Understanding bipartisan push for site-neutral Medicare payments aiming to curb healthcare costs, consolidation
Editor's Note Amid growing concerns over healthcare spending and affordability, there is bipartisan interest in aligning Medicare payments for outpatient services across various care settings through "site-neutral" payments, KFF June 14 reports. As a June 2023 Modern Healthcare article explains, last year Congress reviewed legislation to expand site-neutral payment policies,…
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…
Bill seeks to improve cost transparency, provide relief to patients
Editor's Note The US House of Representatives may vote this week on The Lower Costs, More Transparency Act. Introduced September 8, the proposed act aims to boost healthcare pricing transparency so consumers can make more informed decisions. Key elements include: Hospitals, payers, ambulatory surgery centers (ASCs), and other facilities would…
FTC lawsuit challenges private equity medical group ‘Roll-Up’ deals
Editor's Note The Federal Trade Commission (FTC) is squaring off against a private equity-backed anesthesia practice in Texas, HealthNews Florida November 30 reports. This move is being seen as a first step in the agency seeking to challenge the increasing role of private equity in monopolizing medical groups. In September,…
A closer look at variations in regional health insurance prices
Editor's Note This new study in JAMA Health Forum is one of the first to review publicly available insurer price data and compare regional rate differences. The research was published by JAMA Network on October 27. Following are some highlights: Over half of the US population receives health insurance from…
Price transparency in surgical settings
Takeaways • Healthcare consumers are not aware that they can ask how much something costs. • There is disconnect between the law and common knowledge, and patients generally are confused about what they receive as good faith estimates. • In addition to incorrect CPT codes and OON allowable charges, the…
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