Source: Analysis of Spending on Shoppable Services in Massachusetts, the Pioneer Institute, Boston, August 2020.
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
Graphic: Health Care Cost InstituteResearchers from the Health Care Cost Institute reviewed 210 million claims from individuals with health insurance through their employers in 2017 and compared what insurers paid physicians and other providers for those services against what Medicare would have paid for the same services in 271 metropolitan areas. (Click to enlarge graphic.)
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
As the nation’s hospitals strain to keep up with the demand to care for COVID-19 patients, it seems almost unfair to ask how much all of this treatment will cost. Still, we know that the costs will be high, both for the care itself and for what health insurers, employers and consumers will end up paying.
In a recent report, the health insurance marketplace Covered California projected that the one-year costs of testing and treatment related to COVID-19 could range from $34 billion to $251 billion. These new costs could cause health insurance premiums for individuals and employers to rise by 40% or more next year in the absence of federal action, the report said, adding that insurance premiums would increase because insurers would want to recoup any losses from the pandemic this year and plan for any future losses they might incur next year. Continue reading
Photo: euthman via Flickr
Over the past several years, health care journalists have done great work highlighting the problem of surprise medical bills. There’s been so much coverage that even the U.S. House of Representatives has begun examining the issue, as Vox’s Sarah Kliff reported on March 25.
Among the many surprise patient medical bills that Kliff and others have reported about come from air ambulance companies. Continue reading
One of the most complicated topics to cover in health care today is the role of pharmacy benefit managers (PBMs). Employers and health plans hire these middlemen to manage their prescription benefit programs for workers and health plan members.
Not only do PBMs contract with health plans, but some large health plans, notably UnitedHealthcare which owns Optum, have their own PBMs. Late last year, CVS Health, one of the nation’s largest retail pharmacy chains and owns Caremark, a PBM, said it would buy Aetna, one of the country’s largest health insurers. That deal is pending regulatory review, as Bruce Japsen reported for Forbes early this month. Continue reading