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Providers

2012 Potpourri XXXVIII

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In this holiday season, it is a time for giving presents and our latest Potpourri presents you with many gifts of health information, including some positive news about an ACO program, some cautions for the success of ACOs, an apparently successful disease management program, lung cancer screening, earnings growth for physicians and other health professionals and lessons in bundled payments.

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New Paper on Provider Pricing Power

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Another extensive research paper details the effects of provider consolidation and consequent market power on the health care industry in the United States, and specifically on the growth of health spending. Not a pretty picture, and the effect of the reform law is to exacerbate the problem.

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KPMG Report on Health System Change

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Another consultant’s report on the American health system, this one from KPMG and focusing on the supposed transformation from a volume-based system to one founded on value. While leaders of health care system participants recognize the likelihood of significant change, they also seem determined not to let their share of health system spending drop.

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New Health Care Spending Breakdown

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The Health Care Cost Institute releases a report on spending and utilization in the employer-based health care coverage market for 2011. Spending continues to rise faster than inflation or economic growth and is largely driven by higher prices charged by providers, not by increases in utilization.

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AHRQ on Bundled Payments

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Bundled payments are designed to change the incentives for providers so that they manage patient care in a more cost-effective manner, hopefully without negatively affecting quality. A report from the Agency for Healthcare Research and Quality examines the research evidence to date on the effect of bundled payment approaches, finding that spending and utilization are probably lower, with an uncertain effect on quality.

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Variation in Episode Cost in a Commercial Health Plan

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Research based on data from UnitedHealth Group’s commercial health plans finds wide variation in episode of care costs across both selected procedures and chronic diseases. The research also showed that for care provided by physicians meeting certain quality and efficiency benchmarks, episode of care costs were generally lower than for care provided by other physicians.

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