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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
AI Meets Medicare: Inside CMS’s WISeR Model With Sanjay Doddamani, MD, MBA, Part 2
August 5th 2025In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.
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Trump Directs Pharma Companies on Cutting Drug Prices Under Most-Favored-Nation Order
July 31st 2025President Donald Trump has sent letters to pharmaceutical companies, aiming to compel them to lower drug prices in the US to match the lowest prices offered in other developed nations, a move that could significantly reduce costs and disrupt the current system of pharmacy benefit managers.
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