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Hip, Knee Replacement Cost-Variation for Insured Patients Driven by Hospitals: Study
The cost of new hips and knees for privately insured patients varied widely across three dozen hospitals in six states, with hospitals themselves the primary reason, a study shows.
The cost of new hips and knees for privately insured patients varied widely across three dozen hospitals in six states, with hospitals themselves the primary reason, a study shows.
The research analyzed spending for hospital care plus other medical services during the month after surgery, known as an episode of care. Findings show a two-fold variation in the cost for hip and knee episodes and “the price of the initial inpatient stay was by far the most important factor in a hospital's spending,” wrote researchers for the National Institute for Health Care Reform.
Average spending per episode ran from $17,000 to $35,000 across 36 hospitals in nine markets. Four of the markets were in Michigan (Detroit, Flint, Warren and Lansing), home to the auto industry, which founded the National Institute for Health Care Reform with the United Auto Workers. The study analyzed medical bills for 590,000 individuals with insurance in 2011 though the auto industry
Read the full story here: http://bit.ly/1knSdVM
Source: Modern Healthcare
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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For Neuromuscular Disease Community, an Era of Opportunities and Threats
March 17th 2025Robert Califf, MD, former commissioner of the FDA, delivered a keynote address at the 2025 Muscular Dystrophy Association Clinical & Scientific Conference that highlighted the enormous opportunities for progress in neuromuscular disease care amid a changing policy environment.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
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Oz Confirmation Hearing Probes Vision for Medicaid but Coalesces Around Well-Being
March 14th 2025Mehmet Oz, MD, the nominee to lead CMS under the Trump administration, testified in a confirmation hearing before the Senate Finance Committee, where he found common ground on improving outcomes through healthier lifestyle choices but encountered repeated questions on potential Medicaid cuts.
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