When the American Medical Association publishes its next report on competition among health insurers, notice if Georgia makes into the top 10 among states with the least-competitive health insurance markets.
In the latest AMA report on competition, “The 2019 update to Competition in Health Insurance: A Comprehensive Study of U.S. Markets, Georgia had an overall score of 2,284, meaning the market for health insurers was below the highly concentrated level of 2,500 under the Herfindahl–Hirschman Index (HHI).
Whenever a major merger is announced in health care, the parties routinely tout the benefits for consumers, saying costs will decline and quality will improve. But do the facts bear out these claims?
During the press events announcing these deals, there’s no way to know. Researchers would need a baseline and several years of data to verify the merging partners’ claims and even then such results such as lower costs and improved quality take years to accumulate and measure. Continue reading
Every few months a health insurance news story breaks that’s so big it is likely to require reporters unfamiliar with the beat to get up to speed quickly on how insurance works. A recent case in point came in February when a former medical director for Aetna admitted in a pre-trial deposition that he never looked at a patient’s medical record when approving or denying care. Continue reading
Last year, there were 115 hospital and health system mergers and acquisitions – the highest number recorded in recent history, according to a report from Kaufman, Hall & Associates, a management consulting company that tracks M&A deals in health care.
The number and size of these transactions are transforming the health care system, the company said: “The implications reach far beyond the unprecedented number of individual transactions. Organizational size and scale have mattered for decades – but today, they are proving to be imperatives.” Continue reading
For decades, those who pay for health care have urged providers to move patients out of hospitals into lower cost settings such as home care and doctors’ offices.
That trend is accelerating today as seen in recent mergers involving insurers, pharmacies and providers. Continue reading
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