RAND study reveals private payers pay 250% more than Medicare for healthcare services
Editor's Note A recent analysis by the RAND Corporation, a research and analysis nonprofit, revealed a disparity between hospital and ambulatory surgery center (ASC) prices paid by employers and private payers compared to Medicare prices, Revcycle Intelligence May 15 reports. The study, covering data from 2020 to 2022, showed private…
Per-person healthcare spending grows nearly 19% in 5 years
Editor's Note Average prices for healthcare services trended upward from 2018 to 2022 despite fluctuations in utilization of service, according to the annual Health Care Cost and Utilization Report (HCCUR) from the Health Care Cost Institute (HCCI). In the same timeframe, per-person spending increased nearly 19%. "Prices, in particular, pose a…
Large amounts of personal data possibly stolen in Change Healthcare cyberattack
Editor's Note Personal information about a “substantial portion of people in America” could be at risk from the February 21 cyberattack on UnitedHealth’s Change Healthcare division, The Associated Press reported April 23. Although the company reports no signs of full medical histories or charts were released, notifying all who were…
Survey assesses continued impact of Change Healthcare cyberattack
Editor's Note Fallout from the February 21 cyberattack on Change Healthcare continues to threaten physician practices and their patients nationwide, with respondents to a recent American Medical Association (AMA) survey indicating difficulties with insurance claims and eligibility verification. AMA published the results of the informal survey April 10. Conducted March…
Concierge physician practices expanding to large hospitals
Editor's Note The practice of concierge physicians is expanding as thousands of doctors at large hospital systems shift to a model facilitating high fees and decreased patient load, according to an April 1 report in KFF Health News. The concierge physician model began decades ago in wealthy areas of Florida…
Private payers profit by delaying medical claims
Editor's Note Private payers initially deny reimbursement on 15% of claims, only to later approve more than half of those initial denials, according to a national survey of healthcare institutions published March 21 by Premiere, Inc. Additionally, the denied claims on average tend to be more prevalent for higher-cost treatments…
Updated physician shortage projections smaller but still significant
Editor's Note The gap between demand and supply could result in a shortage of 13,500 to 86,000 physicians by 2036, according to updated projections published March 21 by the Association of American Medical Colleges (AAMC). Although these figures are smaller than projections in the last report, published in 2021, they…
How data puts the ‘value’ in value-based care
What if a surgeon decided to perform a procedure on a patient that was not totally necessary? It happens more often that one might realize. As recently as August 2023, Forbes published an article that cited a Harvard Business Review report stating that over 50% of lumbar spine surgeries are…
Medicare households have double the healthcare spending burden
Editor's Note The healthcare spending burden of Medicare households was double that of non-Medicare households in 2022, according to an analysis published by KFF (Kaiser Family Foundation) on March 14. Using data from the Consumer Expenditure Survey, KFF found that average health-related expenses made up 13.6% of Medicare households’ total…
Alabama immunity legislation shields IVF patients, providers
Editor's Note A new Alabama law provides civil and criminal immunity for providers and patients of in vitro fertilization (IVF) services, the Associated Press reported March 7. Last month, the Alabama Supreme Court effectively ruled that frozen embryos are people with a constitutional right to life, casting doubt on the…
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