The Health Care Cost Institute was started to compile claims and other data across private and public payers and to make that data available for analysis of cost and other health care issues. Right now it comes as close as anything to a universal database of all paid claims across all lines of business. Such a database allows a deeper understanding of practice patterns and costs, and helps identify potential differences in medical treatment for patients covered by distinct payers. The Institute recently released several reports from independent researchers using the HCCI data. (HCCI Reports) Most of these studies confirm views or prior research results, but they have high credibility because of the scope and quality of the data which underlies them. One paper used CalPERS’ reference pricing approach to estimate that the three largest commercial insurers could save $95 million on colonoscopies alone. Another found that states with independent nurse practitioner scope of practice laws had lower unit prices for primary care, but total health spending increased, likely due to increased access. A third study confirmed that hospital consolidation of formerly independent oncology practices significantly increased cancer care costs, mostly because of facility fees and use of more expensive medications. Another piece of research found that the passage of the federal mental health treatment parity law appeared to have no impact on use of mental health services, which suggests that lack of parity was not the reason patients were not getting potentially beneficial care. Research into telehealth payments found very little use and that telehealth is reimbursed at a lower rate when it is used. Some states have begun passing laws mandating parity between in-person and telehealth visits, which makes no sense because the value of telehealth is not only that it can increase access and convenience, but that it has lower costs for the provider to deliver the service, and those lower costs should be passed on to the payer. A final study found that patients who see a physical therapist first when they have lower back pain had lower total treatment costs than if they saw a physician or other provider type first. The savings came from reduced use of the emergency room, prescription painkillers, and from lower hospital and outpatient service use.
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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].
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