deals, the hospitals use the inflated charge master prices as the basis to charge uninsured , or out of network , or insured but not covered for their care, at charge master rates. Which of course the patients can’t afford. And it crushes their finances or they go without care

I’ll summarize. Employers , and their members , are paying far more than they should to companies they don’t like working with , that effectively rip off both the employer and hospital , and they could eliminate the middlemen if they went directly to to the employer.

It’s so simple. Sell your services to the employers that use your services at a price that is less than what nine companies charge for your services and you will make MORE money and employers will save a ton

And if they did this, they could dump the chargemaster and reduce the price they bill patients when they are at their most vulnerable

But they don’t want to change. And don’t get me started on how much hospitals over pay for drugs and devices because of the GPO deals they do. It’s just stupid.

Which in turn leads to the hospital being a bad actor with 340b , facilities fees and afraid of their doctors who demand they pay more for things like glue and implants so they can get vacations.

If you are a politician and reading this. Now you know why this is so fucked up and it’s not about capping rates. The insurance companies are smarter than you. They will just move the money to other places. It’s not about giving money to patients. You can’t shop for care from hospitals that are too gutless to walk away from the ins companies that distort all of healthcare economics

Go to your local hospitals , particularly those at risk of closing and ask for their profitability by carrier. Fully burdened. Ask how much they spend on RCM and consultants. In many cases they could survive if they ran like a real business and hired execs that could do the work rather than just manage consultants. They could work out contracts in their communities rather than with ins companies and benefit everyone.

The middlemen are not needed. Get rid of them

[ZUBY: @ZubyMusic]

Current propaganda levels internationally are rivalling March 2020.

[Kevin Stone 🐋 @5KStone]

@townbrad What year wizard picks?

[MavsMuse @MavsMuse]

🚨 TICKET GIVEAWAY 🚨
I’m giving away two FREE lower-level tickets to the Mavs game tonight! To enter the giveaway…

• RT this tweet
• follow this account @MavsMuse
• (double entry if you reply with an pic of Dwight Powell)

Winner will be chosen around 5:30pm. Good luck! 🤞

[Kevin Stone 🐋 @5KStone]

@MavsMuse

[Kevin Stone 🐋 @5KStone]

@gifdsports

[Kevin Stone 🐋 @5KStone]

@tovash10 Unbelievable

[Deadspin @Deadspin]

BREAKING: The Dallas Mavericks are firing GM Nico Harrison.

[Kevin Stone 🐋 @5KStone]

@Deadspin Irreparable damage 💔...unlike anything we've seen since maybe the the browns moving out in the middle of the night.

[Mark Cuban @mcuban]

If you want some bandaids that help patients

1. Make all deductible phase brand drug purchases be priced at net, after rebate and fees. Not just for ACA, for everyone in every plan. This will save patients 10s of billions

2. Require inter company transfers from owned providers be at Medicare rates. Ends gaming MLRs

3. Rather than giving money to everyone for their HSA, work with providers to guarantee payments for all deductibles, if they charge Medicare rates for ACA plans. This reduces provider bad debt, ends medical debt for patients under the ACA , and makes ACA plans pay more because patients don’t avoid care because of they can’t afford deductibles.

If the numbers work , expand this for all care provided to the uninsured. Means test repayments with a reinsurance cap

This changes the game for insurance

4. Mandate Nationally, that any cash purchases have to be applied to deductibles. This allows for competitive price shopping.

5. Create a national rebate GPO that all states participate in by default that negotiates rebates for brand and specialty drugs.

These aren’t perfect and are generalized. But you get the direction it can go

[Kevin Stone 🐋 @5KStone]

@BigDSports19 He better call and cancel whatever trade he's planning...defense needs 7-9 players, not just 1.

[Kevin Stone 🐋 @5KStone]

@Riffraff3232 Heisman winner?

[Kevin Stone 🐋 @5KStone]

Ouch...looking like a really rough season thanks to our defense wins championship GM.

[🤺 @demontimeg0at]

INSANE STAT:

In the first 2 games of the regular season, Luka Doncic has generated more Points, Rebounds and Assists (131) than Anthony Davis, Cooper Flagg, Klay Thompson and Dereck Lively COMBINED (127)

🤯🤯🤯🤯

[Kevin Stone 🐋 @5KStone]

@clownworld @grok is this Ai?

[Kevin Stone 🐋 @5KStone]

@BobbyBeltTX Shouldve been a double by Steele IMO

[ZUBY: @ZubyMusic]

There are people who constantly lose opportunities because they are disrespectful and rude.

They don't even realise this is the reason, so they go through their entire lives living in the dark and becoming even more unlikeable.

Failure becomes a self-fulfilling prophecy.

[Mark Cuban @mcuban]

They aren’t. He has been very clear that he wants to cut fraud waste and abuse. The way insurance companies have historically arbitraged MA, is abusive and wasteful .

It’s not just upcoding. They game costs for medications and threaten CMS with lies that if rebates go away premiums will go up.

They jack up patient out of pocket so they reach the $2k limit faster. They push up retail pricing so patients pay more.

Dr Cassidy and all of congress and HHS should be all over this. It’s exactly what the administration rightfully should want to change

[Charean Williams @NFLCharean]

Mavs helped the league get a star player to the Lakers, and the NBA helped the Mavs. Quid pro quo.

[Ryan J. Rusak @rjrusak]

Who gets a longer honeymoon: the Chicago pope or the new Bears head coach? Discuss.