About half of charges billed by doctors at an emergency room of a hospital in a network of one of Texas' three largest insurers are billed as out-of-network services because the doctor is contracted, the report found. For the state's second-biggest insurance company, UnitedHealthcare, more than two-thirds of ER charges at in-network hospitals are billed as out-of-network, according to the report. And nearly half of the hospitals technically in that network actually have no in-network ER doctors. "Even if you are a very sophisticated customer and try to choose hospital A over hospital B based on network, you can't control who sees you," said Stacey Pogue, the report's author. "It's a total roll of the dice." [Subscription Required]
The Obamacare open enrollment season begins in just two months. While HealthCare.gov is unlikely to melt down like last year, consumers still may face some complications. Getting those who signed up this year enrolled again for 2015 won't be as easy as it might seem. And the law's interaction between insurance and taxes looks like a sure-fire formula for confusion. For example: The roughly 8 million people who signed up for Obamacare this year are set up for automatic renewal, but those consumers risk sticker shock by missing out on lower-premium options. Additionally, if a consumer's income changed in the past year, they could get stuck with an outdated and possibly incorrect government subsidy.
America spends a lot of money on the paperwork that makes hospitals run— $218 billion per year, to be exact. That works out to 1.43 percent of the entire American economy is spent on hospitals' administrative costs. Of every $100 spent in America, that means $1.43 is going toward the billing specialists and schedulers that make hospitals here work. Hospital administration has grown as a percent of the economy over the past decade, from 0.9 percent in 2000 to 1.43 percent in 2012, a new paper in the journal Health Affairs shows.
To what extent will the recent moderation in the growth of health care prices and spending continue? This is a big question, and the answer relies on many factors. But for plans offered in the new health insurance exchanges as well as a substantial minority of employer-sponsored plans, it may depend, in part, on how long consumers are willing to trade lower premiums for less choice. History offers a cautionary tale. Insurers selling plans in the exchanges are offering fewer choices of doctors and hospitals. According to a 2013 survey by Mercer of employers who sponsor work-based health plans, over one-quarter of employers with more than 20,000 employees and 15 percent of those with over 500 employees offer plans with limited networks of providers selected for quality, as well as cost, considerations.
Federal researchers reported on Tuesday that the number of Americans without health insurance had declined substantially in the first quarter of this year, the first federal measure of the number of uninsured Americans since the Affordable Care Act extended coverage to millions of people in January. The number of uninsured Americans fell by about 8 percent to 41 million people in the first quarter of this year, compared with 2013, a drop that represented about 3.8 million people and that roughly matched what experts were expecting based on polling by private groups, like Gallup. The survey also measured physical health but found little evidence of change.
For-profit health systems operating in states with expanded Medicaid have shown significantly improved financial returns throughout the first half of the year, a new report shows. The report, issued by Pricewaterhouse Coopers LLP, analyzed financial data from the nation's five largest for-profit health systems: HCA Holdings Inc., which owns hospitals in the Kansas City region, LifePoint Hospitals Inc., Tenet Healthcare Corp., Community Health Systems Inc. and Universal Health Services Inc. Those hospitals all saw a decrease in uninsured patients and an increase in patients with Medicaid, which had a positive effect on the hospitals' bottom lines.