Publications
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Trends in Total and Out-of-Pocket Spending in Metro Areas: 2012-2015
Read more: Trends in Total and Out-of-Pocket Spending in Metro Areas: 2012-2015This data brief examines geographic variation in health care per capita spending, with a focus on consumer per capita out-of-pocket spending across geographies (2012-2015). It also explores whether the proportion of people enrolled in consumer-directed health plans (CDHPs) and the proportion not utilizing health care services had any influence on out-of-pocket spending.
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Academic Emergency Medicine: Association Between Maternal Comorbidities and Emergency Department Use Among a National Sample of Commercially Insured Pregnant Women
Read more: Academic Emergency Medicine: Association Between Maternal Comorbidities and Emergency Department Use Among a National Sample of Commercially Insured Pregnant WomenABSTRACT Objectives: Evidence suggests that, despite routine engagement with the health system, pregnant women commonly seek emergency care. The objectives of this study were to examine the association between maternal comorbidities and emergency department (ED) use among a national sample of commercially insured pregnant women. Methods: We conducted a retrospective cohort study using multipayer medical…
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Congressional Budget Office Working Paper Series: An Analysis of Private-Sector Prices for Hospital Admissions
Tags: CBO, Commercially Insured, Geographic Variation, Inpatient Spending, Medicare, Medicare Advantage, Outpatient Spending
Read more: Congressional Budget Office Working Paper Series: An Analysis of Private-Sector Prices for Hospital AdmissionsABSTRACT: Prices for hospital admissions have received considerable attention in recent years, both because they are an important component of health care spending and because they can vary widely. In this paper, we use 2013 claims data from three large insurers to examine the hospital payment rates of those insurers in their commercial plans and…
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Health Affairs: Reference Pricing Changes the ‘Choice Architecture’ of Health Care for Consumers
Read more: Health Affairs: Reference Pricing Changes the ‘Choice Architecture’ of Health Care for ConsumersABSTRACT: Reference pricing in health insurance creates incentives for patients to select for nonemergency services providers that charge relatively low prices and still offer high quality of care. It changes the “choice architecture” by offering standard coverage if the patient chooses cost-effective providers but requires considerable consumer cost sharing if more expensive alternatives are selected….
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Non-Shoppable Health Care Services: Inpatient Hospitalizations
Read more: Non-Shoppable Health Care Services: Inpatient HospitalizationsThis data brief reports on spending and utilization in populations likely unable to shop for a hospital prior to seeking care, comparing spending and length-of-stay for individuals who were admitted through the emergency department (ED) to that of individuals who needed ambulance services the day of their admission through the ED.
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Health Services Research: Payer Type and Low‐Value Care: Comparing Choosing Wisely Services across Commercial and Medicare Populations
Read more: Health Services Research: Payer Type and Low‐Value Care: Comparing Choosing Wisely Services across Commercial and Medicare PopulationsABSTRACT Objective: To compare low‐value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low‐value care. Data Sources: 2009–2011 national Medicare and commercial insurance administrative data. Design: We created claims‐based algorithms to measure seven Choosing Wisely‐identified low‐value services and examined the correlation between commercial…
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JAMA Internal Medicine: A Perspective on Out-of-Pocket Spending
Read more: JAMA Internal Medicine: A Perspective on Out-of-Pocket SpendingTo the Editor Understanding out-of-pocket spending is critical to understanding health care costs in the United States. We applaud the efforts of Adrion et al as an important contribution to understanding the out-of-pocket spending of the commercially insured population younger than 65 years. The commercially insured comprise over 50% of the nonelderly US population and, as…
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NBER Working Paper: Healthcare Spending and Utilization in Public and Private Medicare
Tags: Geographic Variation, Medicare, Medicare Advantage, NBER, Peer Reviewed Journals, Value Based Care
Read more: NBER Working Paper: Healthcare Spending and Utilization in Public and Private MedicareABSTRACT: We compare healthcare spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their healthcare spending. Healthcare spending is 25 percent lower for MA enrollees than for enrollees in traditional Medicare (TM) in the same county with the same risk…
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Medicare Advantage Health Care Utilization – Observation Stays
Read more: Medicare Advantage Health Care Utilization – Observation StaysThis data brief reports on outpatient observations stays in the Medicare Advantage population from 2010 through 2014. The results show that the rate of observations stays increased in total as well as following hospitalizations.
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Medicare Advantage Health Care Utilization – Hospital Readmissions
Read more: Medicare Advantage Health Care Utilization – Hospital ReadmissionsThis data brief, reports on five readmission rate measures for the Medicare Advantage (MA) population: 30-day all-cause hospital-wide readmissions and 30-day all-cause readmissions following acute myocardial infarction (AMI), heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia. The results show that MA readmission rates have been declining over the past five years.