Tag Archives: business

Reference pricing for ‘shoppable’ health care services steers consumers to low-cost providers

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Source: Robinson JC, Whaley C, Brown TT. Association of Reference Pricing for Diagnostic Laboratory Testing with Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests. JAMA Intern Med. Published online July 25, 2016. doi:10.1001/jamainternmed.2016.2492.

When Safeway, a grocery store chain, introduced reference pricing for the most commonly used clinical laboratory tests, spending on those tests dropped by 32 percent over three years, according to a recent study.

Using reference pricing, Safeway saved $2.57 million over the three years of the study (2011 to 2013). Of that amount, $1.05 million (41 percent) went back into consumers’ pockets, and the remaining $1.70 million accrued to Safeway, the study showed. Also, reference pricing led to a 32 percent drop in the average price that consumers paid for 285 different lab tests.

The researchers concluded that reference pricing can lead to savings for employers, workers and family members. JAMA Internal Medicine published the study online on July 25. Continue reading

Fast growth in nursing home ownership ripe for investigation

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com and other outlets. She is a senior fellow at the Center for Health, Media & Policy at Hunter College in New York City, and co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Photo: Ulrich Joho via Flickr

Photo: Ulrich Joho via Flickr

Serious problems at nursing homes are often easy to conceal. That is, unless you specifically dig for patterns of fraud, abuse, or misconduct.  That’s exactly what award-winning Boston Globe journalist Kay Lazar did to uncover a pattern of high profits for the owners, while complaints and problems mounted.

In a series of gripping stories, Lazar provided both micro and macro views of complex and potentially dangerous situations in nursing homes purchased by fast-growing Synergy Health Centers. She explored how failures in the Massachusetts state licensing system hurt families and how state regulators failed to perform the most basic checks on company executives and company finances before granting licenses. Continue reading

Panel offers ideas on uncovering true costs of health care at #AHCJ16

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

money-and-medicineFor those of us covering health insurance, one of the best sessions at Health Journalism 2016 addressed the challenging issue of how to find the true cost of health care.

Moderator Bruce Japsen, who writes about health care and health policy for Forbes, kept the focus on where reporters can look to uncover the actual cost of care in their communities.

That generated a terrific pro tip from panelist Chad Terhune of Kaiser Health News. Continue reading

Many angles to consider when covering insurance company mergers

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

One big story health care journalists can pursue this year is whether federal and state regulators will approve the three pending health insurance company mergers. If they approve the proposals by Anthem to acquire Cigna, Aetna to buy Humana and Centene to purchase Health Net, we’ll cover what concessions regulators will require and how the mergers will affect health insurance markets. Continue reading

ACA limits Medicare’s use of key value metric for drug prices

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Health insurers are trying a wide variety of methods to link drug costs to the value medications deliver to patients. Value-based payment strategies bear watching for two reasons. First, they are aimed at controlling the high costs of prescription medications, and, second, they could usher in new ways of pricing all medications.

The idea that insurers should link a drug’s value to price is not new, but it is gaining traction, at least among private health plans. One proposal calls for paying for drugs based on the quality-adjusted life year, or QALY, a measure used to quantify the value of treatment. Continue reading