Tag: "Health Care Costs"
The Administration continues to promulgate ineffective regulations that are supposed to help patients understand how much money they owe their hospital. Here is this month’s proposed rule updating the hospital Inpatient Provider Payment Services (IPPS) schedule for 2015:
Hospitals are responsible for establishing their charges and are in the best position to determine the exact manner and method by which to make those charges available to the public. Therefore, we are providing hospitals with the flexibility to determine how they make a list of their standard charges public. Our guidelines…are that hospitals either make public a list of their standard charges (whether that be the charge master itself or in another form of their choice), or their policies for allowing the public to view a list of those charges in response to an inquiry.
It is hard to imagine how this is going induce hospitals to present good-faith charges to patients, whether they are insured or not. A better solution would rely on common law, not federal regulation.
By Shunning the Exchanges, Republican Governors Helped Taxpayers and Helped Make ObamaCare Work Better
A new report, by former Missouri Insurance Commissioner Jay Angoff, shows that states in which governors and/or legislators resisted ObamaCare, and whose Attorneys-General challenged its constitutionality, had the lowest cost-per-enrollee:
States which established their own ObamaCare exchanges cost much more to enroll people. The worst, Hawaii, cost $23,899 per enrollee. The “best” of the state-based exchanges is California’s, which cost $758 per enrollee. For all states with their own exchanges, the average cost was $1,503 per enrollee.
If heavily populated Republican states, like Texas and Florida, had established their own exchanges that cost the same as California’s, the bill to federal taxpayers would have been $15 million higher than it was. If they had set up exchanges that cost the same as the average state-based exchange, the tab would have been $30 million higher.
Health-care providers faced between $74.9 billion to $84.9 billion in care costs for the uninsured and people who struggled to pay their medical bills, according to new estimates published in the journal Health Affairs. Using the lower of the two estimates, Urban Institute researchers calculated that hospitals provided $44.6 billion of the uncompensated care, publicly supported community providers delivered $19.8 billion, and office-based physicians provided about $10.8 billion.
Some of the most notable cuts outlined in in the [Affordable Care Act] are to what’s known as Disproportionate Share Hospital payments under the Medicare and Medicaid programs. These safety-net hospitals are expecting to see a total $22.1 billion cut to Medicare DSH payments between the 2014 and 2019 fiscal years, and the ACA originally called for $17.1 billion in cuts to the Medicaid DSH program through 2020.
As many as 42% of Medicare beneficiaries in 2009 underwent unnecessary medical treatments, costing the federal government as much as $8.5 billion, according to a study published yesterday in JAMA Internal Medicine. The analysis is the first large-scale examination into what Medicare spends on procedures that are widely considered to be unnecessary, such as advanced imaging for lower back pain and placing stents in patients with controlled heart disease. (KHN)
This is Austin Frakt:
However, from another point of view, the formula — as flawed as it is — has helped keep Medicare spending lower than it might otherwise have been. Instead of cutting physician payments by the large amount the S.G.R. demands, Congress has increased payment rates, but typically by only tiny amounts — at an annual rate of just 0.7 percent.
But, although fees have only increased 8 percent since 2000, Medicare’s spending on physicians has increased 69 percent per patient. This is because the number and intensity of treatments has increased significantly. Could doctors have responded to lower real fees by cranking up volume?
This is Aaron Carroll:
I’m truly conflicted here. Like any good “economist”, I’m worried about future health care spending. I know that fee-for-service just sucks, and that the financial incentives for practice are totally misaligned. But I remain totally skeptical about pay for performance (see this, this, this, this, this, this, and this). I don’t see much evidence that programs like that work, and I don’t believe that the things we can measure are necessarily the same as how we’d ideally define quality.
I’m also concerned with making doctors the ones responsible for deciding what’s “worth it.”