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Category: Price Transparency

Executive Order Targets Hospital Consolidations & Price Transparency

President Biden's latest Executive Order issued on July 9, 2021 contains provisions to strengthen reviews of hospital consolidations and continuation of hospital price transparency requirements implemented in the prior administration.  Consolidation:  The order encourages FTC and DOJ to review and revise (e.g.., strengthen) existing merger guidelines so that patients aren't harm, citing that the 10 largest health systems now control approximately 25% of the market; that... Read More
Posted by Cristie Travis at Tuesday, July 13, 2021

What About Mental Health and Substance Use Spend?

The spend picture for inpatient mental health and substance use looks different. Spend is being driven by both an increase in utilization and an increase in price. Inpatient substance use increased utilization (18%) combined with significant prices increases (39%) increased spending per person by 64%! Inpatient mental health utilization remained relatively stable until 2017 when it increased 6%. A 14% increase in prices resulted in a 20% increase in spend. MBGH's evaluation of... Read More
Posted by Cristie Travis at Thursday, April 18, 2019

Really Want to Control Your Health Spend?

1) Understand  that price is the major driver behind spend.  The Health Care Cost Institute's 2017 Health Care Cost and Utilization Report  found that the total cumulative change in price from 2013-2017 was a 17.1% increase while utilization remained relaitvely stable. Overall spend increased 16.7% for this same time period.  (2) Continue  effective traditional approaches to control cost.  Willis Towers Watson's 2018 23rd Annual Best... Read More
Posted by Cristie Travis at Thursday, April 18, 2019

Unpacking Spending Growth

On March 13, 2018, the pronouncement was made that in 2016 price, once again, was the major reason the U.S. spends twice as much on health care as other developed countries (JAMA.2018;319(10):1024-1039).  At the end of their article the authors frame this a health policy issue: “As patients, physicians, policy makers, and legislators debate the future of the health care system, data such as these are needed to inform policy decisions.” Categorizing U.S. health... Read More
Posted by Cristie Travis at Sunday, March 25, 2018

Out-of-Network Charges Can Break the Bank

A recent report from America's Health Insurance Plans (AHIP) shows that across the US, some physicians are charging patients fees that are 10 times, and in some cases as much as 100 times, the amount Medicare pays when patients go outside their health plan's network. In Tennessee, for the selected procedures, out-of-network charges range from 7 times what Medicare pays to 33 times what Medicare pays. Hospitals have adopted a similar strategy. A study reported in the June edition of ... Read More
Posted by Cristie Travis at Friday, June 19, 2015

Direct Contracts with Medical Providers Help Self-Insured Employers Control Costs

From the National Business Coalition on Health:  According to Aon Hewitt's “2014 Health Care Survey,” conducted between December 2013 and January of this year, 11% of employers are engaging in some form of direct health care provider and service contracting during this plan year, and 28% expect to do so in the next three to five years.  To see an infographic with major survey findings, click here . To receive a copy of all survey results, click here . Read the full story via ... Read More
Posted by Cristie Travis at Wednesday, September 17, 2014

Wonder How Much Your Physician is Paid by Medicare? Now You Can Know!

From the National Business Coalition on Health:  After decades of secrecy, the Centers for Medicare and Medicaid Services (CMS) has released files on charges and paid amounts to 880,000 medical providers who received $77.4 billion in 2012.  It is likely that these are aggregate data, lacking the individual claim detail that would help purchasers identify which providers consistently deliver the highest quality care at the lowest episodic cost. But CMS' release indicates that they no... Read More
Posted by Cristie Travis at Tuesday, April 29, 2014

TN Receives an "F" in Price Transparency

Tennessee is one of 29 states that received an "F" in a report released today by Health Care Incentives Improvement and Catalyst for Payment Reform. Tennessee is among the majority of states that provides information on hospital and some outpatient "charges". But we know that "charges" are only relevant to those that have no insurance since both public and private insurance plans negotiate prices and therefore do not pay charges. In fact, the negotiated price has little, if any, relationship... Read More
Posted by Cristie Travis at Monday, March 18, 2013

Giving Cost Info to Providers May Not Change Ordering Habits

From the National Business Coalition on Health: In a new article published in the Journal of the American College of Radiology, researchers found that giving providers the cost information at the point of order entry made NO difference in which tests were ordered. Therefore, provider cost transparency alone does not significantly influence inpatient imaging utilization. While this research was conducted entirely within one specialty, there may be significant implications for... Read More
Posted by Cristie Travis at Tuesday, February 12, 2013

Consumer Attitudes on Health Care Costs

From the National Business Coalition on Health : New Robert Wood Johnson Foundation research shows many Americans don't understand why health care costs are increasing nor how the trend affects them on a daily basis. RWJF orchestrated a series of eight focus groups in four major U.S. cities: Chicago, Denver, Philadelphia and Charlotte, N.C. Four of the focus groups included people with employer-sponsored health insurance, two groups were comprised of people who were self-insured, one group was... Read More
Posted by Cristie Travis at Saturday, January 12, 2013

South Carolina's Interesting Approach to Health Reform

Leah Binder, CEO of The Leapfrog Group, puts a spotlight on Governor Nikki Haley's (R-South Carolina) approach to health care delivery system reform and how it complements the health insurance reforms put forth through the ACA. Haley's approach hinges on developing new payment systems which are tied to health care quality and cost. Transparency will be a critical factor in making this payment change possible. Purchasers and patients need to know how physicians and hospitals compare on quality... Read More
Posted by Cristie Travis at Sunday, November 11, 2012

New MBGH Member Benefit: Resolve Health Challenges with Other Employers Who Understand

Join us January 30, 2013 8:30-10:30 for our first meeting! Open to MBGH members and affiliates only. Register by email to [email protected] . You know other businesses face the same employee health and health benefit challenges as you. Instead of reinventing the wheel by yourself the next time one of these challenges arise, imagine being able to work collaboratively with these other businesses to arrive at creative solutions much more quickly. MBGH makes that... Read More
Posted by Cristie Travis at Wednesday, October 10, 2012

Survey Shows Increase in Consumerism

From the National Business Coalition on Health: Patients are morphing into health care consumers with growing use of technology for medical shopping and health engagement, according to a survey conducted by Altarum, the health services research organization. Virtually all (99%) of U.S. health citizens want to play a role in medical decisions about their care. However, consumers vary in just how much of that responsibility they want to assume: - 35% want to make the final decision with... Read More
Posted by Cristie Travis at Tuesday, September 18, 2012

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