Category: Health Care Costs

3 of 4 Physicians Say Government-Sponsored EHRs Not Worth the Cost

Mitch Morris, MD, of the Deloitte Center for Health Solutions discusses the results of the firm’s latest survey of U.S. physicians:

Three out of four physicians surveyed report that EHRs increase costs and do not save them time. This survey is not alone in its findings: Through another recently released survey, Clem McDonald and colleagues found that physicians say that EHRs “waste an average of 48 minutes per day.”

But those of us working with hospitals and physicians on a regular basis don’t need a survey to tell us things are not quite right. Just look at the rapidly growing profession of scribes — people who follow around doctors taking down their observations for recording in an EHR. Meaningful Use? Really?

Dartmouth Debunked? Providers Don’t Drive Variation in Health Spending

Central planners love to cite the Dartmouth Atlas of Health Care. The Atlas is an impressive, decades-long effort to study geographic variance in health spending. The famous Atul Gawande, MD, is likely responsible for the fact that the Dartmouth results are better known among lay people than any other research in health economics.

The reason central planners love the Dartmouth results is that they easily feed into a narrative that goes like this: “Medicare spending in McAllen, Texas, is about twice as much as it is in El Paso, Texas, even though their populations are similar. The doctors in McAllen must be twice as greedy as the doctors in El Paso. So, we need to tighten the screws on Medicare payments until costs in McAllen are cut in half. If we do that nationwide, we solve Medicare’s fiscal crisis.”

UnitedHealthcare’s Price-Transparency Tool is Having an Impact

UnitedHealthcare has released a study describing the results of its myHealthcare Cost Estimator, and mobile version (Health4Me). The results are, perhaps, unusual. The report concludes that patients who used these tools chose higher quality providers. However, it did not report savings from using the tools. I also note that the report was finished on February 25, but only released to the public today.

As far back as 2009, this blog discussed a previous report on consumer-driven health plans published by UnitedHealthcare, in which it promoted very precise estimates of savings through such plans. The lack of such precise estimates for the price-transparency tool suggests it is not having the same effect. On the other hand, it is having an impact by leading patients to choose higher quality providers. This must be beneficial, or UnitedHealthcare would not have released the report, even with such a long delay! And over one million people have downloaded the online app, so there is clearly a lot of interest.

Individual Health Insurance Premiums Rose 24.4 Percent in 2014

debtA new paper written by Professor Amanda Kowalski of Yale University, the National Bureau of Economic Research (NBER), and the Brookings Institution examines the effect of Obamacare on premiums in the individual market for health insurance in 2014 versus 2013. Her analysis includes policies sold in the individual market off the exchanges, as well as those sold on Obamacare exchanges:

Across all states, from before the reform to the first half of 2014, enrollment-weighted premiums in the individual health insurance market increased by 24.4% beyond what they would have had they simply followed state-level seasonally-adjusted trends.

Employer Health Costs Rising Slowly? Some May Not Be Offering Obamacare’s Minimum Benefits

Yesterday, we discussed the slow rate of growth of premiums in employer-based plans. Today, Kaiser Health News reported a surprising discovery: Some employers who assert they are offering benefits may not be. Indeed, their plans may not even offer hospitalization benefits.

How do they get away with it? As often the case with Obamacare, it is a glitch in information technology:

A flaw in the federal calculator for certifying that insurance meets the health law’s toughest standard is leading dozens of large employers to offer plans that lack basic benefits such as hospitalization coverage, according to brokers and consultants.

Third-Party Billing “Bordering on Mail Fraud”

Billing in U.S. health care: You can’t believe it until you’ve experienced it. Price transparency seems to be coming gradually, at least in convenient clinics and places like the Surgery Center of Oklahoma, which post their prices. However, when it comes to hospitals and health insurers, we do not appear to be making much progress.

Last month, I wrote about two healthcare experts who became patients and who got befuddled and bemused by the outrageous and appalling bills that started flying at them soon after their procedures. Here are a couple more examples.

Healthcare entrepreneur John Sung Kim, who founded one healthcare company that went public and is now growing a second one, recently suffered a motorcycle accident. After being patched up, he suffered a third-party billing that he described as “bordering on mail fraud”:

After $26 Billion Paid Out, Meaningful Use of Electronic Health Records Only 4 Percent of Target

At a September 3 meeting of the Administration’s Health IT Policy Committee, the Administration disclosed that only 3,154 eligible professionals (doctors, dentists, etcetera) had “attested” to so-called “meaningful use Stage 2″ to get their bounties from the federal government for installing electronic health records. Only 143 hospitals had attested.

One healthcare leader, who was at the meeting, was disappointed:

“The numbers are very low, particularly for Stage 2 attestation. I mean they are like 4 percent of [providers] that should be currently going for Stage 2,” HITPC member and Intermountain Healthcare CIO Marc Probst commented during the meeting.

Zeke Emanuel, Center for American Progress Give Up on Obamacare

In a new paper, Dr. Ezekiel Emanuel and colleagues associated with the Center for American Progress (President Obama’s go-to think tank) throw in the towel on Obamacare:

Given the current political gridlock, it is unlikely that the federal government will take the lead on reforms to control health care costs system-wide. States must therefore play a leadership role, with the federal government empowering and incentivizing them to act.

If those words sound familiar to you, you are not alone. The Washington Post reports this as “Democrats borrow a GOP idea on health care costs.” The idea is “Accountable Care States”. That’s not a term I’ve heard before, but we cannot expect the Center for American Progress to borrow the label as well as the idea.

Costs of Government Administration of Health Care to Almost Double in Ten Years

This week’s report by staff of the Office of the Actuary of the Centers for Medicare and Medicaid Services concluded that the last few years of muted increases in health spending will soon be ending. Health spending will resume its upward march:

The combined effects of the Affordable Care Act’s coverage expansions, faster economic growth, and population aging are expected to fuel health spending growth this year and thereafter (5.6 percent in 2014 and 6.0 percent per year for 2015-23). However, the average rate of increase through 2023 is projected to be slower than the 7.2 percent average growth experienced during 1990-2008. Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013-23, the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023.

Families USA Has an Excellent Report on Price Transparency — Really

Families USA, a leftist advocacy outfit often criticized in this blog, has published an excellent — not perfect — report on price transparency. Maybe it’s just because I’m feeling generous going into the last long weekend of the summer, but I think this report deserves a shout out from our side:

Prices for the same health care service can vary drastically across providers, and it is difficult for consumers to get information to compare providers based on both price and quality.

Making information on health care prices and quality accessible will help consumers compare costs, choose high-value providers, and anticipate their expenses.