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The COVID-19 pandemic has impacted Americans in a myriad of ways, including their use of the health care system for both COVID- and non-COVID related services. In this brief, we explore the ways in which the first year of the pandemic affected people for one of the most common hospital services – childbirth. In 2020, the first year of the pandemic, more than 3.6 million babies were born in the Uni...

COVID-19 testing has become a regular part of life for many Americans over the last two years. In addition to facilitating individual returns to work, school, and other activities, testing is a crucial component of the public health strategy to monitor and address the spread of the virus. Even as testing becomes more available, there is widespread concern and frustration about the high and variabl...

Abstract: Recent proposals have sought to limit the amount dialysis clinics charge private payers, but little is known about the prices that private insurers actually pay for dialysis. In this study, we provide novel evidence on dialysis prices based on claims data for a large national sample of private employer-sponsored insurance carriers.

Abstract:  We analyze whether receiving care from higher-priced hospitals leads to lower mortality. We overcome selection issues by using an instrumental variable approach which exploits that ambulance companies are quasi-randomly assigned to transport patients and have strong preferences for certain hospitals. Being admitted to a hospital with two standard deviations higher prices raises spe...

ABSTRACT Importance Physician management companies (PMCs), often backed by private equity (PE), are increasingly providing staffing and management services to health care facilities, yet little is known of their influence on prices. Objective To study changes in prices paid to practitioners (anesthesiologists and certified registered nurse anesthetists) before and after an outpatient facility cont...

Valentine's Day – known for romantic candlelit dinners, lavish jewelry, and red roses – is pricey. Indeed, the National Retail Federation's Annual Valentine's Day Spending Survey suggests that an individual spends an average of $175 on these gifts each year. However, data from the Consumer Product Safety Commission shows that the cost of love may be even greater, as more than 300 emergency room vi...

Abstract: CBO examined potential reasons that the prices paid by commercial health insurers for hospitals' and physicians' services are higher, rise more quickly, and vary more by area than the prices paid by the Medicare fee-for-service program.

Health care in the United States is notoriously fragmented. A patient may receive care from a variety of health systems, physicians, and other providers, and that care may or may not be recorded in a patchwork of administrative claims data systems and electronic health record (EHR) systems. At the same time, health data has become an increasingly valuable commodity. Billions of health data points ...

Introduction Excessive emergency room (ER) spending and utilization have long been major areas of focus for health care stakeholders. The ER is an important source of health care for many individuals, especially those who lack a usual source of care, or those with work schedules that limit the ability to access care during "normal business hours." But an ER visit can be extremely expensive, and pa...

Previous HCCI analysis documented rapid growth in insulin spending over the 2012-17 period. High out-of-pocket spending may deter adherence to insulin among individuals with diabetes, with potentially fatal effects. In this blog, we update our analysis of out-of-pocket insulin spending to 2019 using HCCI's unique commercial claims dataset, which includes prescription drug claims for 29 millio...

Abstract Concern about high hospital prices for commercially insured patients has motivated several proposals to regulate these prices. Such proposals often limit regulations to highly concentrated hospital markets. Using a large sample of 2017 US commercial insurance claims, we demonstrate that under the market definition commonly used in these proposals, most high-price hospitals are in markets ...

Question  What is the association of state surprise-billing legislation with prices paid to anesthesiologists in hospital outpatient departments and ambulatory surgery centers? Findings  This retrospective economic analysis of more than 2.5 million claims filed for patients with private health insurance who received anesthesia services in hospital outpatient departments and ambulatory su...

Question Are there differences in insurer spending and care utilization for patients with private insurance undergoing cancer surgery at National Cancer Institute (NCI) centers vs community hospitals? Findings In this cross-sectional study of 66 878 patients with breast, colon, or lung cancer, surgery at NCI centers, compared with community hospitals, was associated with higher insurer prices paid...

 Abstract Objective: The primary objective is to describe the relationship between the days supplied of postsurgical filled opioid prescriptions and refills. Background: The American College of Surgeons (ACS) has called for surgeons to alter opioid prescribing to counteract the opioid epidemic while simultaneously providing pain relief. However, there is insufficient evidence to inform periop...

 Introduction This study assesses the associations between the recent implementation of robust features of state Prescription Drug Monitoring Programs and the abrupt discontinuation of long-term opioid therapies. Methods Data were from a national commercial insurance database and included privately insured adults aged 18–64 years and Medicare Advantage enrollees aged ≥65 years who initiated a...

 ABSTRACT Objectives: Anesthesiology services are a focal point of policy making to address surprise medical billing. However, allowed amounts and charges for anesthesiology services have been understudied due to the specialty's unique conversion factor (CF) unit of payment and complex provider structures involving anesthesiologists and certified registered nurse anesthetists (CRNAs). This st...

ABSTRACT Objectives: To describe the association between the form of hospitals' contracts—either markup from a benchmark or a discount from a list price—and performance: price, charge, cost, and length of stay. Study Design: Retrospective observational study using administrative claims data matched with hospital characteristics from the American Hospital Association Annual Survey and the Healthcar...

Abstract: Patients with sickle cell disease (SCD) or cancer with bone metastasis often present to the emergency department (ED) for treatment of severe pain, and opioid analgesics remain first-line therapies for acute pain in the ED or after discharge. Policies aimed at improving the safety of opioid prescribing, such as state legislative mandates that prescribers register with or u...

The United States Congress passed the No Surprises Act last year, offering several protections to consumers. Beginning in 2022, providers can no longer bill patients for more than their insurance's in-network cost sharing. The law also bans balance billing except in situations where a patient is notified in advance and their written consent is obtained. Independent dispute resolution between insur...

Abstract:  IMPORTANCE  By 2020, nearly all states had adopted oncology parity laws in the US, ensuring that patients in fully insured private health plans pay no more for orally administered anticancer medications (OAMs) than infused therapies. Between 2013 and mid-2017, 11 states implemented parity with out-of-pocket spending caps, which may further reduce patient out-of-pocket spending...

The 2019 Health Care Cost and Utilization Report presents data on health care spending, utilization, and average prices from 2015 through 2019 for individuals under the age of 65 who receive health insurance coverage through an employer. This report examines trends within four categories of service: inpatient admissions, outpatient visits and procedures, professional services, ...

Summary The price of childbirth in New York City varies multifold, depending on where a woman delivers. This variation in price across boroughs, and across providers within boroughs, might make sense if it corresponded to higher-quality care. But higher prices do not always signify better quality. This report examines variation in what is paid for childbirth in each of the five boroughs of New Yor...

Abstract: Private equity firms have increasingly acquired physician practices, and particularly dermatology practices. Analyzing commercial claims from the Health Care Cost Institute (2012–17), we used a difference-in-differences design within an event study framework to estimate the prevalence of private equity acquisitions and their impact on dermatologist prices, spending, utilization, and volu...

Updated 4/16/2021 to include data through 12/30/2020. Since the original post on 9/9/2020, the data have been adjusted to account for claims submission lags. For more information, see Methods Note below. COVID-19 has had an extraordinary impact on the US health care system since its emergence in early 2020. One of the largest and most immediate impacts has been the death toll, with ...

The numbers in this report have been updated to reflect the most recent pricing data made available by Sutter Health. While nearly all of the prices remained unchanged (93%), some, generally higher cost services were revised downward by Sutter. For example, in the initial report we found that C-section prices ranged from $7,634 to $89,244 across the Sutter system, whereas in the more recently avai...