Peer Reviewed Journals
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PNAS: Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reform
Read more: PNAS: Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reformAbstract: Changes in the way health insurers pay healthcare providers may not only directly affect the insurer’s patients but may also affect patients covered by other insurers. We provide evidence of such spillovers in the context of a nationwide Medicare bundled payment reform that was implemented in some areas of the country but not in others,…
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Health Affairs: Treatment Of Opioid Use Disorder Among Commercially Insured US Adults, 2008–17
Read more: Health Affairs: Treatment Of Opioid Use Disorder Among Commercially Insured US Adults, 2008–17Abstract: There is abundant literature on efforts to reduce opioid prescriptions and misuse, but comparatively little on the treatment provided to people with opioid use disorder (OUD). Using claims data representing 12–15 million nonelderly adults covered through commercial group insurance during the period 2008–17, we explored rates of OUD diagnoses, treatment patterns, and spending. We…
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Health Affairs: Physician Prices And The Cost And Quality Of Care For Commercially Insured Patients
Read more: Health Affairs: Physician Prices And The Cost And Quality Of Care For Commercially Insured PatientsAbstract: We analyzed the relationship between prices paid to 30,549 general internal medicine physicians and the cost and quality of care for 769,281 commercially insured adults. The highest-price physicians were paid more than twice as much per service, on average, as the lowest-price physicians were. Total annual costs for patients of the highest-price physicians were…
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Health Affairs: Prevalence And Characteristics Of Surprise Out-Of-Network Bills From Professionals In Ambulatory Surgery Centers
Read more: Health Affairs: Prevalence And Characteristics Of Surprise Out-Of-Network Bills From Professionals In Ambulatory Surgery CentersAbstract: Patients treated at in-network facilities can involuntarily receive services from out-of-network providers, which may result in “surprise bills.” While several studies report the surprise billing prevalence in emergency department and inpatient settings, none document the prevalence in ambulatory surgery centers (ASCs). The extent to which health plans pay a portion or all of out-of-network…
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JAMA Research Letter: Primary Care Spending in the Commercially Insured Population
Read more: JAMA Research Letter: Primary Care Spending in the Commercially Insured PopulationUsing HCCI’s data, we assessed the share among individuals younger than 65 years covered by employer-sponsored insurance from 2013 to 2017. We assessed primary care spending using 2 main definitions: a definition which included the total spending on services rendered by primary care clinicians (broad definition) and one where only CPT codes for specific services specified as…
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Health Services Research: Comparing Different Methods of Indexing Commercial Health Care Prices
Read more: Health Services Research: Comparing Different Methods of Indexing Commercial Health Care PricesThe methodology for HCCI’s Healthy Marketplace Index was published in a Methods Brief for Health Services Research. Abstract Objective: To compare different methods of indexing health care service prices for the commercially insured population across geographic markets. Data Sources: Health Care Cost Institute commercial claims data from 2012 to 2016. Study Design: We compare price indices computed using…
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American Economic Journal: Applied Economics: Health Care Spending and Utilization in Public and Private Medicare
Tags: American Economic Journal: Applied Economics, Medicare, Medicare Advantage, Peer Reviewed Journals, Spending, UtilizationRead more: American Economic Journal: Applied Economics: Health Care Spending and Utilization in Public and Private MedicareAbstract: We compare health care 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 health care spending. Adjusting for enrollee mix, health care spending per enrollee in MA is 9 to 30 percent lower than in Traditional Medicare (TM),…
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BMC Public Health: Area-Level Deprivation and Preterm Birth: Results from a National, Commercially-Insured Population
Read more: BMC Public Health: Area-Level Deprivation and Preterm Birth: Results from a National, Commercially-Insured PopulationAbstract Background: Area-level deprivation is associated with multiple adverse birth outcomes. Few studies have examined the mediating pathways through which area-level deprivation affects these outcomes. The objective of this study was to investigate the association between area-level deprivation and preterm birth, and examine the mediating effects of maternal medical, behavioural, and psychosocial factors. Methods: We conducted a…
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Health Affairs: Variation In Health Spending Growth For The Privately Insured From 2007 to 2014
Read more: Health Affairs: Variation In Health Spending Growth For The Privately Insured From 2007 to 2014ABSTRACT We examined the growth in health spending on people with employer-sponsored private insurance in the period 2007–14. Our analysis relied on information from the Health Care Cost Institute data set, which includes insurance claims from Aetna, Humana, and UnitedHealthcare. In the study period private health spending per enrollee grew 16.9 percent, while growth in…
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Health Affairs: Medicare Advantage And Commercial Prices For Mental Health Services
Tags: Commercially Insured, Health Affairs, Medicare Advantage, Mental Health and Substance Use, Peer Reviewed JournalsRead more: Health Affairs: Medicare Advantage And Commercial Prices For Mental Health ServicesAbstract: In 2014, insurers paid an average of 13–14 percent less for in-network mental health services in their commercial and Medicare Advantage plans than fee-for-service Medicare paid for identical services—despite paying up to 12 percent more than Medicare when the same services were provided by other physician specialties. However, patients went out of network more…