Bulletin Board
Bulletin Board
Tools for Controlling Cost Growth Limited
Employers and insurers sometimes have limited means of reducing growth in health care costs, a new study has found. While hospitals can take incremental steps to manage rising costs, those efforts will be outstripped in geographic markets that have undergone a great deal of consolidation, according to a new analysis from the Georgetown University Health Policy Institute. In areas of such consolidation, the study found, insurers can be reluctant to negotiate hard with hospitals and health systems or to threaten to exclude those providers from their networks and businesses, rather [...]
Hospitals Advocate Losing Chargemaster
Hospitals would no longer need to post their chargemaster prices under a new approach to Medicare payments being advocated by a new hospital lobbying group. The small group, calling itself the Chargemaster Alternatives for Medicare Payment Alliance, wants Medicare to eliminate payment formulas based on chargemaster prices and base them instead on actual costs. Acting in response to a new proposal that hospitals be required to post their chargemaster prices, the group argues that chargemaster prices are irrelevant for all but a few consumers. Learn more about the group, its [...]
It’s Hospitals’ Turn to Sue Opioid Makers
Hospitals are now joining cities and states in suing opioid makers for the financial damages their products have caused. In Arizona, Florida, Kentucky, Mississippi, Tennessee, Texas, and West Virginia, hundreds of hospitals are now suing opioid makers in state courts to seek compensation for the unreimbursed costs they incurred caring for uninsured patients who came to them suffering from overdoses and addiction. For the most part, the most prominent hospitals and health systems in these states have not joined the suits. According to court documents, the suing hospitals estimate that [...]
Use of APMs, Value-Based Payments Continues to Increase
Payments based on alternative payment models and value-based measures continue to play a larger role in health care reimbursement. Almost 36 percent of health care payments involved APMs in 2018. In addition, fee for service accounted for 39 percent of payments. While these figures represent both represent increases over 2017, the rate at which they are growing has slowed. With APMs, one of the challenges is that providers have yet to come to terms with downside risk, which is required under some models. Medicare Advantage plans are especially advanced in [...]
Number of Uninsured Children on the Rise
The number of children insured by Medicaid and CHIP has fallen by more than one million over the past two years after reaching an all-time low (by percentage) in 2016. Why? According to the New York Times, Some state and federal officials have portrayed the drop — 3 percent of enrolled children — as a success story, arguing that more Americans are getting coverage from employers in an improving economy. But there is growing evidence that administrative changes aimed at fighting fraud and waste — and rising fears of deportation [...]