Private equity firms are in the business of making money. On the surface, there is nothing wrong with that. However, a disturbing story in The Washington Post alleges that when private equity is involved in the buying and selling of nursing homes, things are often worse than they seem.
Watching the TV ads during the evening news, you would think Medicare Advantage plans were the greatest health insurance bargain ever invented. Consumers should not be fooled, however.
It’s true that the federal Centers for Medicare and Medicaid Services made it possible for Medicare Advantage (MA) health plans to offer more benefits to seniors enrolled in Medicare. Some of these plans offer coverage for vision, hearing, and gym memberships) while not charging a monthly premium, and some MA plans will even pay for seniors’ Medicare Part B premium, said John Barkett, a senior director of policy affairs at the health care consulting firm Willis Towers Watson. Continue reading
Research released today shows that from 2016 through 2018, self-insured employers and commercial health insurers in 49 states and the District of Columbia paid 247% more, on average, than what the Medicare program would have paid for the same inpatient and outpatient hospital services.
Researchers from RAND analyzed hospital claims data from 3,112 hospitals in every state except Maryland, which was excluded because the state has an all-payer rate setting model in which hospitals charge prices that are equal to what Medicare and private insurers pay, the report explained. The claims totaled $33.8 billion and came from self-insured employers, six state all-payer claims databases and health plans from 2016 to 2018. Continue reading
Early last month, a report from the Pioneer Institute in Boston showed that Massachusetts consumers could have saved $22 million in 2015 if they got health care from lower-cost providers instead of from the highest-priced health care providers.
In “Analysis of Spending on Shoppable Services in Massachusetts,” researchers wrote that consumers could have saved $116.6 million if the savings were adjusted for inflation over four years.
The researchers analyzed what providers charged in 2015 for 16 shoppable services, such as elective or non-emergent surgery. Continue reading
During the coronavirus pandemic, any number of good news stories seem to get little or no coverage because most health care journalists are busy covering COVID-19.
One such case in point was a report earlier this month from the Health Care Cost Institute. In Comparing Commercial and Medicare Professional Service Prices, HCCI researchers compared what health insurers paid to physicians and other providers with what Medicare pays for those services.
This report should not be overlooked for at least three reasons. Continue reading
A federal judge last month ruled against the American Hospital Association and other hospital groups in their lawsuit against the Trump administration’s plan to require hospitals to publish the prices they charge consumers.
As a victory for consumers, that win on June 23 was short-lived as the AHA appealed the decision the next day. Then on June 30, the AHA asked federal health officials to delay the effective date of the federal hospital price transparency rule until the court case is settled. Continue reading