Different Insurers Are Paying Hospitals Widely Varying Prices For The Same Procedures
The findings shine a light on the back-end negotiations and contracts between dominant hospitals and insurers. Meanwhile, HHS Secretary Alex Azar promises to make value-based care models easier to sustain, and an alliance is trying to combat the trend of hospitals buying up doctors' practices.
Modern Healthcare:
Dominant Hospitals Dictate Price And Contract Terms
Different insurers pay widely varying prices for the same procedures at the same hospitals, indicating that insurers' bargaining leverage influences healthcare prices, according to an updated healthcare economics paper. That was one of the new takeaways from a Commonwealth Fund-backed paper that used actual claims data from three national insurers to explain how hospitals get paid. Spending on U.S. hospital care represents about 6% of the entire economy and providers continue to consolidate throughout the country, which underlines the importance of understanding healthcare pricing dynamics. (Kacik, 5/9)
Modern Healthcare:
Azar Tells Hospitals ACO Models Will Get Easier
HHS Secretary Alex Azar on Wednesday vowed to make value-based care models easier for providers to build and sustain, specifically praising the CMS' latest idea for direct provider contracting in Medicare. Some providers read into the promise that HHS will ease provider self-referral restrictions that they say inhibit physicians and hospitals from building accountable care organizations. (Luthi, 5/9)
Politico Pro:
New Alliance Fights Trend Of Hospitals Buying Doctor Practices
Several physician groups are joining in a new alliance aimed at slowing hospitals from buying doctor practices, by urging independent physicians to embrace value-based payments. The Partnership to Empower Physician-Led Care will lobby to sustain stand-alone practices as Medicare and other health insurers move to alternative payment systems. (Pittman, 5/10)
And more hospital news comes out of Mississippi, Texas, Illinois and Ohio —
Bloomberg:
Not So Great GASB: Accounting Rule Pushes Hospital Near Default
The financial health of Magnolia Regional Health Center, a 200-bed public hospital in northern Mississippi, has gone from fair to serious condition all because of an accounting rule. Magnolia is in danger of breaching the covenant on a $74 million municipal-bond issue because the rule requires the hospital, whose employees are members of Mississippi’s pension fund, to bring onto its books its share of the retirement system’s $16 billion unfunded liability. The $127 million obligation has pushed its debts above a limit set by bondholders and may cause a default as soon as early next year -- an event that would allow investors to demand immediate repayment or take control of the hospital. (Braun, 5/9)
Dallas Morning News:
Texas Health Plans $300 Million Expansion To Fort Worth Hospital
A $300 million expansion being planned at downtown Fort Worth hospital will be the largest construction project in Texas Health Resources’ history, the health system said Wednesday. The expansion to Texas Health Harris Methodist Hospital Fort will add a nine-story surgical patient tower, 144 patient beds and boost the center’s capacity for complex cases, the announcement said. (Rice, 5/9)
Chicago Sun Times:
Chicago Hospitals Form Partnership To Battle Asthma 'Hot Spots'
Chicago is the nation’s epicenter for asthma disparity, with African-American children on the South and West sides dying from asthma at eight times the rate of their white counterparts. In those neighborhoods, the city’s asthma rate among black children — roughly one in four (24 percent) — is twice the national average, according to University of Illinois Hospital Community Assessment of Needs (UI-CAN) survey. (Guys, 5/9)
Cleveland Plain Dealer:
Investigations At University Hospitals Fertility Clinic Ongoing, Unlikely To Lose Accreditation
University Hospitals and accreditation organizations continue to investigate a freezer incident at the fertility clinic in early March that damaged 4,000 eggs and embryos and affected 950 patients. In a written statement, UH said it continues "to carefully review the root causes of the fertility clinic incident" and work with the Ohio Department of Health and the College of American Pathologists as those organizations investigate the fertility clinic failure. (Christ, 5/9)
