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Mar
01

Medical Care: The Differential Effects of Insurance Mandates on Health Care Spending for Children’s Autism Spectrum Disorder

ABSTRACT Objectives: There is substantial variation in treatment intensity among children with autism spectrum disorder (ASD). This study asks whether policies that target health care utilization for ASD affect children differentially based on this variation. Specifically, we examine the impact of state-level insurance mandates that require commercial insurers to cover certain treatments for ASD f...

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Mar
01

Obstetrics & Gynecology: Rate of Pelvic Organ Prolapse Surgery Among Privately Insured Women in the United States, 2010-2013

Abstract OBJECTIVE: To analyze utilization of, and payments for, pelvic organ prolapse procedures after the 2011 U.S. Food and Drug Administration (FDA) communication regarding transvaginal mesh. METHODS: This is a retrospective cohort study examining private claims from three insurance providers for inpatient and outpatient prolapse procedures from 2010 to 2013 in the Health Care Cost Institute. ...

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Feb
23

Health Payer Intelligence: Medicare Advantage Evaluation Requires Transparent Claims Data

 By Thomas Beaton February 23, 2018 - The growth of the Medicare Advantage (MA) market requires the release of more claims data to evaluate the commercial and government impact of the program, according to a recent JAMA commentary from the Health Care Cost Institute, ProPublica, and the VA. "Despite the important and increasing role of Medicare Advantage plans, there is fairly little insight ...

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Feb
21

How common is your health care spending?

It is well documented that Americans spend a lot on health care, but this issue is often discussed in terms of share of GDP, billions of dollars, or an astoundingly high hospital bill. These numbers can be hard to relate to; it's hard to imagine billions of dollars, let alone a share of the national economy. A pricey bill may get our attention, but can seem like a special case that doesn't relate ...

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Feb
15

RevCycle Intelligence: Hospital Cost-Shifting Increases Private Payer Payments by 1.6%

Healthcare organizations that faced Medicare reimbursement reductions under the Affordable Care Act engaged in hospital cost-shifting that resulted in 1.6 percent higher average payments from private payers, a new working paper from the National Bureau of Economic Research uncovered. Researchers reported that hospitals penalized under the Hospital Readmission Reduction Program (HRRP) and the Hospi...

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