Commercially Insured
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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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Wall Street Journal: The Math Behind Higher Health-Care Deductibles
Read more: Wall Street Journal: The Math Behind Higher Health-Care DeductiblesBy. Melanie Evans, Yaryna Serkez, and Merrill Sherman More U.S. workers are taking a bigger out-of-pocket hit from their employer-provided health plans. Blame high deductibles. High-deductible plans required patients to spend $2,200 to $4,300, on average, in 2016 before insurance kicked in, and amounts can be significantly more. Employers have embraced high deductibles to cut…
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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…
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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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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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CNBC: Health-care spending increased at a faster pace in 2015 as prices rose
Read more: CNBC: Health-care spending increased at a faster pace in 2015 as prices roseBy: Dan Mangan Spending on health care for people who have private insurance accelerated last year, ending a two-year period of more modest spending growth, a new study finds. In 2015, overall spending for people with private health insurance increased by 4.6 percent, according to the Health Care Cost Institute report. Most of that increase,…
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2015 Health Care Cost and Utilization Report
Tags: Commercially Insured, Drug Spending, HCCUR, Inpatient Spending, Outpatient Spending, Physician Spending, Utilization
Read more: 2015 Health Care Cost and Utilization ReportThe 2015 Health Care Cost and Utilization Report shows that spending per privately insured averaged $5,141 in 2015, up $226 from the year before. Key Findings Health care spending averaged $5,141 per individual in 2015, up $226 from the year before. Out-of-pocket spending rose 3.0 percent in 2015, to an average of $813 per capita….