| | | Site of Care Drives Price. A new study by America's Health Insurance Plans (AHIP), published in The American Journal of Managed Care (AJMC), found that health care price variation based on where a service was performed led to $1.9 billion in additional health care spending on seven commonly-performed medical services in 2013. Key findings include: * In 2013, the price of a routine office visit conducted in a hospital outpatient department * was 21 percent higher than if it had been conducted in a physician's office.
* The price for chest radiography performed in a hospital outpatient department was 258 percent higher than for the same service performed in a physician's office.
* An increase in price variation, combined with a shift in favor of services being performed in hospital outpatient departments, led to a 44 percent increase in total health spending from 2008-2013. View the full study here: AJMC.
High Deductible Health Plans Accelerating Trend Toward Unpaid Patient Bills. In an analysis, USA Today (3/8) discusses how the shift to high deductible health plans has created "a growing problem" for hospitals: "patients aren't paying their bills." According to USA Today, "for every patient dollar being billed, hospitals have historically failed to collect 65 cents." The article explains revenue cycle management is "not designed to collect small, incremental payments from hundreds or thousands of patients. They are designed to bill a handful of large entities - insurance companies - not individuals who walk in the door." The piece adds experts said hospitals must develop more "user-friendly billing practices and processes" and patients need to budget better for medical expenses. |
DE. It costs $1.1 billion a year to treat diabetes in Delaware, signaling a need to invest in innovative healthcare and prevention efforts around the state, officials say. Delaware Online reports that at the Delaware Leadership Summit on Diabetes in Rehoboth Beach last week panelists said complications from the chronic disease, costs of treatment and lack of insurance coverage are at the root of the billion dollar problem. Delaware Online also reported that overeating and obesity were drivers of type 2 diabetes, with one third of Delaware residents being obese. Diabetes-related complications could include heart disease or stroke. On average employees with diabetes cost about 2.5 times more to treat than employees without. Read the full article here: Delaware Diabetes.
PA. Highmark, Blue Cross and Blue Shield lost $221 million on its health plans in ACA marketplaces in 2014, and it expects to lose another $500 million in 2015 because enrollees have required more care than anticipated. That has caused the insurer to pay more in claims than it collected in premiums. Last month, Highmark announced it would cut provider rates on average in Pennsylvania by 4.5%, effective April 1, to keep these plans viable, rather than shutting them down. For the average physician, the 4.5% pay cut would reduce overall revenue by only 0.5%, given that ACA enrollees constitute just a portion of his or her patient roster, according to a Highmark spokesman. He also noted that before the ACA, Highmark had offered a low-cost, limited-benefit plan called SpecialCare with provider rates that were 27.5% lower than going commercial rates, and that physicians had accepted them. (Medscape Medical News, 3/3)
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| Healthy Living!* Go with the whole grain. Whole-wheat tortillas offer belly-filling fiber and a wholesome, nutty flavor. Or branch out with other healthy choices, such as whole-grain corn tortillas or even options made from brown rice or quinoa. (UnitedHealthcare HealtheNews, March 2016) |
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*Nothing contained in Healthy Living should be considered, or used as a substitute for, medical advice, diagnosis or treatment. Healthy Living is provided to highlight lifestyle choices that may affect persons' daily lives. Healthy Living does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. We advise you to always seek the advice of a physician or other qualified health care provider with any questions regarding personal health or medical conditions. Never disregard, avoid or delay in obtaining medical advice
David M Banet & Associates, Inc.
45 Dowlin Forge Road ยท Exton, PA 19341
Phone: 610.644.9220 * Fax: 610.644.9277 * Email: info@dmbanet.com
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