Health Care Costs Continue to Grow

One thing is certain as we head into 2020, health care costs continue to rise. Here are some of the key statistics reported in 2019: $3.8 trillion is the predicted health care spend in 2019[1] 4.8% is the predicted increase in health care spend in 2019[2] 5.7% is the average rate national health spending is … Continued

An Accident of History

A fascinating article entitled, “The employer-health insurance connection an ‘accident of history’” by David Balat appeared in the November 9, 2019 edition of The Hill. The article briefly traces the history of healthcare in the United States and how it evolved into an employer-sponsored benefit. “Most early prepaid medical care programs in this country began … Continued

The Cost of Inpatient Care

Kaiser State Health Facts has issued a report of 2017 adjusted expenses per inpatient day for all 50 states.[1] “These figures, which are based on information from the 2017 American Hospital Association Annual Survey, include all operating and nonoperating expenses for registered U.S. community hospitals, defined as public, nonfederal, short-term general and other hospitals. The … Continued

2018 Medical Loss Rebates

The Affordable Care Act (“ACA”) requires health insurance companies to disclose how much they spend on health care and how much they spend on administrative costs, such as salaries and marketing. If an insurance company spends less than 80% (85% in the large group market) of premiums on medical care and efforts to improve the … Continued

Fate of the ACA

In February 2018, 20 Republican state attorney generals and governors filed suit to have the ACA declared unconstitutional in the U.S. District Court for the Northern District of Texas in a case captioned, Texas, et al. v. United States of America, et al., 4:18-cv-00167. The plaintiffs were successful and the case is now on appeal … Continued

Is the Legislative Focus on Surprise Billing Misplaced?

In a September 3, 2019 article in Health Affairs, Michael E. Chernew, Maximillian J. Pany, and Richard G. Frank make the argument for market-based price caps to address soaring health costs. “The gap between prices in the US and other countries, the large price-cost margins in the commercial sector, and the wide variation in prices … Continued

KFF Annual Employer Health Benefits Survey

Today the Kaiser Family Foundation released its annual Employer Health Benefits Survey. The annual survey of employers “provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs, and employer practices. The 2019 survey included 2,012 interviews with nonfederal public and private firms.” Here are just … Continued

Surprise Medical Bills Study

On June 20, 2019, Peterson-Kaiser published “An examination of surprise medical bills and proposals to protect consumers from them.” The study used “claims data from large employer plans to estimate the incidence of out-of-network charges associated with hospital stays and emergency visits that could result in a surprise bill.” It also surveyed state and federal … Continued

Ground Ambulances and Surprise Billing Legislation

Ground ambulance bills are the largest source of unexpected out-of-network medical bills according to research by Christopher Garmon, a health economist at the University of Missouri-Kansas City. His research showed that “[i]n more than half of cases involving ambulance transportation, the ambulance services were out of network […].”[1] Over 50% of ground ambulance rides end … Continued

The Current State of Federal Surprise Medical Billing Legislation

As the statistics demonstrate, surprise medical billing is a big issue in the U.S.: About 1 in 6 Americans are faced with a surprise medical bill each year. 16% of inpatient stays and 18% of emergency visits leave patients with out-of-network charges. 26% of admissions from the emergency room result in a surprise medical bill.[1] … Continued