Prices
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American Journal of Health Economics: Why Don’t Commercial Health Plans Use Prospective Payment?
Read more: American Journal of Health Economics: 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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ER facility prices grew in tandem with faster-growing charges from 2009-2016
Read more: ER facility prices grew in tandem with faster-growing charges from 2009-2016HCCI often reports the prices of health care services, defined as the average amount a provider is paid for a given service based on negotiations with health care insurers. These prices typically represent a portion of charges, which are the amounts health care providers bill for the procedures they perform. The charge amount is often…
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Medical Care Research and Review: Prices for Physicians’ Services in Medicare Advantage and Commercial Plans
Tags: Commercially Insured, Medicare Advantage, Out-of-Network, Peer Reviewed Journals, Physician Spending, PricesRead more: Medical Care Research and Review: Prices for Physicians’ Services in Medicare Advantage and Commercial PlansABSTRACT: The prices that insurers pay physicians ultimately affect beneficiaries’ health insurance premiums. Using 2014 claims data from three major insurers, we analyzed the prices insurers paid in their Medicare Advantage (MA) and commercial plans for 20 physician services, in and out of network, and compared those prices with estimated amounts that Medicare’s fee-for-service (FFS) program…
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2016 Health Care Cost and Utilization Report
Tags: Drug Spending, Geographic Variation, HCCUR, Inpatient Spending, Out-of-Pocket, Outpatient Spending, Physician Spending, Prices, Utilization
Read more: 2016 Health Care Cost and Utilization ReportThe 2016 Health Care Cost and Utilization Report shows that spending per privately insured person grew by 4.6 percent, faster than in previous years. Price increases were the primary driver. The report covers the period 2012 through 2016 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedHealthcare. The data in…
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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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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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KHN: Need A Medical Procedure? Pick The Right Provider And Get Cash Back
Read more: KHN: Need A Medical Procedure? Pick The Right Provider And Get Cash BackLaurie Cook went shopping recently for a mammogram near her home in New Hampshire. Using an online tool provided through her insurer, she plugged in her ZIP code. Up popped facilities in her network, each with an incentive amount she would be paid if she chose it. Paid? To get a test? It’s part of…
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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…
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CNN Money: Jeff Bezos, Warren Buffett, and Jamie Dimon want to fix health care
Read more: CNN Money: Jeff Bezos, Warren Buffett, and Jamie Dimon want to fix health careBy: Chris Isidore Amazon is partnering with Buffett’s Berkshire Hathaway and JPMorgan Chase, the nation’s largest bank, to try to address one of the nation’s thorniest and priciest problems — soaring health care costs. The three companies unveiled an as yet unnamed company to give their U.S. workers and families a better option on health…