Posts Tagged “Health Care Costs”
ShowHide 3rd Party PapersMcKinsey Quarterly: A provider that creates a best-practice IT platform can generate significant operating efficiencies.
AHIP: The Value of Provider Networks and the Role of Out-of-Network Charges in Risking Health Care Costs
Commonwealth Fund: Based on analysis of OECD health data from 2008, the United States continues to differ markedly from other countries on a number of health system measures.
Archives of Internal Medicine: Improving follow-up appointments is often considered one of the key strategies for reducing costly hospital readmissions, but a new study suggests that better discharge processes don’t reduce 30-day readmission rates at all.
Thomson Reuters: A Path To Eliminating $3.6 Trillion In Wasteful Healthcare Spending
CMS ONC: Estimated Financial Effects of the “Patient Protection and Affordable Care Act,” as Amended
BU Public School of Health: This report documents and investigates the excess in Massachusetts hospital
costs per person above the average for the United States
Urban Institute: In 2040, half of adults age 65 and older will spend at least 19 percent of their incomes on health care, up from 10 percent in 2010
MetLife Study: New Insights and Innovations for Reducing Health Care Costs for Employers
MA Attorney General: AGO releases this preliminary report based on its ongoing investigation of health care cost trends and cost drivers
CBO January 2010: The Budget and Economic Outlook: Fiscal Years 2010 to 2020
ShowHide Commentary
The Great MLR Calculation Debate
by Kevin Roche on Tuesday, August 31, 2010
The new health law attempts to dictate how much of insurance premiums insurers must spend on medical care, so of course there is now extensive haggling on defining the calculation. The NAIC has released its version, which now goes to HHS for review.
2010 Potpourri XXXI
by Kevin Roche on Saturday, August 28, 2010
Summer nears an end, but not our Potpourris. This one includes the costs of malpractice, an innovative provider error disclosure program, employer wellness paybacks, blood pressure medication issues, the cost of new technologies, provider pricing power and the mental health of Californians.
Tags: Care Management, Health Care Costs, Hospital, Malpractice, Personalized Medicine, Wellness and Prevention
Employer Health Plan Changes for 2011
by Kevin Roche on Friday, August 27, 2010
Everyone is anxious to see the early effects of the reform law on health care costs. Another survey of large employer groups regarding their 2010 and 2011 expectations indicates that those costs are continuing to go up, probably at a faster pace.
Emergency Room Use
by Kevin Roche on Tuesday, August 24, 2010
A study discusses trends in the use of emergency rooms. Medicaid beneficiaries are the vast majority of the increase in utilization, which may reflect poor access to primary care or inappropriate health care seeking behavior.
Tags: Health Care Costs, Hospital, Medicaid, Medical Care
The Cost of Medical Errors
by Kevin Roche on Thursday, August 19, 2010
Medical errors have received a lot of attention since the Institute of Medicine published a seminal report almost a decade ago. A new analysis from the Society of Actuaries suggests that such mistakes cost the country at least $20 billion a year and potentially a much greater sum.
Tags: Health Care Costs, Malpractice
State Variations in Health Insurance Costs
by Kevin Roche on Wednesday, August 18, 2010
AHRQ released a statistical brief looking at state differences in the cost of employment-based health insurance and how much of that cost is borne by employees. Follow-up research to understand factors contributing to the variation would be interesting.
Medicare’s Solvency Extended–Or Is It?
by Kevin Roche on Friday, August 13, 2010
In a sign that the media is less willing to accept some of the Administration’s misleading pronunciations about health care, when HHS claimed that the Medicare Trustee’s report showed the new health law extended Medicare solvency by several years, most sources noted that the CMS Actuary disagreed.
Tags: Government, Health Care Costs, Medicare
2010 Potpourri XXVIII
by Kevin Roche on Saturday, August 7, 2010
Summer begins to wane, but not our Potpourris. Another one full of useful data, including health insurance costs for 2011, a new telehealth joint venture, use of kiosks in physician offices, prostate cancer screening, health care use cutbacks, teledermatology and sharing of physician notes with patients.
Tags: Consumers, Health Care Costs, Health Insurance, Monitoring, Physicians, Telemedicine, Wellness and Prevention
End-of-Life Care
by Kevin Roche on Wednesday, August 4, 2010
The New Yorker carries an exceptional article by Atul Gawande on end-of-life care, highlighting irrational reimbursement policies and the difficult decisions that both patients and providers must make.
Tags: Health Care Costs, Health Care Quality, Medical Care, Physicians
Massachusetts Reports
by Kevin Roche on Tuesday, August 3, 2010
Although its reform effort appears to have gone amok, largely for cost reasons, the state of Massachusetts is producing a lot of useful data and research on medical service delivery, including three recent ones on avoidable emergency room and hospital use and the state of primary care services.
Tags: Health Care Costs, Health Care Reform, Hospital, Physicians
More Geographic Variation Research
by Kevin Roche on Monday, August 2, 2010
A study of diagnostic practices for Medicare beneficiaries reveals geographic variations. These variations not only may suggest either under or overuse of diagnostic tests but they can bias other research results and payment methods. A second study suggests that caution should be applied in analyzing regional variation to ensure that all possible sources of the differences are taken into account.
Tags: Health Care Costs, Medical Care, Medicare, Physicians
Medicare’s Physician Reimbursement Problem
by Kevin Roche on Friday, July 30, 2010
There has been no more gnarly health care problem for Congress than how to deal with physician reimbursement. At some point, as a Health Affairs article points out, it will have to come up with a better solution than the temporary fixes it has used for years.
Tags: Government, Health Care Costs, Medicare, Physicians
Workers’ Comp Medical Cost Increases
by Kevin Roche on Tuesday, July 27, 2010
Workers’ compensation health cost trends may provide some insight into underlying medical cost issues across the system and vice versa. An NCCI report looks at factors driving trends in medical cost increases for workers’ compensation.
2010 Potpourri XXV
by Kevin Roche on Saturday, July 17, 2010
Another week, another potpourri, this time with items on workers’ compensation drug spending, benefit consulting firm mergers, hospital readmissions, geographic variation in spending and use of mobile vans to deliver health care.
Tags: Drugs, Health Care Costs, Hospital, M&A, Medical Care, Workers Compensation
Creating New Health Conditions is Costly
by Kevin Roche on Wednesday, July 14, 2010
There are so many sources of the rapid increases in national health spending that it is hard to track them all. A recent article estimates the costs of “medicalization”, the process of turning problems into medical issues which end up incurring health costs.
Tags: Health Care Costs, Medical Care
Rhode Island Insurance Rates
by Kevin Roche on Tuesday, July 13, 2010
Struggling with the continuing rise in health insurance premiums, Rhode Island’s Insurance Commissioner takes some creative steps to attempt to slow the rise of hospital costs, which are a major contributor to the premium increases.
End-of-Life Care and Patients’ Preferences
by Kevin Roche on Monday, July 12, 2010
Medical care provided near the end of a patient’s life accounts for a significant portion of total national health spending and is often inconsistent with patient wishes. New research evaluates the effects of a more detailed set of physician advance orders for frail and elderly persons.
Fireworks Potpourri
by Kevin Roche on Saturday, July 3, 2010
We light up the sky with a scintillating selection of health care bombshells. Okay, maybe not that great, but some hopefully useful info on the VA’s health information system, MRIs and emergency cardiac care, business method and process patents, end-of-life care, actuaries’ views on how to control costs and, of course, more issues in Massachusetts.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care
The US Health System Stinks…Or Does It?
by Kevin Roche on Thursday, July 1, 2010
The Commonwealth Fund issues one of its regular reports designed to demonstrate how bad the US health system is compared to those of other developed countries. Unfortunately, the report is based almost exclusively on subjective survey data and fails to provide any adjustments to create a truer picture of the status of our system vis-a-vis others.
Tags: Government, Health Care Costs, Health Care Quality, Health Care Reform
Services With Increasing Costs
by Kevin Roche on Wednesday, June 30, 2010
Where does all that health spending go and what areas are incurring some of the largest increases? An AHRQ statistical brief looks at hospital costs from 2001 and 2007 and identifies the ten fastest growing diagnoses by cost in that period.
2010 Potpourri XXIII
by Kevin Roche on Saturday, June 26, 2010
Once more into the breach with the Saturday health care roundup, including medication adherence, monitoring patients’ health status in their homes, Massachusetts’ reform update and insurance costs, hospitals’ economic contribution, hospital cost shifting and consumers’ views on use of health IT.
Tags: Drugs, Health Care Costs, Health Care Reform, Health Insurance, HIT, HomeCare, Hospital, Monitoring, Telemedicine
Medical Innovation and the American Economy
by Kevin Roche on Wednesday, June 23, 2010
The Council for American Medical Innovation has released a report about the value of medical innovation to the United States’ economy. Concern is expressed about maintaining a vigorous medical product industry in the face of funding, reimbursement and regulatory challenges.
Tags: Devices, Health Care Costs, HIT
PWC Report on Employer Health Costs
by Kevin Roche on Tuesday, June 22, 2010
PriceWaterhouseCooper has a Health Research Institute which periodically looks at medical cost trends. Consistent with other recent publications, PWC believes that costs are continuing to increase at a rate well above that of inflation or GDP growth.
Geographic Variation in Drug Expenses
by Kevin Roche on Monday, June 21, 2010
Medicare’s Part D benefit covers most prescription drugs and has added significantly to the program’s cost, although not as much as originally projected. Now that the program has been in existence for a few years, researchers looked at whether the same geographic variation in spending exists for drugs as does for other Medicare services.
Tags: Drugs, Health Care Costs, Medicare
ThomsonReuters on Saving Health Dollars
by Kevin Roche on Friday, June 18, 2010
It is an oft repeated claim that there are hundreds of billions of dollars of waste in the health system, which if limited or removed would greatly relieve financial pressure on public budgets, companies and individuals. A Thomson Reuters report gives its view on where the waste is and how it can prevented.
Tags: Health Care Costs
Milliman Releases 2009 Health Cost Index
by Kevin Roche on Monday, June 14, 2010
Milliman issued its annual look at health care costs for a family of four, including employer payments and out-of-pocket. Costs continue to rise well-above the rate of inflation or GDP growth.
Will Reform Act Slow Health Costs?
by Kevin Roche on Thursday, June 10, 2010
Two federal budget experts examine CBO’s final analysis of the deficit effect of the health reform bill as passed and find that it is very likely that instead of a small amount of deficit reduction over the next decade, it will likely to add to an already desperate federal fiscal crisis.
Group Medical Visits
by Kevin Roche on Wednesday, June 9, 2010
As long as cost pressures continue, people will search for new and better ways to control them. One area of focus has been the cost of a physician interaction and group visits are an emerging approach to reduce that cost.
Big Effort Needed to Create Informed and Engaged Patients
by Kevin Roche on Tuesday, June 8, 2010
One theory for improving the health care system is to rely on more-informed and engaged consumers to help improve decision-making about treatment options. A recent Health Affairs article suggests there is a long way to go on this goal.
Tags: Consumers, Health Care Costs, Medical Care
Physician Cost Profiling
by Kevin Roche on Wednesday, June 2, 2010
Physicians control most of the spending in health care. Understanding their practice patterns can be useful. New research demonstrates the difficulty of accurately attributing care to specific physicians.
Tags: Health Care Costs, Physicians
Living Longer and Paying More for Health
by Kevin Roche on Tuesday, May 25, 2010
Boston College researchers have examined the expected remaining lifetime health costs for an average person at various ages and linked that expected spending to health status, finding that healthy people will actually end up spending more.
Tags: Consumers, Health Care Costs
Hospital Readmissions
by Kevin Roche on Monday, May 24, 2010
Hospital readmissions are one area of health spending being studied intensively to identify causes and possible solutions to inappropriate or avoidable rehospitalizations. A California agency issued a report on readmissions in that state.
Tags: Health Care Costs, Hospital
2010 Potpourri XVI
by Kevin Roche on Saturday, May 8, 2010
No mother’s day would be complete without some health care news to ruminate on. This week’s include psychiatric drugs, the cost of the SGR fix, home health care costs, telemedicine and using computers to aid in diagnosis.
Tags: Drugs, Health Care Costs, Health Care Reform, HIT, Medicare, Telemedicine
More Imaging-Related Studies
by Kevin Roche on Friday, May 7, 2010
Imaging services have been labeled one of the “bad boys” of health care, but a review of recently published studies shows that while there are negative aspects to use of imaging, it has benefits as well.
Tags: Diagnostics, Health Care Costs
Online Physician Visits
by Kevin Roche on Wednesday, May 5, 2010
Traditional telemedicine has expanded in recent years to include a variety of methods for patients to interact with physicians in real and delayed time, including email, secure messaging, and video over the computer. A study examines the effect of these interactions on health spending.
Tags: Health Care Costs, Physicians, Telemedicine
Self-Directed Care
by Kevin Roche on Friday, April 30, 2010
Here’s a novel idea–give patients a set amount of money to spend on health care needs and allow them to manage what services they use for that money. It is a notion that is spreading internationally and just represents an attempt to restore traditional economics to health care.
Tags: Care Management, Consumer Directed Health, Health Care Costs
Hospital Value
by Kevin Roche on Thursday, April 29, 2010
Milliman, Inc. is a very prominent and capable actuarial firm which does excellent research on health care issues. The firm released a report on high, and low, value hospital regions, focusing on spending as the indicia of value.
Tags: Health Care Costs, Hospital
Physician Ownership of SurgiCenters and Operation Rates
by Kevin Roche on Friday, April 23, 2010
Another item that falls in the “shocking, just shocking” category. Research reveals that physicians who have an ownership interest in ambulatory surgical centers tend to do more surgeries at that surgicenter and to send the easier cases there.
Tags: Health Care Costs, Physicians
Misleading VA Health Information System Numbers
by Kevin Roche on Thursday, April 22, 2010
EMRs are posited to provide enormous benefits to the health system. The Veteran’s Administration has one of the most comprehensive large EMR installations. An article in Health Affairs provides a very misleading picture of the supposed cost benefits of the system.
Tags: Health Care Costs, HIT
UnitedHealth Group’s Suggestions for Medicaid Savings
by Kevin Roche on Wednesday, April 21, 2010
The new health law greatly expands Medicaid and government spending. Figuring out how to keep that spending from breaking state budgets will be difficult. A large national health plan company provides suggestions on how to control Medicaid costs.
Tags: Health Care Costs, Medicaid
Patients’ Knowledge and Its Effect on Cost
by Kevin Roche on Monday, April 19, 2010
One theory of the consumer-directed health movement has been that educated and motivated patients will make better value-based decisions regarding their health care, helping to reduce overall costs. A recent study published in AJMC supports this theory.
Health Care, the Federal Deficit and Federal Debt
by Kevin Roche on Monday, April 12, 2010
A commentary in the New England Journal of Medicine reminds us that health care has been a major contributor to the federal deficit and consequently the national debt and that it is likely to continue to add to our financial woes, notwithstanding the recent health act.
What! Massachusetts Again? Yep, With a Side of Maine and New York
by Kevin Roche on Friday, April 9, 2010
States that supposedly led the way on health care reform are finding out it was the bleeding edge that they were on. Insurers are always the easy target, but bashing them won’t solve the underlying cost problem. If the federal bill actually is implemented, the experience of these states will likely be replicated nationally.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance
Socio-Economic Status and Health Behaviors
by Kevin Roche on Thursday, April 1, 2010
What is the link, if any, between socio-economic status, health behaviors and health status? Researchers have theorized and pondered whether there is correlation or causation and in which direction. A new study from England provides some additional thoughts on the topic.
Tags: Consumers, Health Care Costs
The Massachusetts Debacle
by Kevin Roche on Tuesday, March 30, 2010
The Massachusetts Attorney General’s final report on what is driving health care cost increases in Massachusetts confirms the preliminary version’s finding that most of the spending rise is due to nothing more than application of raw provider market power to extract high prices from private payers. Another report also examines hospitals’ pricing practices.
Tags: Health Care Costs, Health Care Reform, Hospital, Physicians
More on Hospital Costs and Pricing
by Kevin Roche on Monday, March 29, 2010
Health Affairs publishes a study with a creative approach to understanding hospital costs, hospital pricing, Medicare payments and market power. The authors’ conclusion is that profitable hospitals have higher expenses because they have more money to spend, and those higher expenses may make them look unprofitable in regard to Medicare payments.
Tags: Health Care Costs, Hospital
Relative Pay of Primary Care and Specialist Physicians
by Kevin Roche on Friday, March 26, 2010
MedPAC had outside researchers look at the effects of paying all physician services in the United States under the Medicare fee schedule. Changes in that schedule were supposed to be creating more equal pay between primary care and specialist physicians, but that does not appear to have happened.
Tags: Health Care Costs, Physicians
Towers Watson Employer Survey
by Kevin Roche on Monday, March 22, 2010
Towers Watson is a large employee benefits consulting firm which regularly surveys companies regarding their health plan and related offerings. The latest survey offers insights on trends in plan design and cost containment efforts.
Tags: Health Care Costs, Workplace
More Imaging Issues
by Kevin Roche on Tuesday, March 16, 2010
Use of imaging services has become the poster child for health care spending problems, even though excessive imaging may have been rather rapidly controlled by private sector use of imaging benefit managers. New research pours salt on the wounds.
Tags: Care Management, Health Care Costs
2010 Potpourri IX
by Kevin Roche on Saturday, March 13, 2010
One more sampling of health care news, covering provider reaction to the EHR meaningful use rule, telemedicine, people’s perceptions of their health status and insurance coverage and hospital costs and prices.
Tags: Health Care Costs, Health Insurance, HIT, Hospital
Hospital Costs and Quality
by Kevin Roche on Wednesday, March 10, 2010
Following up on similar research, an article delves into the relationship between hospital costs and quality, finding inconsistent associations between high cost and better quality. It does not appear that low-cost hospitals have higher readmission rates and greater downstream costs.
CDC Health Status Report
by Kevin Roche on Tuesday, March 2, 2010
The Centers for Disease Control issues a massive compendium of health facts and information called Health United States 2009. In addition to basic information regarding health care, it has some description and analysis of particular issues such as use of medical technology.
Tags: Devices, Government, Health Care Costs, Health Care Quality
Maybe It’s the Providers that Are the Cause of Spending Increases.
by Kevin Roche on Monday, March 1, 2010
Two more studies suggest that provider price increases, particularly those of hospitals, are the cause for overall spending rises and notes that there is little competitive check on providers’ ability to raise prices. When are policy-makers going to start paying attention?
2010 Potpourri VII
by Kevin Roche on Saturday, February 27, 2010
The latest in our regular amalgamation of health care news items, including telehealth, how many people really die from not having health insurance, silent PPOs, progress in automating claims processing and more on individual insurance policy price hikes.
Tags: Health Care Costs, Health Care Reform, Health Insurance, Telemedicine
Competition Leads to Lower Hospital Costs
by Kevin Roche on Friday, February 26, 2010
Research indicates that commercial health insurance, while it has geographic variation in spending, does not vary in the same way as Medicare. A primary factor explaining private health plan geographic spending variation appears to be the state of competition for hospital services in different locales.
Tags: Health Care Costs, Health Insurance, Hospital, Medicare
Sources of Medicare Spending Growth
by Kevin Roche on Wednesday, February 24, 2010
A Health Affairs article examines changes in the composition of Medicare spending over the last two decades, finding that chronic disease is now the primary driver of that spending and that the nature of service demand has shifted from inpatient to outpatient and prescription drugs.
Tags: Health Care Costs, Medicare
More on Regional Spending Variation
by Kevin Roche on Tuesday, February 23, 2010
The New England Journal of Medicine publishes dueling commentaries on geographic and provider spending variations. Having a clear understanding of whether there are providers who render more care with no better outcomes would help formulate reforms to change their behavior.
2009 Health Spending and Future Projections
by Kevin Roche on Wednesday, February 10, 2010
The Office of Actuary at CMS provides its estimate of 2009 health spending and projections for future years. Partly due to the recession, health spending grew rapidly as a per cent of GDP. Healthy, or unhealthy, growth over the next decade is also projected.
Tags: Health Care Costs
Prices Not Major Contributor to Medicare Spending Variation
by Kevin Roche on Friday, February 5, 2010
New research published in Health Affairs finds that geographic variation in Medicare spending is not strongly driven by price variation. Utilization differences appear to be the major cause of that variation.
Tags: Health Care Costs
CBO Looks at Republican Budget Proposal
by Kevin Roche on Tuesday, February 2, 2010
CBO analyzes a Republican proposal on federal spending, finding that the health care-related provisions would significantly reduce federal spending and national health expenditures, while increasing covered persons by an unspecified number.
Massachusetts Report on Provider Pricing Impact
by Kevin Roche on Monday, February 1, 2010
The Massachusetts Attorney General investigates and discovers that hospitals and some physicians have market power and consequently are able to demand high payments and those payments are the main cause of increases in the cost of health insurance, not utilization increases.
Tags: Health Care Costs, Hospital, Physicians
Variations in Hospital Payments in One State
by Kevin Roche on Friday, January 29, 2010
Rhode Island released a report on payments to hospitals from various sources and looked at factors accounting for significant differences in payment levels. The variation is likely entirely due to hospital bargaining power by large systems, which in turn is driving health insurance premium increases.
Tags: Health Care Costs, Hospital
More Breast Cancer Screening Controversy
by Kevin Roche on Thursday, January 28, 2010
The recommended schedule for mammography screenings to detect breast cancer is examined in a Cochrane report, which finds that the current recommendation probably leads to overdiagnosis and treatment and the women are not being properly presented with the overall risks and benefits.
Tags: Comparative Effectiveness, Health Care Costs, Health Care Quality, Wellness and Prevention
Older Employees and Workers’ Compensation
by Kevin Roche on Wednesday, January 27, 2010
While employees over 65 are a very small part of the work force, their numbers are growing and the recession likely will keep people working longer. These employees have some different characteristics in regard to workers’ compensation claims, according to a new NCCI report.
2010 Potpourri I
by Kevin Roche on Saturday, January 9, 2010
The tort lawyer lobby errand boys in Congress just don’t know when to stop. Even after Senator Rockefeller got his hand slapped for questioning CBOs analysis of potential savings from tort reform, Congressman Bruce Baley decided to go back for more. And sure enough, CBO gave him an even more detailed justification of the savings [...]
Tags: Health Care Costs, Health Insurance, Malpractice, Medicare, Personalized Medicine, Telemedicine
National Health Spending in 2008
by Kevin Roche on Wednesday, January 6, 2010
National health spending growth slowed in 2008, but still grew at a rate much faster than GDP, meaning health care continues to account for a greater share of total GDP. More alarming, the rate of federal spending on health care grew much faster than the overall spending increase.
Tags: Health Care Costs
New Year Potpourri
by Kevin Roche on Friday, January 1, 2010
Many thanks for your readership of the last year and here are a few health care predictions and observations about likely trends for 2010.
West Virginia Health Report Identifies Possible Savings
by Kevin Roche on Thursday, December 31, 2009
States have often been leaders in experimenting with different methods of delivering and financing health care. West Virginia commissioned a report to identify methods by which it might reduce costs, while increasing coverage and not harming quality.
Drug Advertising and Prices
by Kevin Roche on Monday, December 7, 2009
The CBO looks at the characteristics of drug promotion spending and activity. Another study reveals that direct-to-consumer advertising for Plavix did not appear to increase the number of prescriptions but was correlated with a sharp rise in the price of the drug.
Tags: Drugs, Health Care Costs
MedPac Analysis Finds Less Geographic Spending Variation
by Kevin Roche on Thursday, December 3, 2009
One of the supposed sources for cost reduction is eliminating inappropriate geographic variation in medical care; variation that is unassociated with better outcomes. A MedPac report suggests variation, while significant, may be less of an issue than other analyses have found.
Senate Begins Health Reform Debate
by Kevin Roche on Monday, November 30, 2009
The Senate takes up its version of the health reform bill, creating an opportune moment to revisit what the goals of reform are and whether this bill will actually widen access, lower cost or improve quality. The answer is likely not.
Costs of End-of-Life Hospitalizations
by Kevin Roche on Monday, November 23, 2009
AHRQ issues a statistical brief examining the costs of end-of-life care. About one-third of American’s who die do so in a hospital, at an average cost two-and-a-half times greater than that for patients discharged alive.
Tags: End of Life, Health Care Costs
ECRI Advises Plans on Top Technologies for 2010
by Kevin Roche on Thursday, November 19, 2009
The ECRI Institute released a report advising payers on technologies to watch for in 2010, including genetic testing, imaging technologies, orthopedic devices and EHRs and PHRs. Most are very expensive but their comparative benefits or risks have not been proven in clinical trials.
Office of the Actuary Strikes Again
by Kevin Roche on Tuesday, November 17, 2009
The CMS Office of the Actuary zings the House bill, finding it will likely increase total national health care spending, its proposed savings from cuts in payments to Medicare institutional providers are unlikely to be sustainable and may reduce beneficiaries’ access to services.
Few Innovations Lower Cost
by Kevin Roche on Thursday, November 12, 2009
A study reported in the Annals of Internal Medicine tried to find medical innovations that significantly lowered costs, with only minor reduction in quality or outcome. Very few were found, which is consistent with innovation, especially technologic innovation, being found to be a major health cost driver in other studies.
Tags: Health Care Costs, Medical Care
GAO Report on Medicare Use of Physician Profiling
by Kevin Roche on Thursday, November 5, 2009
The General Accounting Office gives its perspective on the viability of the per capita method of physician resource use profiling by Medicare and provides useful insight into the topic of variable physician practice patterns.
Tags: Health Care Costs, Physicians, Providers
Weekend Potpourri
by Kevin Roche on Saturday, October 24, 2009
A miscellany of interesting items for your weekend browsing pleasure.
Tags: Care Management, Government, Health Care Costs, Health Care Reform, Telemedicine
More Variation in Spending Research
by Kevin Roche on Monday, October 19, 2009
A study reported in Circulation indicates that California teaching hospitals that utilize more resources in treating heart failure had lower rates of mortality. The study results call into question the methods and findings of some Dartmouth Atlas research. Another report looks at supply and variation in MRI usage.
Tags: Care Management, Health Care Costs, Hospital, Medical Care, Providers
Concentration in Children’s Health Spending
by Kevin Roche on Thursday, October 1, 2009
A review of what money is spent on which children for Medicaid and CHIPS yields insights on possible cost-saving and quality improvement opportunities.
Clinical Preventive Care Summary
by Kevin Roche on Wednesday, September 30, 2009
The Robert Wood Johnson Foundation has published a review of the cost effects of clinical preventive care measures.
Tags: Health Care Costs, Medical Care, Wellness and Prevention
The Advantage of Medicare Advantage
by Kevin Roche on Friday, September 25, 2009
AHIP presents evidence on the value of Medicare Advantage plans in delivering more efficient and effective care.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Hospital
Are Our Health Costs High?
by Kevin Roche on Thursday, September 24, 2009
Researchers associated with the Dartmouth Atlas project reinforce their viewsg on high health costs in a NEJM Perspective.
The Health Care Version of NIMBY
by Kevin Roche on Thursday, September 17, 2009
Everybody says we need cost control and expanded access, but nobody wants to pony up.
Geographic Variation in Health Spending
by Kevin Roche on Monday, September 14, 2009
Geographic variation in health spending is hot, but the reasons for it are still murky.
Tags: Health Care Costs, Health Care Reform, Medical Care, Providers
Quality Improvement is Not Easy
by Kevin Roche on Thursday, August 27, 2009
A commentary on Medicare’s experience in attempting to improve the quality of heart failure care demonstrates just how hard it may be to get better outcomes and lower cost.
More Evidence of Continuing Cost Increases
by Kevin Roche on Tuesday, August 25, 2009
Aon has estimated that private insurers health costs will increase at over 10% next year.
And Now For Something Completely Different
by Kevin Roche on Saturday, August 22, 2009
An Op-ed suggests we spend too little on healthcare. That may depend on who is paying.
Tags: Health Care Costs, Medical Care
NEHI Study Estimates Cost of Medication Non-Compliance
by Kevin Roche on Wednesday, August 19, 2009
A recent report from NEHI states that medication therapy non-compliance leads to $290 billion in avoidable medical costs every year.
Tags: Care Management, Drugs, Health Care Costs, Pharmaceutical
Looking at Hospital Input Costs
by Kevin Roche on Friday, August 14, 2009
One relatively unexplored method for reducing health spending is lowering providers’ input costs. A New York Times article examines one category of hospital costs.
Tags: Health Care Costs, Hospital, Providers
AHIP Survey Illustrates Physician Fee Issues
by Kevin Roche on Wednesday, August 12, 2009
Insurers have been under sharp attack for causing many of the problems reform is designed to address. One response has been to shift the responsibility for these problems to other components of the health system; in this case physicians’ fees.
Tags: Health Care Costs, Health Insurance, Physicians, Providers
Obesity, Obesity
by Kevin Roche on Monday, August 3, 2009
A new study shows increasing amounts of US health care spending are caused by obesity.
Tags: Chronic Disease, Consumers, Health Care Costs, Wellness and Prevention
Health Care, Small Business and Jobs
by Kevin Roche on Tuesday, July 21, 2009
Health care costs can limit small business growth, stunting a major source of new jobs.
Tags: Employers, Health Care Costs, Workplace
Fraud and Abuse–Are We Doing Enough to Stop It?
by Kevin Roche on Wednesday, July 15, 2009
One of the most commonly identified areas for health cost savings is fraud and abuse, but has enough effort been devoted to stopping the practices?
Cost Sharing and Health Outcomes
by Kevin Roche on Tuesday, July 14, 2009
Patient cost sharing reduces utilization, but appears to limit use of appropriate as well as inappropriate care.
Tags: Consumers, Government, Health Care Costs, Incentives
Don’t Blame Drugs For Cost Issues
by Kevin Roche on Friday, July 10, 2009
The limiting of growth in drug spending is a health care success story.
Tags: Drugs, Health Care Costs, Pharmaceutical
More Innovation From the Private Sector
by Kevin Roche on Wednesday, July 8, 2009
A Company mandates that its employees check their health status.
UnitedHealth Proposes Administrative Cost Savings
by Kevin Roche on Wednesday, July 8, 2009
A new UnitedHealth Group report identifies $332 billion over ten years in administrative cost savings.
Tags: Administrative Costs, Government, Health Care Costs, Health Care Reform, Health Insurance
Health Plan Medical Expenses Keep Rising
by Kevin Roche on Tuesday, July 7, 2009
A consulting firm study indicates that medical expenses for commercial health plans continue to rise at a rate far above inflation.
Tags: Health Care Costs, Health Insurance, Payor
JAMA Commentary Gives Crux of Cost Control Issue
by Kevin Roche on Wednesday, July 1, 2009
A recent JAMA commentary gives a concise summary of the cost control problems.
Tags: Government, Health Care Costs, Health Care Reform, Medical Care
Study Looks At Part D Impact on Drug and Medical Spending
by Kevin Roche on Tuesday, June 30, 2009
A study reported in the current issue of NEJM indicates that enrollment in Part D significantly increased drug spending for those persons who previously had no or a low level of drug coverage, but also led to a lower level of medical spending.
Tags: Health Care Costs, Health Insurance, Medicare, Pharmaceutical
Dumping on the CBO
by Kevin Roche on Friday, June 26, 2009
Unhappy with its projections, Democrats have beginning disparaging the CBO’s estimates on health reform.
Tags: CBO, Government, Health Care Costs, Health Care Reform
Maybe We Should Focus on Cost Control First
by Kevin Roche on Wednesday, June 24, 2009
Reality appears to have hit the health reform train head-on in the form of the costs of expanding coverage. Maybe we should focus on getting costs under control and then coverage extensions would be affordable.
Tags: Government, Health Care Costs, Health Care Reform, Health Insurance, Legislation
Shared Decision Making
by Kevin Roche on Tuesday, June 23, 2009
Shared decision-making for preference-sensitive conditions has the potential to improve quality and control spending. States are exploring required use of the technique and it should be considered in federal reform efforts.
Tags: Care Management, Consumers, Health Care Costs, Health Care Quality, Health Insurance
More Required Reading from the CBO
by Kevin Roche on Monday, June 22, 2009
The CBO’s June 16th letter to Senator Conrad is an excellent summary of health reform and cost control ideas and implementation issues.
Tags: CBO, Comparative Effectiveness, Government, Health Care Costs, Health Care Reform, Health Insurance
One Reason Health Reform Will be Hard
by Kevin Roche on Tuesday, June 2, 2009
An interesting news report on Kaiser Health News gives an indication of why health reform that affects costs will be very difficult. The story details the fight in one New Jersey town over building a new hospital.
Tags: Health Care Costs, Medical Care
Room for Improvement in Preventing Hospital Admissions
by Kevin Roche on Friday, May 29, 2009
The Agency for Healthcare Research and Quality’s (“AHRQ”) Healthcare Cost and Utilization Project released a report in April 2009 outlining hospitalizations that might have been preventable had the patients been receiving appropriate ambulatory care.
Tags: Health Care Costs, Hospital, Medical Care
Cost/Quality Relationship Unclear
by Kevin Roche on Wednesday, May 27, 2009
A study reported in Health Affairs, vol. 28, page 897 (May/June 2009), provides a further input to the question of the relationship, if any, between costs and quality in health care.
Tags: Health Care Costs, Health Care Quality, Hospital, Medical Care, Medicare
More Coverage = More Physician Visits = Less Cost?
by Kevin Roche on Thursday, May 21, 2009
A recent story in the Boston Globe raises intriguing questions about the effect of health coverage expansions on physician visits and other services and consequently, costs.
An Opportunity for Birthing Quality and Cost Improvement
by Kevin Roche on Thursday, May 21, 2009
The Los Angeles Times ran an article on May 17, 2009, regarding Cesarean births. Birth services are a microcosm of the problems in the broader health system.
Tags: Government, Health Care Costs, Hospital
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Washington Post: Federal and state programs will pay slightly more than half the tab for health care purchased in the United States by 2012
Atul Gawande: The health-care bill has no master plan for curbing costs. Is that a bad thing?
Unions pressure Democrats on health insurance tax