Anthem to hospitals: We won’t pay your high imaging prices

Insurance giant Anthem’s new policy of refusing coverage in nine states for outpatient imaging tests performed in a hospital has created quite a stir. Good for them! While acting in their own self interest as all insurers do, they are appropriately attacking the biggest problem in health care today: prices. As more and more people are […]

Employer fights potential monopoly from hospital merger

Suffering under the crushing burden of health care costs, Americans have been looking for a hero for many years now. A person or institution that can shake things up and bring costs down. Some analysts have argued that large employers were best positioned to accomplish this, and a steel producer in West Virginia is trying […]

Employers hold the key to health care cost reductions

Man showing business graph on wood table The hoopla surrounding the new Amazon/Berkshire Hathaway/JPMorgan Chase alliance makes it seem like large employers are finally getting mad about the high cost of health care. But employers have been mad about such costs for decades. Margot Sanger-Katz, in the New York Times, points out that corporations have been experimenting with […]

Surgeries go down, prices go up. What else is new?

The list of contradictions in health care is long and mind-boggling. But here’s the one that bothers me the most: The number of inpatient surgeries at hospitals decreased by more than 16 percent from 2012 to 2016. Over the same period, prices increased almost 30 percent. The result is that total spending on inpatient surgeries […]

Do we really want insurers providing our health care?

n the battle between hospitals and insurance companies, it appears insurers have the upper hand. And they’re starting to barge in to hospitals’ own territory: providing actual patient care. What am I talking about? I’m talking about the growing list of existing or proposed corporate partnerships between insurers and providers—Cigna/Express Scripts, CVS/Aetna, UnitedHealth/Optum/DaVita Medical Group, Humana/Kindred Healthcare. […]

Large employers exerting their influence on the costs of surgery

With the news of Kroger negotiating its own fixed-price surgery deals, we may be approaching a critical mass of employers who are taking health care matters into their own hands. The Dayton Daily News describes the type of deal Kroger negotiated to ensure excellent surgical care for its employees at a more affordable price: Fixed price deals … […]

Azar talks the talk, as we now wait for the walk

Alex Azar, the new secretary of Health and Human Services, is hitting all the right notes, as he travels around the country spelling out his priorities for health care. Price transparency, value-based payments, easily shared medical records, hospital competition. Best of all, he’s promising disruptive federal intervention to make things happen. As Avik Roy points out in Forbes, […]

Rush University Medical Center’s rush to the future

In the health care landscape, academic health systems are unique. Often located in urban areas, they have a disproportionate share of emergency trauma patients, as well as patients with chronic disease and a host of other social ills. Making sure patients follow through with a treatment plan or post-surgical recovery protocol is a big problem. […]