“What is most worrying to me is that there has been fairly profound consolidation among hospitals and when they gain market power they have the ability to raise prices,” said Zack Cooper, the study’s co-author. “They have the ability to gain more favorable contractual terms, which allows them to raise prices and resist the new, more sensible payment reforms.” In other news from the health industry: artificial hip lawsuits, out-of-pocket costs, insulin pumps and surprise medical bills.
Hospital prices are the main driver of U.S. healthcare spending inflation, and that trend should direct any policy changes going forward, according to a new study. For inpatient care, hospital prices grew 42% from 2007 to 2014 while physician prices rose 18%, according to researchers who studied the Health Care Cost Institute’s claims data for people with employer-sponsored insurance from Aetna, Humana and UnitedHealthcare Group. Similarly, for hospital-based outpatient care, hospital prices increased 25% while physician prices grew 6%, the new Health Affairs study found. (Kacik, 2/4)
Johnson & Johnson, the world’s largest maker of health-care products, has agreed to settle the bulk of consumers’ lawsuits alleging it sold defective artificial hips and misled patients about their dangers, according to a lawyer for the plaintiffs. “The parties have reached an agreement that hopefully will resolve most, if not all, of the litigation,’’ said attorney Mark Lanier, one of the leaders of the consolidated 10,000-suit litigation against J&J and its DePuy unit, maker of Pinnacle hip-replacement devices. He declined to provide details of the settlement. (Feeley and Korosec, 2/4)
Anthem Blue Cross and Blue Shield has given people in the Georgia insurance exchange more time to visit WellStar Health System doctors and presumably not face higher out-of-pocket costs. The contract for exchange coverage between Anthem and Marietta-based WellStar ended Monday. But instead of making WellStar exchange patients out of network immediately, Anthem said it would allow another 90 days of network coverage for those members who selected, were assigned or tried to choose a WellStar-affiliated primary care physician. (Miller, 2/4)
An advocacy group for patients with Type 1 diabetes is calling out a new UnitedHealthcare policy that expands an existing agreement with Medtronic and makes the manufacturer’s medical devices the “preferred” insulin pumps for children with the autoimmune condition. On Friday, Minnetonka-based UnitedHealthcare published a bulletin to health care providers saying the Medtronic product would become the preferred insulin pump for children age 7 and older who are receiving a prescription for an insulin pump for the first time. (Snowbeck, 2/4)
Surrounded by patients who told horror stories of being stuck with hefty bills, President Donald Trump recently waded into a widespread health care problem for which almost everyone — even those with insurance — is at risk: surprise medical billing. Trump’s declaration that taming unexpected bills would be a top priority for his administration echoed through the halls of Congress, where a handful of Republican and Democratic lawmakers have been studying the problem the past couple of years. (Luthra and Huetteman, 2/5)
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