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Jan 17 2014

HHS notice on obtaining Medicare physician spending data

http://www.gpo.gov/fdsys/pkg/FR-2014-01-17/pdf/2014-00808.pdf
Jan 17 2014

According to the American Hospital Association, hospitals provided over $45 billion in uncompensated care in 2012, including charity care and bad debt write-offs, and they had $56 billion in under compensated care, which is there way of calculating that Medicare and Medicaid paid them less than the cost of care.

http://www.ahanews.com/ahanews/jsp/display.jsp?dcrpath=AHANEWS/AHANewsNowArticle/data/ann_011414_underpayment&domain=AHANEWS
Jan 17 2014

A survey reported in Health Affairs finds that most orthopedic surgeons don't know what the devices they are implanting cost, although more than 80% said cost should be important in device selection.

http://content.healthaffairs.org/content/33/1/103.abstract?=right
Jan 16 2014

Avalere Health projects that Medicaid enrollment in private health plans will grow substantially, up 20% over last year and up by 38% from 2013 to 2016, as more states push most or all of their Medicaid eligibles into private plans and the expansions under the reform law kick in.

http://www.avalerehealth.net/expertise/managed-care/insights/analysis-medicaid-plans-expected-to-grow-20-this-year-under-aca-expansion
Jan 16 2014

UnitedHealth Group, the first of the nation's large health plan companies to report earnings, said per share profit rose from $1.20 in the fourth quarter of 2012 to $1.41 this year.  Revenue rose to over $31 billion.  The company affirmed a forecast of $5.40 to $5.60 in earnings per share for 2014.

http://www.bloomberg.com/news/2014-01-16/unitedhealth-quarterly-profit-climbs-as-enrollment-rises.html
Jan 16 2014

Teladoc, which provides remote consultations for individual consumers and health plan members, said that it now covers 7.5 million people and will double its revenues in 2014.

http://www.teladoc.com/news/2014/01/15/teladoc-announces-adding-one-million-new-members-and-expects-to-double-annual-revenue-in-2014/
Jan 16 2014

ikaSystems, which provides administrative software for payers, says it has raised additional financing from existing investors.

http://www.ikasystems.com/News/PressReleases/TabId/108/ArtMID/506/ArticleID/131/ikaSystems-Announces-Additional-Funding-Following-Record-Year.aspx
Jan 16 2014

A statistical brief from AHRQ looked at trends in health expenditures for the over-65 population for 2001, 2006 and 2011, in constant dollars.  $414.3 billion was spent on health care for this population in 2011, $100 billion higher than in 2001.  Average per person expense was $9863 compared to $8815 in 2001.  The percent of people with an ER visit, inpatient stay or hospital outpatient visit declined from 2001 to 2011 and outpatient care and drugs accounted for more expense in 2011 than in 2001.  Average costs for all types of services were higher in 2011.  Medicare paid for 62.4% of the elderly's health expense in 2011 compared to 54.7% in 2001.

http://meps.ahrq.gov/mepsweb/data_files/publications/st429/stat429.pdf
Jan 16 2014

An AHRQ statistical brief based on survey data for 2012 finds that about 55.4 million employees were enrolled in their company's health plan (including dependents, the total number covered is much higher).  Eighty percent were in a plan with a deductible.  Single deductibles averaged $881 at larger employers and over $1500 at smaller ones, family deductibles  averaged $3300 for small firms and $1800 at larger ones.  About 66% of enrollees had copays, with more small companies than large ones including them in the benefit design.  The average copay was $23.77.  Around 27% of plans had coinsurance, with the average being about 19% of cost.

http://meps.ahrq.gov/mepsweb/data_files/publications/st427/stat427.pdf
Jan 15 2014

In a statistical brief that helps explain why so few younger Americans are signing up for coverage under the exchanges, AHRQ survey data for 2011 finds that 13.4% of adults aged 18 to 64 think they are two healthy to need insurance and 26% said health insurance isn't worth the cost, relatively stable with the same responses in 2010.  But  a smaller percent agreed with the statement in both years, indicating that attitudes can shift in both directions.  Interestingly, wealthier and higher education people are more likely to say they need insurance and it is worth the cost.

http://meps.ahrq.gov/mepsweb/data_files/publications/st426/stat426.pdf
Jan 15 2014

Mercom Capital Group released a report of VC funding for HIT in 2013, finding that $2.2 billion was raised, up substantially from $1.2 billion in 2012.  There were 571 deals and 466 investors.  There were two HIT IPOs in the year, and 165 M& A transactions in the sector.

http://store.mercom.mercomcapital.com/products-page/healthcare-it-reports/hit-2013-annual-and-q4-funding-report/
Jan 15 2014

A brief report from Mark Farrah Associates indicates that Blue Cross/Blue Shield plans currently enroll about 98.7 million Americans, 31% of the total population and 40% of the commercially insured group.  There are 36 BCBS companies, several are large multi-state organizations such as WellPoint, with plans in 14 states and HCSC, with plans in 5 states, including Texas and Illinois.  Blues plans received over $186 billion in premiums in 2012 and are the largest plans in 45 states.

http://www.markfarrah.com/healthcare-business-strategy/Blue-Cross-Blue-Shield-Plan-Consolidation-Continues.aspx
Jan 15 2014

According to Mark Farrah Associates as of December 1, 2013, there were 15,146,000 people in Medicare Advantage plans, about a 9% increase over the same time last year.  UnitedHealth Group has about 21% of the market, followed by Humana with 16% and Kaiser with 8%.  Around 17% of MA enrollment comes from employer retiree group plans.  2014 open enrollment ended on December 7, so the early indications are that there was strong growth.

http://www.markfarrah.com/healthcare-business-strategy/
Jan 15 2014

Millenium Laboratories, which helps personalize drug therapies, has acquired RxAnte, which provides analytics and decision support for medication adherence.

http://www.rxante.com/objects/pdfs/Millennium-Announces-Strategic-Acquisition-of-RxAnte.pdf
Jan 14 2014

HHS has announced that it will begin releasing physician level utilization data on a case-by-case basis.  This is a huge development that will allow the identification of physician practice patterns and an understanding of which doctors may be engaging in inappropriate overuse.

http://www.modernhealthcare.com/article/20140114/NEWS/301149951?AllowView=VDl3UXk1TzRDL0NCbkJiYkY0M3hlMEtvaTBVZEQrYz0=&utm_source=link-20140114-NEWS-301149951&utm_medium=email&utm_campaign=hits&utm_name=top
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About this Blog

Kevin RocheThe 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 khroche@healthy-skeptic.com.

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Research

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...
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The Office of the Actuary annual report on national health spending, covering 2018.
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2019 Kaiser Family Foundation Employer Health Benefits Report
October 1, 2019
MedPAC 2019 Report to Congress
June 18, 2019

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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 through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com. © Roche Consulting, LLC. Terms of Use.

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