- Fair Pricing Law Prompts Most California Hospitals To Adopt Policies To Protect Uninsured Patients From High Charges June 2013
Millions of uninsured Americans rely on hospital emergency departments for medical care. Throughout the United States, uninsured patients treated in or admitted to the hospital through the ED receive hospital bills based on what hospitals call “billed charges.”
- Geographic Variation in Fee-for-Service Medicare Beneficiaries’ Medical Costs Is Largely Explained by Disease Burden May 2013
Control for area differences in population health is necessary to measure geographic variations in medical spending. We study casemix adjustment methodological issues and evaluate alternative approaches using claims from 1.6 million Medicare beneficiaries in 60 representative communities.
Americans today are living longer than at any point in the nation’s history. In a recent article in The Washington Post, Ezra Klein notes how this phenomenon and the prevalence of chronic illnesses is both challenging the U.S. health care system.
Over the past two decades, a wave of hospital mergers and acquisitions has resulted in many highly concentrated hospital markets across the United States. This phenomenon has raised concerns that consolidated hospitals are using their increased bargaining power to secure higher prices from health plans, thereby adding to the nation’s already unmanageable health care costs.
Reducing health care costs dominates current health policy discussions, raising important questions about who is responsible for bending the cost curve. A recent article in The Boston Globe explores the challenges providers face in becoming better stewards of health care resources.
Millions of uninsured Americans are potentially one major illness away from financial catastrophe. When faced with a major illness, individuals without health insurance may need to draw on multiple financial resources, including retirement savings, to cover medical bills.
Medicaid bed-hold policies may increase the likelihood of hospitalization of long-stay nursing home residents and increase costs for the federal Medicare program.
The cost of providing employer-sponsored insurance coverage continues to rise, and new legislation requires employers with at least 50 employees to offer affordable coverage or face a financial penalty. Employers are responding in a variety of ways to rein in their health expenditures while complying with these new regulations.
- Value-Based Insurance Design Yields Near- and Long-Term Improvements in Medication Adherence March 2013
Medication adherence is critical to the management of chronic conditions. Yet, many patients forgo medication when confronted with unmanageable or rising medication costs, a phenomenon termed cost-related nonadherence.
Substituting generics in place of more costly brand-name alternatives has the potential to lower drug spending for health plans. In a HCFO-funded study, researchers examined benefit and formulary design in Medicare Part D plans to determine their impact on generic drug use for cholesterol medication (statins) and to estimate potential savings to Medicare from generic substitution.