Publications
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Health Affairs: Rising Use Of Observation Care Among The Commercially Insured May Lead to Total And Out-Of-Pocket Cost Savings
Tags: Commercially Insured, Health Affairs, Inpatient Spending, Observation Stays, Out-of-Pocket, Peer Reviewed Journals
Read more: Health Affairs: Rising Use Of Observation Care Among The Commercially Insured May Lead to Total And Out-Of-Pocket Cost SavingsABSTRACT: Proponents of hospital-based observation care argue that it has the potential to reduce health care spending and lengths-of-stay, compared to short-stay inpatient hospitalizations. However, critics have raised concerns about the out-of-pocket spending associated with observation care. Recent reports of high out-of-pocket spending among Medicare beneficiaries have received considerable media attention and have prompted direct policy…
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Price of insulin prescription doubled between 2012 and 2016
Read more: Price of insulin prescription doubled between 2012 and 2016In honor of National Diabetes Month, our inaugural blog post focuses on a topic of particular interest to people with diabetes: the price of insulin. Insulin is the hormone responsible for the body’s ability to use sugar and prevent dangerously high and potentially deadly levels of blood sugar. Diabetics are unable to make enough insulin…
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New England Journal of Medicine: The Value of Health Insurance through Price Discounts
Read more: New England Journal of Medicine: The Value of Health Insurance through Price DiscountsNEJM CATALYST: “As context for the ongoing health care reform debate, we analyzed Health Care Cost Institute (HCCI) data. HCCI is a nonpartisan, nonprofit organization aimed at providing complete and accurate information about health care utilization and costs in the United States. Our goal was to demonstrate the value of insurance through these discounted rates….
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Health Affairs: Effects Of State Insurance Mandates On Health Care Use And Spending For Autism Spectrum Disorder
Read more: Health Affairs: Effects Of State Insurance Mandates On Health Care Use And Spending For Autism Spectrum DisorderABSTRACT: Forty-six states and the District of Columbia have enacted insurance mandates that require commercial insurers to cover treatment for children with autism spectrum disorder (ASD). This study examined whether implementing autism mandates altered service use or spending among commercially insured children with ASD. We compared children age twenty-one or younger who were eligible for mandates…
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JAMA Oncology: Association Between Quality of Care for Breast Cancer and Health Insurance Exchange Coverage An Analysis of Use of Radiation Therapy After Breast-Conserving Surgery
Read more: JAMA Oncology: Association Between Quality of Care for Breast Cancer and Health Insurance Exchange Coverage An Analysis of Use of Radiation Therapy After Breast-Conserving SurgeryABSTRACT Research comparing quality of cancer care by insurance categories concluded that cancer patients without insurance or with Medicaid experienced inferior quality of care compared with those with private insurance. A new insurance category created from the Affordable Care Act (ACA) is insurance purchased from the Health Insurance Marketplace (also known as the exchange). The present…
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Health Affairs: Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets
Tags: Health Affairs, Inpatient Spending, Market Concentration, Outpatient Spending, Peer Reviewed JournalsRead more: Health Affairs: Insurer Market Power Lowers Prices In Numerous Concentrated Provider MarketsABSTRACT: Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration—as measured by the Herfindahl-Hirschman Index (HHI)—interact and are correlated with prices. We found evidence that in the range of the Department of Justice’s and Federal Trade Commission’s definition of a moderately concentrated market (HHI of…
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NBER: Does Multispecialty Practice Enhance Physician Market Power?
Read more: NBER: Does Multispecialty Practice Enhance Physician Market Power?ABSTRACT: In markets for health services, vertical integration – common ownership of producers of complementary services – may have both pro- and anti-competitive effects. Despite this, no empirical research has examined the consequences of multispecialty physician practice – a common and increasing form of vertical integration – for physician prices. We use data on 40 million…
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Women’s Health Issues: Maternal Medical Complexity Impact on Prenatal Health Care Spending among Women at Low Risk for Cesarean Section
Tags: Commercially Insured, Inpatient Spending, Maternal Health, Outpatient Spending, Peer Reviewed Journals
Read more: Women’s Health Issues: Maternal Medical Complexity Impact on Prenatal Health Care Spending among Women at Low Risk for Cesarean SectionABSTRACT Background: Obstetric procedures are among the most expensive health care services, yet relatively little is known about health care spending among pregnant women, particularly the commercially-insured. Objective: The objective of this study was to examine the association between maternal medical complexity, as a result of having one or more comorbid conditions, and health care…
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Psychiatric Services: Telehealth Delivery of Mental Health Services: An Analysis of Private Insurance Claims Data in the United States
Read more: Psychiatric Services: Telehealth Delivery of Mental Health Services: An Analysis of Private Insurance Claims Data in the United StatesABSTRACT: Objective: This study characterizes telehealth claims for mental health and substance abuse (MH/SA) services by using national private claims data. Methods: Telehealth-related mental health service claims were identified with private claims data from 2009 to 2013. These data—provided by the Health Care Cost Institute—included claims from Aetna, Humana, and UnitedHealth for more than 50 million individuals…
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Health Affairs: Medicare Competitive Bidding Program Realized Price Savings For Durable Medical Equipment Purchases
Read more: Health Affairs: Medicare Competitive Bidding Program Realized Price Savings For Durable Medical Equipment PurchasesABSTRACT: From the inception of the Medicare program there have been questions regarding whether and how to pay for durable medical equipment, prosthetics, orthotics, and supplies. In 2011 the Centers for Medicare and Medicaid Services (CMS) implemented a competitive bidding program to reduce spending on durable medical equipment and similar items. Previously, CMS had used…