ACA

Price Transparency and All Its Warts

Legislators in more than 30 states have proposed legislation to promote price transparency, with most efforts focused around publishing average or median prices for hospital services. Some states already have price transparency policies in place. California requires hospitals to give patients cost estimates for the 25 most common outpatient procedures. Texas requires providers to disclose price information to patients upon request. Ohio passed price transparency legislation last year; however a lawsuit filed by the Ohio Hospital Association has delayed implementation. The cost of a knee replacement is $15,500 at the Surgery Center of Oklahoma, whereas the national average is $49,500.

2020-05-14T03:31:16+00:00March 14, 2017|Categories: Patient, Policy|Tags: , , , , , |

Costs of a Hospital Monopoly in Underserved Counties

There is a growing body of evidence that hospital mergers lead to higher prices for consumers, employers, insurance, and government overall. It is imperative to educate patients and lawmakers as to how the consolidation of hospitals and medical practices raise costs, decrease access, eliminate jobs, and ultimately reduce care quality as a result. Lawmakers should focus on this “first pillar” of cost control as they go back to the drawing board.

Gaming the System: Pediatrics, Mammograms, and MACRA

Imagine what quality metrics the pediatric cardiac surgeon is going to track. He would do well to collect statistics on how often he images patients for appendicitis because it is likely a rare occurrence. Things are really looking up for the use of data and technology in healthcare. Costs are likely to keep rising with everyone scoring in the 99th% percentile once they figure out how to game the system. But we certainly cannot stand in the way of science or progress now can we?

2020-05-14T03:27:54+00:00February 21, 2017|Categories: Policy, Practice|Tags: , , , , , , |

Affordable Care for Children: One Pediatricians’ Experience

Compensation at the “Big 5” ranged from $10.1 million for Humana’s CEO to more than $66 million for the CEO of United Healthcare in 2015. CEO compensation for Anthem, Aetna, and Cigna also fell within that range. Affordable health care has definitely helped people. But who exactly are we trying to help? I am not convinced it is the children growing up in America today.

2020-05-03T17:16:05+00:00June 6, 2016|Categories: Policy, Practice|Tags: , , , , |
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