Commercially Insured
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ER spending among the commercially insured continued to rise in 2016, driven by the price and use of high severity cases (2009-2016)
Tags: Commercially Insured, Emergency Room, Geographic Variation, Outpatient Spending, Prices, Utilization
Read more: ER spending among the commercially insured continued to rise in 2016, driven by the price and use of high severity cases (2009-2016)HCCI recently expanded its reporting on emergency room (ER) spending trends to include the most recent data available (2016). We characterize trends in spending, price, and utilization for the five Current Procedural Terminology (CPT) codes designed to capture the level of severity and complexity of every ER visit. While average prices for all five ER…
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Health Services Research: Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs
Tags: Commercially Insured, Emergency Room, HSR, Opioids, Out-of-Pocket, Peer Reviewed Journals, Utilization
Read more: Health Services Research: Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and CostsABSTRACT Objective: To compare differences in opioid prescription, health care utilization, and costs among patients with low back pain (LBP) who saw a physical therapist (PT) at the first point of care, at any time during the episode or not at all. Data Sources: Commercial health insurance claims data, 2009–2013. Study Design: Retrospective analyses using…
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Health Payer Intelligence: Pros and Cons of High Cost Sharing for Employer Health Plans
Tags: Commercially InsuredRead more: Health Payer Intelligence: Pros and Cons of High Cost Sharing for Employer Health PlansBy Thomas Beaton Employer-sponsored health plans that include high cost sharing expectations can help control spending for plan sponsors, but could create longer-term health risks for employee beneficiaries. Striking the right balance between lowering costs and enabling healthy decision-making can be a challenge for employers and payers looking to design cost-effective plans. How can plan…
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NBER: The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured
Tags: Commercially Insured, Inpatient Spending, Market Concentration, NBER, Outpatient Spending, Peer Reviewed Journals
Read more: NBER: The Price Ain’t Right? Hospital Prices and Health Spending on the Privately InsuredABSTRACT: We use insurance claims data covering 28 percent of individuals with employer-sponsored health insurance in the US to study the variation in health spending on the privately insured, examine the structure of insurer-hospital contracts, and analyze the variation in hospital prices across the nation. Health spending per privately insured beneficiary differs by a factor of…
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Business Wire: Vitals Reduced Medical Spending for Employers by $56M. Three people every hour shop and save on their health care
Read more: Business Wire: Vitals Reduced Medical Spending for Employers by $56M. Three people every hour shop and save on their health careVitals today released its 2018 Book of Business report. The annual summary reports the metrics associated with shopping activity and savings achieved by employers and employees using Vitals SmartShopper. SmartShopper is a high-tech, high-touch health care program that allows consumers to shop for and choose better-value medical care. Over the past four years, SmartShopper has…
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American Journal of Obstetrics & Gynecology: Nationwide trends in the utilization of and payments for hysterectomy in the United States among commercially insured women
Read more: American Journal of Obstetrics & Gynecology: Nationwide trends in the utilization of and payments for hysterectomy in the United States among commercially insured womenABSTRACT Background: Laparotomy followed by inpatient hospitalization has traditionally been the most common surgical care for hysterectomy. The financial implications of the increased use of laparoscopy and outpatient hysterectomy are unknown. Objectives: The objective of the study was to quantify the increasing use of laparoscopy and outpatient hysterectomy and to describe the financial implications among…
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Medical Care: The Differential Effects of Insurance Mandates on Health Care Spending for Children’s Autism Spectrum Disorder
Tags: Autism, Children, Commercially Insured, Inpatient Spending, Medical Care, Outpatient Spending, Peer Reviewed Journals
Read more: Medical Care: The Differential Effects of Insurance Mandates on Health Care Spending for Children’s Autism Spectrum DisorderABSTRACT Objectives: There is substantial variation in treatment intensity among children with autism spectrum disorder (ASD). This study asks whether policies that target health care utilization for ASD affect children differentially based on this variation. Specifically, we examine the impact of state-level insurance mandates that require commercial insurers to cover certain treatments for ASD for…
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Obstetrics & Gynecology: Rate of Pelvic Organ Prolapse Surgery Among Privately Insured Women in the United States, 2010-2013
Read more: Obstetrics & Gynecology: Rate of Pelvic Organ Prolapse Surgery Among Privately Insured Women in the United States, 2010-2013Abstract OBJECTIVE: To analyze utilization of, and payments for, pelvic organ prolapse procedures after the 2011 U.S. Food and Drug Administration (FDA) communication regarding transvaginal mesh. METHODS: This is a retrospective cohort study examining private claims from three insurance providers for inpatient and outpatient prolapse procedures from 2010 to 2013 in the Health Care Cost…
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RevCycle Intelligence: Hospital Cost-Shifting Increases Private Payer Payments by 1.6%
Read more: RevCycle Intelligence: Hospital Cost-Shifting Increases Private Payer Payments by 1.6%Healthcare organizations that faced Medicare reimbursement reductions under the Affordable Care Act engaged in hospital cost-shifting that resulted in 1.6 percent higher average payments from private payers, a new working paper from the National Bureau of Economic Research uncovered. Researchers reported that hospitals penalized under the Hospital Readmission Reduction Program (HRRP) and the Hospital Value-Based…
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Health Affairs: Health Spending Growth Is Accelerating; Prices Are In The Driver’s Seat
Read more: Health Affairs: Health Spending Growth Is Accelerating; Prices Are In The Driver’s SeatHEALTH AFFAIRS BLOG: “Perhaps nothing illustrates the intractability of America’s struggle with health spending more than the recent announcement by Amazon, JP Morgan, and Berkshire Hathaway that they were founding a new entity to address health care costs for their employees. Despite lacking any concrete details this announcement managed to wipe billions of dollars in…