2016 ASSA: How does competitions among insurers affect premiums

Typically, most economists believe that increased competition decreases prices.  However, is that the case for competition among health insurers? On the one hand, competition among health insurers could decrease prices if consumers choose plans based on premiums.  Competition may increase insurer’s incentive to negotiate with providers and may force insurers to make lower margins or lower…

Hospitals moving to the ‘burbs

The ACA offers States the option to expand Medicaid eligibility to millions of Americans.  The goal of the expansion was to increase poor and middle class Americans’s access to affordable health care.  However, access to acute care may be getting more difficult for poor individuals. A recent article looking at Milwaukee’s hospital market describes how hospitals are…

Will a VA scandal happen in England?

The VA scandal of long wait times is now well-known. Part of the reason why patients were left off official wait lists–ironically–was because VA senior staffers wanted to reduce wait times. Senior VA staff monitored wait times closely to check for any upticks. Some of the VA management at the Phoenix hospital believed the only…

The End of Hospital Cost Shifting?

Medicare is cutting reimbursement to hospitals.  Austin Frakt (HSR 2013) gives some highlights findings from a CMS report: [The ACA] will permanently reduce the Medicare payments hospitals would otherwise receive. Its ‘productivity adjustment’ will scale payments downward by the average rate at which private nonfarm businesses’ productivity increases. That rate has been estimated to be…

California Hospitals Charge Fair Prices to the Uninsured

Why is that?  Because in 2006 California passed the Hospital Fair Pricing Act.  Melnick and Fonkych (2013) describe the bill as follows. The Hospital Fair Pricing Act…mandated that hospitals develop formal, written financial assistance policies and limit the  prices they charge uninsured patients with low to moderate incomes…Under the law, hospitals must limit the amounts they collect from…

Effect of P4P on Hospital Profits

How do value-based purchasing programs affect hospitals’ bottom lines? This is a particularly important question as the Affordable Care Act (ACA) mandates that CMS reward high-quality, low-cost hospitals with bonuses and give financial penalties to low-quality, high-cost hospitals. In 2003, CMS began a pay-for-performance (P4P) demonstration. Using this demonstration as a natural experiment, Kruse et…

Healthcare for Hospitals

Benefits are taking up a continually greater share of employee compensation. This trend is as true for hospitals as any other industry. Keenan Health Care summarizes some recent trends for California hospitals. According to a survey of 83 California health care organizations (representing 219 hospitals): Benefits represent 28% of the employee compensation for the average…