Transforming Health Care Through Evidence and Collaboration
Transforming Health Care Through Evidence and Collaboration
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Half of U.S. health spending goes to care for just 5 percent of patients, and any effort to improve the efficiency of our health care dollars must prioritize these patients. Speakers discussed coverage and care for the high-cost, high-need population.

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Medicare & Medicaid

Zack Cooper, Stuart Craig, Martin Gaynor & John Van Reenen

This comprehensive analysis of claims data from three national insurers documents the extensive variation in the prices that hospitals receive for the same procedure. Payment rates vary not only across and within hospital markets but also within individual hospitals, suggesting that the relative bargaining power of hospitals and insurers plays a role in price determination. The work also establishes that monopoly hospitals are paid higher prices and are more likely to obtain contracts that place them at lower financial risk, whereas hospital prices are lower and contracts are more likely to be based on prospectively determined rates when the insurer market is more concentrated. Finally, analysis of hospital mergers over a five-year period demonstrates post-merger hospital price increases, with the largest impact observed when merging facilities are in closer proximity to one another.  

This Research Insights summarizes findings from a study showing that a small percentage of nursing homes—particularly larger and for-profit facilities—are using self-reported scores to inflate their ratings in Medicare's five-star nursing home rating system.

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On November 1, ACA marketplace open enrollment begins for 2018. Given the political turmoil around the ACA this year, consumers who depend on the marketplaces for coverage are likely wondering what to expect come November 1. This webinar helped consumers and reporters unpack what is known and still unknown about the individual market.

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With many states now pursuing Medicaid waivers and the Trump administration promising states “freedom to design programs that meet the spectrum of diverse needs,” this webinar will explore the coming decision points and potential impact of these waivers.

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This webinar offered a primer for understanding potential changes to Medicaid as well as story ideas for reporters across the country.

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This webinar brought together experts in state and federal health policy to discuss the impact of potential changes to Medicaid with tips for reporters covering this evolving story.

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Half of U.S. health spending goes to care for just 5 percent of patients, and any effort to improve the efficiency of our health care dollars must prioritize these patients. Speakers discussed coverage and care for the high-cost, high-need population.

High-Need-Patients-Webinar-Graphic