In this essay, Dr. Frakt explains how the balance of market power between hospitals and insurers affects premiums. His review of the evidence drawn from prior research on this topic indicates that excessive market power of hospitals is a significant worry as we seek to contain premium growth.
This Capitol Hill briefing brought together leaders who have served in Democratic and Republican Administrations, led and advised major health care companies, and spurred improvements in health policy for many decades. They shared their insights on the outlook for health policy post-election and their experiences spearheading the transformation of health care payment and delivery.
This health policy briefing on Capitol Hill brought together top health care leaders with diverse business and policy expertise.
This Health Matters webinar, hosted by USC Annenberg's Center for Health Journalism with support from NIHCM Foundation, explored the implications of the shift from paying for volume toward paying for value in health care. Panelists assessed the mixed track record of Accountable Care Organizations and other early results from alternative payment models.
This NIHCM-funded study is using data from the Massachusetts All Payer Claims Database to describe referral patterns across the state and to evaluate the impact of global payments on referrals and spending. Results are expected to inform the development of ACOs and other delivery/payment system innovations.
This comprehensive analysis of claims data from three national insurers documents the extensive variation in the prices that hospitals receive for the same procedure. Payment rates vary not only across and within hospital markets but also within individual hospitals, suggesting that the relative bargaining power of hospitals and insurers plays a role in price determination. The work also establishes that monopoly hospitals are paid higher prices and are more likely to obtain contracts that place them at lower financial risk, whereas hospital prices are lower and contracts are more likely to be based on prospectively determined rates when the insurer market is more concentrated. Finally, analysis of hospital mergers over a five-year period demonstrates post-merger hospital price increases, with the largest impact observed when merging facilities are in closer proximity to one another.
In this essay, Dr. Sinaiko explains the latest developments and research and offers her thoughts on the ways this approach may evolve in the future.
Physicians estimate that more than 20% of medical care is unnecessary and can cause serious patient harm. This webinar reviewed additional approaches to curbing unnecessary medical treatments and spending.
This briefing brought top public- and private-sector health care leaders and policy experts to Capitol Hill to share their unique perspectives on efforts to drive value in health care.
This Washington, DC briefing on Capitol Hill featured experts from policy, business and academia sharing their insights on how to improve health outcomes for Americans while managing the cost of care.
This data brief pulls together the most current data available from multiple sources to provide an overview of national health spending.
In this data brief we examine why we spend more than $8,000 per person on health care and the factors driving spending growth.
Allison Lipitz-Snyderman and colleagues have shed new light on why cancer patients receive non-recommended care. Their study, supported by a NIHCM research grant, finds that use of low-value services is driven by physician preference, with little influence from the particular characteristics of a given patient.
This Research Insights summarizes findings from a new study showing that hospital market power drives higher negotiated prices for privately insured patients.
This Research Insights summarizes a study that found hospital prices grew faster than physician prices from 2007 to 2014.
This Health Matters webinar, hosted by USC Annenberg's Center for Health Journalism with support from NIHCM Foundation, offered insights into what’s driving pharmaceutical prices, explained how these costs impact patients and consumers, and suggested ways in which journalists can cover this evolving story.
Joe Carlson has been awarded the 20th Annual Trade Journalism Award for his Modern Healthcare investigation of the disconnect between costs and outcomes, “You Don’t Always Get What You Pay For.” He found that in many cases, the hospital with the lower average cost for inpatient and outpatient PCI procedures also had a lower readmission rate for PCI patients.
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