External Research
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JAMA Pediatrics: Effects of Autism Spectrum Disorder Insurance Mandates on the Treated Prevalence of Autism Spectrum Disorder
Read more: JAMA Pediatrics: Effects of Autism Spectrum Disorder Insurance Mandates on the Treated Prevalence of Autism Spectrum DisorderABSTRACT Importance: Most states have passed insurance mandates requiring commercial health plans to cover services for children with autism spectrum disorder (ASD). Insurers have expressed concerns that these mandates will increase the number of children diagnosed with ASD (treated prevalence) and therefore increase costs associated with their care. To our knowledge, no published studies have…
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JAMA Internal Medicine: Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults
Read more: JAMA Internal Medicine: Out-of-Pocket Spending for Hospitalizations Among Nonelderly AdultsABSTRACT Importance: Patients’ out-of-pocket spending for major health care expenses, such as inpatient care, may result in substantial financial distress. Limited contemporary data exist on out-of-pocket spending among nonelderly adults. Objectives: To evaluate out-of-pocket spending associated with hospitalizations and to assess how this spending varied over time and by patient characteristics, region, and type of…
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Health Affairs: Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays
Tags: Commercially Insured, Health Affairs, Inpatient Spending, Medicare, Medicare Advantage, Outpatient Spending, Peer Reviewed JournalsRead more: Health Affairs: Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare PaysABSTRACT There is ongoing debate about how prices paid to providers by Medicare Advantage plans compare to prices paid by fee-for-service Medicare. We used data from Medicare and the Health Care Cost Institute to identify the prices paid for hospital services by fee-for-service (FFS) Medicare, Medicare Advantage plans, and commercial insurers in 2009 and 2012….
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Journal of Telemedicine and Telecare: Reimbursements for telehealth services are likely to be lower than non-telehealth services in the United States
Read more: Journal of Telemedicine and Telecare: Reimbursements for telehealth services are likely to be lower than non-telehealth services in the United StatesABSTRACT: Telehealth technologies promise to increase access to care, particularly in underserved communities. However, little is known about how private payer reimbursements vary between telehealth and non-telehealth services. We use the largest private claims database in the United States provided by the Health Care Cost Institute to identify telehealth claims and compare average reimbursements to non-telehealth…
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An Examination of Private Payer Reimbursements to Primary Care Providers for Healthcare Services Using Telehealth, United States 2009-2013
Read more: An Examination of Private Payer Reimbursements to Primary Care Providers for Healthcare Services Using Telehealth, United States 2009-2013This issue brief, in partnership with the National Academy for State Health Policy, reports on reimbursement to primary care provides for health care services using telehealth. Key findings include: • Half of telehealth-related state policies were implemented in the last five years.• Although many states permit reimbursements for telehealth services, only seven states have passed statutes mandating parity with reimbursements…
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Health Affairs: Health Spending Slowdown Is Mostly Due To Economic Factors, Not Structural Change In The Health Care Sector
Tags: Affordable Care Act, Commercially Insured, Health Affairs, Market Concentration, Peer Reviewed JournalsRead more: Health Affairs: Health Spending Slowdown Is Mostly Due To Economic Factors, Not Structural Change In The Health Care SectorABSTRACT: The source of the recent slowdown in health spending growth remains unclear. We used new and unique data on privately insured people to estimate the effect of the economic slowdown that began in December 2007 on the rate of growth in health spending. By exploiting regional variations in the severity of the slowdown, we determined…
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Health Care Costs from Birth to Death
Tags: Children, Chronic Conditions, Commercially Insured, Out-of-Pocket, Prices, Society of Actuaries
Read more: Health Care Costs from Birth to DeathHealth Care Costs from Birth to Death examines health care spending from birth to age 90 for people covered by commercial health insurance and for those covered by Medicare fee-for-service. The research sponsored by the Society of Actuaries (SOA) using data from the Health Care Cost Institute (HCCI) estimates that the average 55-year-old retiree will…