Hospital Costs
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Improving Hospital Compliance With Price Transparency Rules
Price transparency has long been viewed as a critical component of driving competition and consumerism in health care. Until recently, however, price data were largely unavailable and out of reach of nearly all consumers, policymakers, and researchers.Starting January 2021, through the Hospital Price Transparency rule, the Centers for Medicare and Medicaid Services (CMS) required hospitals to post...
Hardwiring Best Practices for Safe Mobility and Delirium Prevention in Older Adult Patients
IntroductionThis case study, featuring the University of Alabama Birmingham Hospital, underscores how deliberate system redesign can embed evidence-based mobility and delirium prevention strategies into routine care. This approach improves outcomes for older adults — reducing complications, length of stay, and post-acute care needs — and offers a scalable model to transform front-line workflows ac...
Price Markups for Clinical Labs: Employer‑based Insurance Pays Hospital Outpatient Departments 3X Than Physician Offices and Independent Labs for Identical Tests
West Health in collaboration with the Health Care Cost Institute (HCCI) conducted an analysis of the high prices that employer-based insurance pays hospital outpatient departments for clinical lab tests. We found that insurers are paying 3 times more for identical tests (such as simple blood and urine tests) when billed by hospital outpatient departments compared to physician offices and independe...
Health Savers Initiative: Capping Hospital Prices
CHAIRMENMITCH DANIELS LEON PANETTA TIM PENNYPRESIDENTMAYA MACGUINEASDIRECTORS BARRY ANDERSON ERSKINE BOWLES CHARLES BOWSHER KENT CONRAD DAN CRIPPEN VIC FAZIO WILLIS GRADISON JANE HARMAN WILLIAM HOAGLAND JIM JONES LOU KERR JIM KOLBE MARJORIE MARGOLIES DAVE MCCURDY JAMES MCINTYRE, JR. DAVID MINGE JUNE O’NEILL MARNE OBERNAUER, JR. RUDOLPH PENNER ROBERT REISCHAUER CHARLES ROBB ALAN K. SIMPSON JOHN SPR...
Moving to Site Neutrality in Commercial Insurance Payments
Hospital care is the largest single source of expenditures within the health care system, driven in large part by high prices. One factor behind those high prices are payment differentials based on site-of-care, regardless of safety or clinical effectiveness.In a previous Health Savers Initiative brief, “Equalizing Medicare Payments Regardless of Site-of-Care,“ we estimated adopting site-neutral p...
Private Insurance Payments to California Hospitals Average More Than Double Medicare Payments
Private insurers paid hospitals in California on average more than double what Medicare paid them for similar services in 2015 and 2016. Our analysis of financial data filed by hospitals with the California Office of Statewide Health Planning and Development (OSHPD) found substantial variation across hospitals in the relationship of private insurance payments to Medicare. For the 10 percent of Cal...
Healthcare Consolidation: Major Contributor to Rising Costs
Compared to other developed nations, the United States spends far more on healthcare yet still experiences lagging health outcomes. At the same time, healthcare spending in the United States continues to outpace our economic growth. One of the key contributing factors to rising healthcare costs is rising market consolidation. Since 2010 there have been more than 1000 hospital mergers, which has re...