Tag: "Health Care Costs"

Boom! Hospital Revenue Up 5 Percent in Twelve Months

This morning’s Quarterly Services Survey (QSS) released by the Census Bureau reported that hospitals’ revenue rose 4.9 percent from the end of the second quarter in 2013 to the end of the second quarter in 2014. From the first quarter to the second quarter of 2014, it jumped 2.8 percent, overcoming a first quarter drop of minus 0.8 percent. Revenue for ambulatory services rose only 2.4 percent in the same twelve months. It jumped 3.0 percent from the first quarter of 2014, but had dropped 2 percent in the first quarter from the end of 2013.

The QSS surveys a sample of service businesses, and is assuming increasing importance in economic research. It is important because it reveals complementary — and in this case contradictory — data about health spending. As I’ve discussed frequently at this blog, healthcare employment is growing steadily, but not in hospitals. Growth is in the outpatient setting. I had hoped that this indicated that health services were moving out of the high fixed-cost hospital setting and into lower fixed-cost outpatient settings, especially convenient retail clinics.

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Sep 11, 2014 | 7 comments | by

Why are Health Insurers Persecuting Innovative Drug-Makers, Instead of Bloated Hospitals?

One constant refrain heard in national health policy circles is the need for “integrated” or “coordinated” care. To be sure, I have never heard anyone speak favorably of “disintegrated” or “un-coordinated” care. While there are many good-faith practitioners who do want to integrate and coordinate care for patients, these terms are often used to camouflage a more straightforward way to raise prices. Here’s an example from Bloomberg BusinessWeek:

money-burdenFor the past four years, Pennsylvania insurance company Highmark has watched its bills for cancer care skyrocket. The increase wasn’t because of new drugs being prescribed or a spike in diagnoses. Instead, the culprit was a change that had nothing to do with care: Previously independent oncology clinics and private practices have been acquired by big hospital systems that charge higher rates, sometimes three times as much, for chemotherapy drugs. “The site of care and the type of service provided does not change at all,” says Tom Fitzpatrick, Highmark’s vice president of contracting. “The only significant difference that we primarily see is the [patient] gets a wristband placed on them.”

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Jul 29, 2014 | 13 comments | by

“We Are Trying to Come Up with Theories”: The “Final” First Quarter GDP Estimate May Not Be So Final After All

This blog noted that Obamacare led the Bureau of Economic Analysis to make a seriously flawed estimate of health spending in the first quarter of 2014. Instead of an initial growth in Gross Domestic Product (GDP), and  revised drop of one percent , the “final” estimate was a drop of 2.9 percent annualized, Well, according to the New York Times, there are still “baffling contradictions” in the data on health spending that might lead to a remarkable revision of the “final” estimate:

Behind that reversal were the results of a quarterly survey of service providers. The survey, conducted by the Census Bureau, asks 18,000 companies in 11 service industries about their revenue and expenses. Health care providers, including physicians and hospitals, reported a decline in revenue from the previous quarter.

Eventually, there will be a more comprehensive annual survey, which could change the numbers…Mr. Mandel, the B.E.A. economist, said the bureau was trying to figure out what happened. “On the why, I don’t have a clear answer,” he said in an interview. “We are trying to come up with theories.”

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Jul 11, 2014 | 8 comments | by

Headlines I Wish I Hadn’t Seen

Confident DoctorsObamaCare made me fire my doctor.

As health care law’s employer mandate nears, firms cut worker hours, struggle with logistics.

Insurers on New York’s exchange seeking significant rate increases.

Only 25 percent of patients are offered cost estimates before treatment

Injury, violence are leading causes of death for young Americans.

Jul 08, 2014 | 14 comments | by

Health Spending and First Quarter GDP: What Happened?

A couple of months ago, I noted that the only thing growing in the stagnant economy in the first quarter was health spending. Further, another source suggested that most of that spending was from Medicaid, a welfare program. Such “growth” is not really good for the economy.

The final estimate of real first quarter Gross Domestic Product (GDP) has thrown everyone for a loop, reporting an annualized decline of 2.9 percent. It was a huge revision: The previous estimate was that first quarter GDP had declined by only one percent.

The huge error in the earlier figure was almost entirely driven by a poor estimate of the effect of ObamaCare by the Bureau of Economic Analysis (BEA):

The downward revision to consumer spending was mostly to services, especially to health care services. The revision to health care services reflected the incorporation of newly available Census Bureau quarterly services survey (QSS) data for the first quarter. The QSS data reflect the revenues of for-profit and nonprofit hospitals, physician offices, nursing homes, and other health care providers and the expenses of nonprofit hospitals and other nonprofit health care providers. Prior to receiving the Census QSS data, BEA used information on Medicaid benefits and on Affordable Care Act insurance exchange enrollments to prepare the previously published estimates of health services.

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Jul 02, 2014 | 15 comments | by

Hits and Misses

yogaPractice does not make perfect; meditation does.

Two-thirds of uninsured young adults find health coverage unaffordable; nearly half do not see the value of health insurance.

New study: Cat people are smarter than dog people.

“Walking school buses” being used to combat obesity.

Random thoughts don’t necessarily provide valuable insights.

Health Wonk Review: Certain aspects of ObamaCare might be leading to unintended outcomes that improve medical care.

Jun 10, 2014 | 10 comments | by

Government Spending on Uncompensated Care is Less Than One Half of One Percent of Government Health Spending

One of the reasons given for universal health insurance coverage is that uninsured people receive medical care but do not pay their bills. It’s true: A new analysis published by the Kaiser Family Foundation estimates that providers delivered $84.9 billion worth of medical care to uninsured people, for which they were not directly paid. However, federal, state, and local governments compensated providers $35.9 billion, leaving $49.0 billion truly uncompensated.

health-care-costsIs that a lot? Well, all levels of government spent $1.3 trillion on health care that year. So, government funding of uncompensated care is 0.4 percent of all government health care spending. If government stepped up and compensated the remaining $49.0 billion, the total payout would amount to about one percent of all government health spending.

Is this really something we should be turning ourselves inside out over? Especially given the evidence that Medicaid does not give timely access to care, and the emerging signals that ObamaCare reduces timely access to care, it is far from clear that adding ObamaCare’s insurance bureaucracy on top of this situation is going to be worth the trouble, even for the beneficiaries.

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Jun 09, 2014 | 6 comments | by

4 to 7 Million Will Be Fined under ObamaCare’s Individual Mandate

From the Congressional Budget Office and the Joint Committee on Taxation:

CBO and JCT estimate that 23 million uninsured people in 2016 will qualify for one or more of those exemptions. Of the remaining 7 million uninsured people, CBO and JCT estimate that some will be granted exemptions from the penalty because of hardship or for other reasons.

All told, CBO and JCT estimate that about 4 million people will pay a penalty because they are uninsured in 2016 (a figure that includes uninsured dependents who have the penalty paid on their behalf). An estimated $4 billion will be collected from those who are uninsured in 2016, and, on average, an estimated $5 billion will be collected per year over the 2017–2024 period.

(CBO, Payments of Penalties for Being Uninsured Under the Affordable Care Act: 2014 Update)

Jun 06, 2014 | 14 comments | by

Medicaid Spending More Than Doubled, 1999-2010

Sometimes a picture tells a thousand words. And this growth in Medicaid dependency happened mostly during a Republican Administration, well before ObamaCare’s expansion. And the trend from 2006 through 2010 is straight. That is, the 2008 financial crisis and subsequent recession did not cause the expansion. It’s just what our government does, apparently.

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Jun 06, 2014 | 13 comments | by

More on Medicare’s Latest Data Dump

Yesterday, we noted the New York Times‘ analysis of hospital charges from the Centers for Medicare & Medicaid Services (CMS) latest data dump. The same data dump showed how the amounts Medicare paid to hospitals and other providers for different services. The Hill‘s Ferdous Al-Faruque has pointed out some extreme differences:

health-care-costsThe agency found wide discrepancies in how much services cost in different regions of the nation and within the same geographic area. In 2012 a major joint replacement surgery cost Medicare $15,901 in Baltimore while the same procedure cost $239,138 in Los Angeles, the report says.

This variation appears too extreme. If it is a quality difference, surely the lower-quality provider is so bad that it should not be accepting patients! The seeming arbitrariness of Medicare payments might be one good explanation for the variance in costs observed by the Dartmouth Health Atlas team.

Like the physician data dump, for which we praised CMS, this is a treasure trove of data. CMS has also presented the data in a reasonably user-friendly way. It took me less than ten minutes to figure out the dashboard, which allows users to make charts and tables of almost any shape and size.

Well done, CMS. Keep ’em coming.

Jun 04, 2014 | 25 comments | by
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