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Hospital Cost Shifting May Be a Thing of the Past
Convention wisdom has long held that hospitals make up for reimbursement shortfalls in government insurance and uncompensated care by shifting those costs to the privately insured.
Convention wisdom has long held that hospitals make up for reimbursement shortfalls in government insurance and uncompensated care by shifting those costs to the privately insured.
Two studies released this month indicate that this may no longer be the case, although they reach different conclusions about how hospitals are coping with the slowdown in Medicare and Medicaid financing.
Rice University economist Vivian Ho and her colleagues looked at revenue by payer at Texas hospitals between 2000 and 2007. They concluded that hospitals have grown revenue by increased use of technology. Ho said she found no evidence that hospitals are shifting costs to private payers to compensate for the fact that they have to deal with the nation’s highest percentage of uninsured patients. She said technology accounted for two-thirds of the growth in prices. She also noted that hospitals are treating sicker patients because lower-acuity cases are being treated more frequently in outpatient settings.
Read the full story here: http://bit.ly/HaK49c
Source: Healthcare Daily
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A With Richard Hughes IV
April 21st 2025Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.
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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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Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
April 4th 2025This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.
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