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News You Need to Know Today
Healthcare Economics | April 2018
Thursday, April 5, 2018
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Editor's Choice: Economics

High cost of billing complexity: Up to $54B in physician office revenue challenged every year

Every year, physician offices may deal with as much as $54 billion in revenue being challenged by insurers, with fee-for-service (FFS) Medicaid being “the most challenging type” of payer to bill, according to a study published in Health Affairs.

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Joshua Gottlieb, PhD
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High cost of billing complexity: Up to $54B in physician office revenue challenged every year

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Joshua Gottlieb, PhD
Every year, physician offices may deal with as much as $54 billion in revenue being challenged by insurers, with fee-for-service (FFS) Medicaid being “the most challenging type” of payer to bill, according to a study published in Health Affairs.
READ MORE >

5 legislative, regulatory priorities for hospitals in 2018 and beyond

The failure to pass funding for reinsurance and cost-sharing reduction subsidies for the Affordable Care Act (ACA) exchanges and the potential for pharmaceutical-backed changes to the 340B drug discount program are just some of the major issues on the American Hospital Association’s radar this year, according to executive vice president of government affairs Tom Nickels.

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aha_tom_nickels_ache_at_podium.jpg
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5 legislative, regulatory priorities for hospitals in 2018 and beyond

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aha_tom_nickels_ache_at_podium.jpg
The failure to pass funding for reinsurance and cost-sharing reduction subsidies for the Affordable Care Act (ACA) exchanges and the potential for pharmaceutical-backed changes to the 340B drug discount program are just some of the major issues on the American Hospital Association’s radar this year, according to executive vice president of government affairs Tom Nickels.
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AAMC: Med schools, teaching hospitals generate $562B, 3.1% of GDP

Not far from any policy debate is the oft-repeated fact that healthcare makes up one-sixth of the U.S. economy. Newly published research took a deeper dive to investigate the impact of medical schools and teaching hospitals. And, as one would guess, they contribute a lot of the American economy, accounting for 3.1 percent of gross domestic product.

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AAMC: Med schools, teaching hospitals generate $562B, 3.1% of GDP

Share on Twitter Share on Facebook Share on Linkedin
Not far from any policy debate is the oft-repeated fact that healthcare makes up one-sixth of the U.S. economy. Newly published research took a deeper dive to investigate the impact of medical schools and teaching hospitals. And, as one would guess, they contribute a lot of the American economy, accounting for 3.1 percent of gross domestic product.
READ MORE >

Upside-only ACOs increased Medicare spending

Accountable care organizations (ACOs) were supposed to result in savings for Medicare, but an analysis from Avalere said ACOs in the Medicare Shared Savings Program (MSSP) have instead increased federal spending—an evaluation a national group of ACOs called “rather simplistic," ignoring positive impacts they've made on quality.

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Upside-only ACOs increased Medicare spending

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Accountable care organizations (ACOs) were supposed to result in savings for Medicare, but an analysis from Avalere said ACOs in the Medicare Shared Savings Program (MSSP) have instead increased federal spending—an evaluation a national group of ACOs called “rather simplistic," ignoring positive impacts they've made on quality.
READ MORE >

Consolidation in California has raised healthcare prices

Mergers and acquisitions that have consolidated healthcare markets in California have raised prices for procedures and insurance premiums, especially in the northern part of the state, according to a report from the University of California, Berkeley’s Petris Center on Health Care Markets and Consumer Welfare.

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Consolidation in California has raised healthcare prices

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Mergers and acquisitions that have consolidated healthcare markets in California have raised prices for procedures and insurance premiums, especially in the northern part of the state, according to a report from the University of California, Berkeley’s Petris Center on Health Care Markets and Consumer Welfare.
READ MORE >

Data, analytics top priorities for supply chain leaders in 2018

In a survey conducted by Global Healthcare Exchange, some of the top providers for supply chain performance said making better use of data would be their No. 1 priority this year, either through expanded analytics or standardizing their data process across the organization.

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Data, analytics top priorities for supply chain leaders in 2018

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In a survey conducted by Global Healthcare Exchange, some of the top providers for supply chain performance said making better use of data would be their No. 1 priority this year, either through expanded analytics or standardizing their data process across the organization.
READ MORE >

Maryland all-payer hospital program saves $586M in 3 years

The global budgeting, all-payer program adopted for most of Maryland’s hospitals has succeeded in keeping the growth in hospital revenue and Medicare expenditures below the rest of the nation through its first three years, while also reducing readmissions and complications.

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Maryland
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Maryland all-payer hospital program saves $586M in 3 years

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Maryland
The global budgeting, all-payer program adopted for most of Maryland’s hospitals has succeeded in keeping the growth in hospital revenue and Medicare expenditures below the rest of the nation through its first three years, while also reducing readmissions and complications.
READ MORE >

Design problems blamed for departures of Next Generation ACOs

The number of participants in the Next Generation ACO model has shrunk to 51 after seven accountable care organizations (ACOs) announced they’ll drop out of the program in the largest departure of providers since the model was introduced.

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Patient in center of network of physicians.
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Design problems blamed for departures of Next Generation ACOs

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Patient in center of network of physicians.
The number of participants in the Next Generation ACO model has shrunk to 51 after seven accountable care organizations (ACOs) announced they’ll drop out of the program in the largest departure of providers since the model was introduced.
READ MORE >

Data can make the difference in cutting waste from the supply chain

When Indiana’s Goshen Health decided to de-affiliate from Indiana University Health in 2016, it knew its supply costs were going to increase for its 122-bed hospital, cancer center and 27 physician practice locations, according to chief financial officer Amy Floria. That meant waste in the supply chain had to be cut out—like the 80 percent of hospital supplies which had sat untouched on a shelf for two years.

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Amy Floria Goshen Health HIMSS
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Data can make the difference in cutting waste from the supply chain

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Amy Floria Goshen Health HIMSS
When Indiana’s Goshen Health decided to de-affiliate from Indiana University Health in 2016, it knew its supply costs were going to increase for its 122-bed hospital, cancer center and 27 physician practice locations, according to chief financial officer Amy Floria. That meant waste in the supply chain had to be cut out—like the 80 percent of hospital supplies which had sat untouched on a shelf for two years.
READ MORE >

Prices and labor costs, not overutilization, set U.S. healthcare system apart

A new study published in JAMA challenges some of the more common explanations for why the U.S. spends more on healthcare than other high-income countries, finding the U.S. isn’t an outlier on measures like utilization, share of primary care physicians or social services spending.

READ MORE >
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Prices and labor costs, not overutilization, set U.S. healthcare system apart

Share on Twitter Share on Facebook Share on Linkedin
A new study published in JAMA challenges some of the more common explanations for why the U.S. spends more on healthcare than other high-income countries, finding the U.S. isn’t an outlier on measures like utilization, share of primary care physicians or social services spending.
READ MORE >

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