Following a private equity acquisition, physician practices saw a 20.2 percent increase in charges per claim, an 11 percent raise in the allowed amount per claim, and a 37.9 percent increase in new patient visits. Private equity acquisition of physician practices in dermatology, gastroenterology, and ophthalmology was associated with increased healthcare spending and utilization, according […]
Failing to post files in a machine-readable format was the most common violation of the hospital price transparency rule among NCI-designated cancer centers. Less than one-third of hospitals with National Cancer Institute (NCI) cancer center designation were fully compliant with the CMS hospital price transparency rule, according to research published in JAMA Surgery. The price […]
Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]
The Medicare program and Medicare beneficiaries could have saved a combined $1.6 billion if provider-based facilities charged the same payment rate as freestanding facilities, OIG found. Medicare and its beneficiaries paid significantly higher prices at provider-based facilities than they would have paid to freestanding facilities for the same services, according to a report from the […]
A Medicare out-of-pocket healthcare spending cap could halve out-of-pocket spending for beneficiaries, but could boost overall traditional Medicare spending. By implementing a $5,000 spending cap in traditional Medicare, policymakers might be able to halve out-of-pocket healthcare spending for high-spending Medicare beneficiaries, but they risk an increase in overall Medicare spending, a study from Urban Institute […]
Healthcare spending could drop by more than $11.4 billion next year if enhanced premium tax credits enacted in the American Rescue Plan expire, new research finds. Hospital spending would decline by $3.8 billion, while spending on physician practice services would drop by $1.3 billion, according to a report from the Robert Wood Johnson Foundation and […]
The Great Resignation forced employers to focus on how they can improve healthcare benefits to retain talent, but employers and employees have differing opinions on healthcare coverage. As the Great Resignation sweeps across the US, employers and their human resource teams are often misaligned with employees regarding health insurance coverage and the role healthcare benefits […]
Medicare Advantage plans draw a more diverse beneficiary population and can result in lower healthcare spending for low-income beneficiaries. Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage […]
Around 3,600 healthcare providers that have experienced pandemic-related revenue losses and expenses will receive payments through this round of Phase 4 COVID-19 Provider Relief Funds. Through the Health Resources and Services Administration (HRSA), HHS has released the fifth round of Phase 4 COVID-19 Provider Relief Funds, which includes $1.75 billion for healthcare providers that […]
From 2021 to 2030, national healthcare spending will return to its steady upward growth as the unusual impacts of the coronavirus pandemic dissipate. CMS has released its projections for national healthcare spending from 2021 to 2030, noting that healthcare as a share of the gross domestic product (GDP) will remain comparable to the share […]