Health plans don’t like being beaten up over premium increases, so they have tended to shift the blame, generally correctly so, to providers for utilization and unit price increases. The American Journal of Managed Care carries another piece of research aimed at discerning trends in hospital pricing over the last few years. (AJMC Research) The researchers used a database for 45 to 50 million people, under age 65, with commercial group health insurance and examined the actual total payments from the insurer and the covered person for inpatient hospitalizations for 350 admission categories. On an unadjusted basis, for the years 2008 through 2010, prices per admission grew 8.2% per year. The intensity of health care services does change constantly, usually in a justifiable fashion, so the authors adjusted for intensity, and with those adjustments, prices grew around 6.8% per year. Either number is far above general inflation during this period or growth in per capita GDP. Prices for many of the most common admission diagnoses grew in a variable pattern, but almost all were well above inflation and GDP growth. While rural areas had price growth close to the national average, major metropolitan areas showed more variation, with Houston showing slow price growth, for example, while in the same state, Dallas and San Antonio had much more rapid increases. The research supports our long-time belief that unit prices, particularly hospital inpatient and outpatient prices, are a much more important factor in health care spending growth than utilization changes.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
NextGen, an electronic medical records firm, is being put out of its public company misery, as a PE firm will pay $1.6 billion for the one-time high-flier.
September 7, 2023
A number of companies which attracted large financing rounds during the epidemic have imploded when reality set in. The latest is Cano Health, which is a little surprising since it...
August 15, 2023
Another over-hyped digital health company screws shareholders who bought the hype, as Babylon Health has to bail itself out by going private, with nothing being returned to ordinary shareholders. The...
June 26, 2023
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace