Commercially Insured
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NBER: Why Don’t Commercial Health Plans Use Prospective Payment?
Tags: Commercially Insured, Geographic Variation, Inpatient Spending, Market Concentration, NBER, Peer Reviewed Journals
Read more: NBER: Why Don’t Commercial Health Plans Use Prospective Payment?ABSTRACT One of the key terms in contracts between hospitals and insurers is how the parties apportion the financial risk of treating unexpectedly costly patients. “Prospective” payment contracts give hospitals a lump-sum amount, depending on the medical condition of the patient, with limited adjustment for the level of services provided. We use data from the…
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Washington Post: How companies are quietly changing your health plan to make you pay more
Read more: Washington Post: How companies are quietly changing your health plan to make you pay moreBy: Carolyn Johnson While politicians have been embroiled in a fiery debate over President Obama’s signature health-care law, a quiet but profound shift is fundamentally reshaping how health insurance works for the roughly 155 million Americans who receive coverage through their employers. A national survey of employer health benefits released Wednesday shows how much deductibles…
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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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Necessary versus Sufficient Claims Data
Read more: Necessary versus Sufficient Claims DataThis data brief compares membership characteristics and health care service prices in non-ERISA and ERISA populations. The results suggest that non-ERISA data may be sufficient for policy relevant analyses, even when ERISA data is not available.
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Star Tribune: The dollars pile up with diabetes
Read more: Star Tribune: The dollars pile up with diabetesBy: Christopher Snowbeck Per capita spending on patients with diabetes hit $16,021 in 2014, which was an increase of about 6 percent or $897 from the previous year, according to a report released Monday. The average person in an employer plan during 2014, meanwhile, wracked up $4,396 in medical spending, which was up 3 percent…
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2014 Diabetes Health Care Cost and Utilization Report
Read more: 2014 Diabetes Health Care Cost and Utilization ReportThe 2014 Diabetes Health Care Cost and Utilization Report examines how much is spent on health care for adults and children with diabetes, where those dollars are spent, and how that compares to people without diabetes. It is based on the health care claims of more than 40 million Americans younger than 65 covered by…
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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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Healthzette: The Health Savings We’re Missing – Cost transparency tools exist … yet we’re not using them
Read more: Healthzette: The Health Savings We’re Missing – Cost transparency tools exist … yet we’re not using themBy: Kristen Fischer We have the tools to shop around and save on health care costs — but we aren’t using them. A new Harvard Medical School study reveals that consumer access to price transparency tools doesn’t make them any more popular or likely to decrease health care spending. Do we not want to save…