Source: Health Care Pricing ProjectResearch from the Health Care Pricing Project shows that among 15 hospitals in Philadelphia, the price of a lower-limb MRI varied so much that a consumer going to the highest-priced hospital would pay six times more than that same consumer would pay at the lowest-priced hospital.
It’s no secret that health care prices nationwide vary widely from one market to the next, and even within individual markets. A panel on hospital mergers during AHCJ’s Health Journalism 2016 conference in Cleveland will examine the many factors driving these variations in hospital prices. We’ll also discuss how consumers can shop more effectively for the lowest-priced care.
The session, “Merger mania of health providers and the rise of dominant and potential monopolies,” will be 4:40-6 p.m. on Saturday, April 9. Continue reading
Photo: Mark via Flickr
Hospitals have been merging and acquiring physician practices at a breakneck pace. They say it’s what they have to do to save money on big-ticket items like health care information technology, and to move toward the coordinated care models encouraged by the Affordable Care Act.
But insurers, state attorneys general and federal antitrust enforcers have a different take. They say consolidation can give hospitals monopoly power to drive up prices and hurt consumers. Continue reading
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
Source: B. Biles, G. Casillas, and S. Guterman, “Competition Among Medicare’s Private Health Plans: Does It Really Exist?” The Commonwealth Fund, August 2015.Click to enlarge.
Anyone examining health insurance competition should look closely at a new report from the Commonwealth Fund, which indicates competition among Medicare Advantage (MA) plans is so rare that only one county studied is considered to not have a highly concentrated MA market.
After reviewing enrollment data in all U.S. counties with at least 10 residents enrolled in Medicare Advantage plans, the report, “Competition Among Medicare’s Private Health Plans: Does It Really Exist?,” said that in the 100 counties with the most MA members, market power is concentrated among three big insurers in almost two-thirds of those counties. Continue reading
One local story to follow when any health insurer considers acquiring another is how the new entity could affect competition. By that standard, there could be 817 local stories to cover simply as a result of Anthem’s plan to acquire Cigna, according to the American Hospital Association (AHA).
In a letter Thursday to the U.S. Department of Justice, Melinda Reid Hatton, AHA’s senior vice president and general counsel, said Anthem’s acquisition of Cigna could reduce competition among health insurers in at least 817 geographic markets and affect 45 million Americans. Continue reading