Until recently, hospitals in California had little reason to reduce the fees they charged for procedures like knee and hip replacement. Insurance companies might come their way, trying hard to bargain down their rates. But the hospitals knew that if enough of them said “no” to these lower fees, insurance companies would be left with…
Healthcare markets are complex and confusing places. But one fact is simple and straightforward: all else equal, hospitals and emergency departments are a lot more expensive than outpatient clinics. Which makes it all the more bewildering that so many low income patients prefer hospitals over primary care clinics. Bewildering until now. Shreya Kangovi and colleagues…
In this video, I talk about why doctors should talk to patients about out-of-pocket costs when evaluating treatment options.
We have experienced an impressive slowdown in the growth of healthcare expenditures in recent years, a slowdown attributed in part to the plethora of important drugs which have gone generic in recent years. But state Medicaid programs, according to a recent study in Health Affairs, could have slowed healthcare costs even more, if they had been quicker to switch patients from trade to…
The hospital price transparency bill that was signed into effect on August 21 has elicited criticism from the Duke health community. House Bill 834 mandates that hospitals and medical care agencies in North Carolina—including Duke University Medical Center—provide pricing information on 140 of the most common health care procedures to the Department of Health and…
I just came across this picture, from the Kaiser family foundation website, illustrating just how often employee healthcare costs take up 10% or more of employee payroll. The number was already pretty high more than a decade ago, but it’s gotten even higher: For large employees, this amounts to almost $5 per hour put aside…
A new report out of Massachusetts concludes that people there are paying more for their health insurance, at the same time that the services covered by their insurance are declining. Here’s a picture from a Kaiser summary of the report: The Kaiser story also points out that a big problem in Massachusetts is that people…
Joanne Reed’s breast cancer was discovered at an early stage, early enough that her doctors would be able to remove the tumor with surgery (either a mastectomy or a lumpectomy) and then, with a touch of chemo, she would face a decent chance of living out her life without a recurrence. But then Reed’s cancer…
For very good reason, there has been lots of attention on healthcare prices in the United States lately. We spend more on healthcare in this country than anywhere else in the world, and we also charge higher prices for the healthcare we offer. Physicians in the United States make much more than their counterparts elsewhere…
Ten years ago, my tennis partner suffered a stroke. He was a sixty-year-old at the time, working to move up into the top ten players in his age group. In the country! You could not have found a healthier sixty-year-old. He played tennis three-plus hours a day, scampering across the court like a hyperactive adolescent. …