ABSTRACT Objective: To compare differences in opioid prescription, health care utilization, and costs among patients with low back pain (LBP) who saw a physical therapist (PT) at the first point of care, at any time during the episode or not at all. Data Sources: Commercial health insurance claims data, 2009–2013. Study Design: Retrospective analyses using two‐stage residual inclusion instru...
By Thomas Beaton Employer-sponsored health plans that include high cost sharing expectations can help control spending for plan sponsors, but could create longer-term health risks for employee beneficiaries. Striking the right balance between lowering costs and enabling healthy decision-making can be a challenge for employers and payers looking to design cost-effective plans. How can plan sp...
By: Kelly Gooch A newly revised study reveals insights into monopoly pricing, finding hospital market structure is strongly linked with pricing and insurer contract structure. For the study, researchers primarily examined private insurance claims data from Aetna, Humana and UnitedHealth. The data, provided by the Health Care Cost Institute, covers healthcare received by 28 percent of America...
By: Sarah Kliff On October 19, 2016, Jessica Pell fainted and hit her head on a nearby table, cutting her ear. She went to the emergency room at Hoboken University Medical Center, where she was given an ice pack. She received no other treatment. She never received any diagnosis. But a bill arrived in the mail for $5,751. "It's for the ice pack and the bandage," Pell said of the fee. "That is...
ABSTRACT: We use insurance claims data covering 28 percent of individuals with employer-sponsored health insurance in the US to study the variation in health spending on the privately insured, examine the structure of insurer-hospital contracts, and analyze the variation in hospital prices across the nation. Health spending per privately insured beneficiary differs by a factor of three across...
