For those with insurance through an employer, the price of healthcare increased in 2010 even as the use of healthcare did not, a new report shows.
The Health Care Cost Institute, a not-for-profit that was launched last year, released its first report this week. It looks at healthcare prices, use, intensity of services and total spending for one out of five people with employer-sponsored insurance younger than age 65.
Price—not the frequency or intensity of medical care—proved to be behind the 3.3% growth in healthcare spending for the population, said authors of the new report.
Here's a look at price changes for major categories of healthcare services:
Source: Health Care Cost Institute
Several further studies using the data are expected, including research expected later this year on aging and healthcare costs.
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It is time, once again, for my dispatch from the hallways of the Non-Profit Health Care Investor Conference in New York.
I am not allowed past the hallway into presentations by top executives from large and financially strong health systems, who take questions from analysts and investors. The conference is sponsored by Citigroup, the Healthcare Financial Management Association and the American Hospital Association.
Here's some of what I learned this year by cornering executives in the hallway:
Among systems, there is a concentration on growth, and not just for hospitals.
Ascension Health, the largest U.S. not-for-profit health system, will seek to diversify geographically and across healthcare services, said Robert Henkel, president and CEO of the system. “We don't see the end of growth anytime soon,” he said.
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High deductibles have grown more commonplace in recent years, adopted by employers seeking to shift healthcare costs to households and promoted by policymakers as a way to make patients more cost-conscious.
The shift, however, has also left households vulnerable to medical debt and hospitals with more write-offs from privately insured patients who do not pay.
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Underwriters, which bring municipal bonds to the market, will be required to divulge their possible conflicts of interest and disclose the potential risks of complex debt deals that were volatile and costly for borrowers during the credit crisis under a new interpretation of muni market rules.
The Municipal Securities Rulemaking Board rule interpretation becomes effective in August. There are some limits on the new disclosures that matter to many healthcare borrowers.
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The U.S., we know, spends far more than other countries on hospitals, doctors and other medical care. Now, researchers behind the latest international comparison of health spending have looked at supply of services, use, prices and quality for clues to why spending here is so much greater than a dozen other nations.
Here's a look at how much greater. It's the report's comparison of health spending as a percentage of gross domestic product:
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Deductibles for patients covered by the leanest insurance under health reform could see deductibles that easily exceed average commercial deductibles, a new estimate shows.
High deductibles have been named as one culprit behind unpaid medical bills that contribute to hospital write-offs and household financial distress.
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Ten physician groups agreed in 2011 to extend their test of Medicare accountable care, which began in 2005, for another two years. Now, six remain.
Three did not go far. Dartmouth Hitchcock in New Hampshire, Park Nicollet Health Services in Minnesota and the University of Michigan all moved into another more sophisticated Medicare accountable care experiment known as the Pioneer program in January.
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Mutual interest between private equity and the healthcare industry has produced some headline-grabbing deals in recent years: Oak Hill Capital Partner's joint venture with the largest U.S. Catholic health system; venture funds launched by large health systems, including the latest by Rex Healthcare ; and the buyout of a struggling Boston health system by Cerberus Capital Management.
But beyond these flashy deals is an influx of capital into healthcare from private investors, including a string of deals during the past 12 months by the newly formed investment arm of Cambia Health Solutions.
Cambia, a not-for-profit, was previously the Regence Group, an insurer in the Pacific Northwest.
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Researchers found striking variation in care for cancer patients in the final months of their lives at hospitals in the National Comprehensive Cancer Network, a newly published study shows. The same was true for patients treated by another group of hospitals with recognition from the National Cancer Institute.
In fact, cancer patients in the final months of their lives received widely varying treatment at academic hospitals and community hospitals as well.
As my colleague Jessica Zigmond reports, the study, published in Health Affairs, found no hospital group did better than another when it came to adhering to a handful of National Quality Forum measures of end-of-life cancer care.
Those measures include visits to the intensive-care unit during the last month of life and chemotherapy during the final 14 days of life. Such care may be of little use, as is likely the case with chemotherapy, and out of line with patients' preferences, the authors said.
The study, which looked at data for about 215,000 Medicare enrollees between 2003 and 2007, cited research that found a “majority of patients prefer comfort over curative care and would rather die at home than in the hospital.”
Here's a look at the results for the percentage of patients who died in the hospital, from an analysis by the study's authors published in the journal Health Affairs:
Source: Health Affairs
As the authors noted: “no hospital group excelled on other measure of end-of-life care, such as in hospital death rate or days in the intensive care unit during the last month of life. These results indicate a need for a broad re-examination of end-of-life cancer care and whether it meets the needs and wants of patients.”
That examination may also have implications for healthcare spending. An analysis published in 2010 found one-quarter of 2006 Medicare expenses went toward spending for patients in the last year of life.
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Hospitals last year turned to direct bank loans to limit risk from another short-term vehicle to finance capital spending, known as variable-rate demand bonds. Now, the body that oversees transparency in the tax-exempt market is asking borrowers to voluntarily disclose direct bank loans to investors.
The plea, announced by the Municipal Securities Rulemaking Board this week, acknowledges that rules largely do not require such disclosure, but says the information would help promote “a fair and efficient market.”
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Hospitals last year turned to direct bank loans to limit risk from another short-term vehicle to finance capital spending, known as variable-rate demand bonds. Now, the body that oversees transparency in the tax-exempt market is asking borrowers to voluntarily disclose direct bank loans to investors.
The plea, announced by the Municipal Securities Rulemaking Board this week, acknowledges that rules largely do not require such disclosure, but says the information would help promote “a fair and efficient market.”
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