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In Most of the US, Self-insured Employers Lack Power at the Bargaining Table With Hospitals
In this episode of Managed Care Cast, the lead author of an article in the July issue of The American Journal of Managed Care describes the latest research that looks at the power of self-insured employers to negotiate hospital prices and the relationship between employer market power and hospital prices.
In this episode of Managed Care Cast, the lead author of an article in the July issue of The American Journal of Managed Care® describes the latest research that looks at the power of self-insured employers to negotiate hospital prices and the relationship between employer market power and hospital prices.
Matthew Eisenberg, PhD, and coauthors used US Census Bureau County Business Patterns data from 2010 to 2016 to estimate employer market power in metropolitan statistical areas (MSA) and used Truven Health MarketScan commercial claims to estimate mean hospital prices and price ratios at the MSA level.
The paper, "Large Self-insured Employers Lack Power to Effectively Negotiate Hospital Prices," notes a few alternative ways that employers have tried to increase their ability to raise their purchasing power, but success has been limited.
Eisenberg, an economist and assistant professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, joined Managed Care Cast to discuss these findings.
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Expanding Access to Gene Therapies: Addressing Patient Burden, High Costs
December 3rd 2024Gene therapies can be life-changing for people, but the high cost plus the burden of treatment remain barriers to access and utilization, explained Kevin Niehoff, PharmD, BCMAS, of IPD Analytics.
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CMS, HHS Finalize Mandatory Model to Boost Kidney Transplant Access, Equity
December 2nd 2024The 6-year mandatory Increasing Organ Transplant Access Model aims to boost kidney transplants and address disparities by incentivizing hospitals, enhancing care coordination, and measuring transplant outcome performance.
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Expert Insights on How Utilization Management Drives Physician Burnout
November 26th 2024On this episode of Managed Care Cast, we speak with the author of a study published in the November 2024 issue of The American Journal of Managed Care® to explore the link between utilization management and physician burnout.
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Medicare Competitive Bidding Program Cuts Spending Without Impacting COPD Outcomes
November 29th 2024While the Medicare Competitive Bidding Program reduced spending, it did not significantly impact supplemental oxygen use or clinical outcomes among patients with chronic obstructive pulmonary disease (COPD).
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