Commercially Insured
-
Modern Healthcare: A Peek Behind the Curtain on Hospital Prices
Read more: Modern Healthcare: A Peek Behind the Curtain on Hospital PricesHCCI’s research on the prices private insurers pay versus Medicare was featured in Modern Healthcare on the recent CMS price transparency rule. From the article: “That bright light illuminates hospitals’ most lucrative revenue streams. Private insurers pay an estimated 51 percent to 200 percent more than the federal Medicare program, according to a recent Health Care Cost…
-
Modern Healthcare: Caring for oldest, sickest patients now a growth business
Read more: Modern Healthcare: Caring for oldest, sickest patients now a growth businessHCCI’s research on spending for individuals with employer-sponsored health insurance was featured in an article for Modern Healthcare. From the article: “Spending per person with employer-sponsored insurance was about $5,900 in 2018, according to the Health Care Cost Institute’s latest data.” Caring for Medicare Advantage patients now a growth business Medicare Advantage patients are the…
-
American Journal of Managed Care: Policies to Address Surprise Billing Can Affect Health Insurance Premiums
Read more: American Journal of Managed Care: Policies to Address Surprise Billing Can Affect Health Insurance PremiumsAbstract: Objectives: To quantify the proportion of health plan spending on services for which surprise billing is common—provided by radiologists, anesthesiologists, pathologists, emergency physicians, emergency ground ambulances, and emergency outpatient facilities—and estimate the potential impact of proposed policies to address surprise billing on health insurance premiums. Study Design: Analysis of 2017 commercial claims data from…
-
AHCJ: Report Shows Wide Variation in What Insurers Pay Providers Versus What Medicare Would Have Paid
Read more: AHCJ: Report Shows Wide Variation in What Insurers Pay Providers Versus What Medicare Would Have PaidHCCI’s research on comparing commercial and Medicare professional service prices was featured in the newsletter of the Association of Health Care Journalists. From the article: “In Comparing Commercial and Medicare Professional Service Prices, HCCI researchers compared what health insurers paid to physicians and other providers with what Medicare pays for those services. This report should not be…
-
Comparing Commercial and Medicare Professional Service Prices
Read more: Comparing Commercial and Medicare Professional Service PricesPeople in the United States routinely cite health care and health care costs as top concerns.1,2,3,4 For the more than 160 million people who get insurance from their employer, the cost of health care is high, growing, and outpacing growth in wages.5,6,7 Across the country, health care costs show up in the form of higher premiums and…
-
Commercial Prices Relative to Medicare Vary Within Metro Areas Across Specialties and by Type of Service
Read more: Commercial Prices Relative to Medicare Vary Within Metro Areas Across Specialties and by Type of ServiceEarlier HCCI research found that at the national level, commercial payers paid prices that were, on average, 122% of Medicare. However, we found that commercial professional service prices varied dramatically across states from 98% of Medicare in Alabama to 188% of Medicare in Wisconsin. There was similar variation within states, such as California, and also…
-
Charge Amounts for Professional Procedures to Commercial Insurance and Traditional Medicare
Read more: Charge Amounts for Professional Procedures to Commercial Insurance and Traditional MedicareIn the start of 2019, Centers for Medicare and Medicaid Services finalized federal policies that required hospitals to publish the amount they charge for common services, documents commonly referred to as chargemasters. While similar policies have been in place at the state level since the early 2000s, this was the first federal mandate to require…
-
ADRD Prevalence in Various Insurance Populations: A Collaboration with The Alzheimer’s Association
Read more: ADRD Prevalence in Various Insurance Populations: A Collaboration with The Alzheimer’s AssociationAlzheimer’s disease and related dementias (ADRD) represent a significant and growing cost to the United States health care system. While the prevalence and cost of ADRD related to Medicare Fee-for-Service beneficiaries is documented in the Center for Medicare and Medicaid Services’ Chronic Conditions Warehouse, less is known about the prevalence and cost of ADRD among…
-
The New York Times: Most Coronavirus Tests Cost About $100. Why Did One Cost $2,315?
Tags: Administered Drugs, Commercially Insured, Drug Spending, Inpatient Spending, Outpatient Spending, Prices, The New York TimesRead more: The New York Times: Most Coronavirus Tests Cost About $100. Why Did One Cost $2,315?HCCI’s research with iFHP on international comparisons of health care prices was cited in an article in The New York Times on COVID-19 test prices. From the article: “How can a simple coronavirus test cost $100 in one lab and 2,200 percent more in another? It comes back to a fundamental fact about the American…
-
Impact of New Technology on Prices and Use: A Case Examination of Robot-Assisted Surgeries
Read more: Impact of New Technology on Prices and Use: A Case Examination of Robot-Assisted SurgeriesSurgery accounts for the largest share of inpatient and outpatient spending among individuals with employer-sponsored insurance, representing 49 percent of inpatient spending and 37 percent of outpatient spending in 2018 according to HCCI’s most recent annual report. In recent years, the number of surgical procedures performed using robot assistance has increased dramatically. Intuitive, Inc., which…