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Mar
05

KHN: Need A Medical Procedure? Pick The Right Provider And Get Cash Back

Laurie Cook went shopping recently for a mammogram near her home in New Hampshire. Using an online tool provided through her insurer, she plugged in her ZIP code. Up popped facilities in her network, each with an incentive amount she would be paid if she chose it. Paid? To get a test? It's part of a strategy to rein in health care spending by steering patients to the most cost-effective providers ...

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Mar
02

Crain's Chicago Business: This fast-growing doctors group is betting it all on hips and knees

Baby boomers are living longer, getting their aching hips and knees replaced as they age. That puts Illinois Bone & Joint Institute in the sweet spot of medicine. Hip and knee replacements are among the most common surgeries in the U.S.—and they're pricey. Everything involved in replacing one, from surgery to the weeks of rehab that follow, costs an average $36,000, according to Guroo, a site ...

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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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