U.S. Health-Care System Ranks as One of the Least-Efficient
by Lisa Du, Wei Lu
America is number 50 out of 55 countries that were assessed.
America was 50th out of 55 countries in 2014, according to a Bloomberg index that assesses life expectancy, health-care spending per capita and relative spending as a share of gross domestic product. Expenditures averaged $9,403 per person, about 17.1 percent of GDP, that year — the most recent for which data are available — and life expectancy was 78.9. Only Jordan, Colombia, Azerbaijan, Brazil and Russia ranked lower.
The U.S. has lagged near the bottom of the Bloomberg Health-Care Efficiency Index since it was created in 2012. Hong Kong and Singapore — consistently at the top — are smaller countries with less diverse populations. Their governments also play a stronger role in regulating and providing care, with spending per capita averaging $2,386 and longevity averaging about 83 years.
Falls are leading cause of injury and death in older Americans
Every second of every day in the United States an older adult falls, making falls the number one cause of injuries and deaths from injury among older Americans.
In 2014 alone, older Americans experienced 29 million falls causing seven million injuries and costing an estimated $31 billion in annual Medicare costs, according to a new report published by the Centers for Disease Control and Prevention in this week’s Morbidity and Mortality Weekly Report (MMWR).
The Department of Health and Human Services highlighted findings from a few new studies that show Americans are experiencing slower growth in health care premiums, increased access to coverage, and higher quality of care.
More Affordable: The average premium for families with employer-sponsored health plans grew just 3.4 percent in 2016, according to the Kaiser Family Foundation and Health Research and Educational Trust survey, extending a period of unusually slow growth since 2010. The White House Council of Economic Advisers calculates that the average family premium is $3,600 lower in 2016 than if premiums had grown at the same rate as the pre-ACA decade.
The independent analysis released this morning by the Kaiser Family Foundation finds that the average family premium for the 150 million Americans with employer-sponsored health plans increased by only 3.4 percent in 2016.
Average Medicare payments for a lower extremity joint replacement hospitalization and 90-day post-discharge period declined $1,166 more for hospitals participating in the first 21 months of the Bundled Payments for Care Improvement initiative than for comparison hospitals that did not participate, according to a study published online today by the Journal of the American Medical Association. The lower Medicare payments were primarily due to reduced use of institutional post-acute care, the authors said. Claims-based quality measures, including unplanned readmissions, emergency department visits and mortality, were not statistically different between the BPCI and comparison populations. “Further studies are needed to assess longer-term follow-up as well as patterns for other types of clinical care,” the authors said. Separately, the Centers for Medicare & Medicaid Services today released a report on first-year results for Models 2 to 4 of the initiative, which include retrospective and prospective bundled payments that may or may not include the acute inpatient hospital stay for a given episode of care.
Employer-sponsored insurance covers over half of the non-elderly population; approximately 150 million nonelderly people in total. To provide current information about employer-sponsored health benefits, the Kaiser Family Foundation (Kaiser) and the Health Research & Educational Trust (HRET) conduct an annual survey of private and nonfederal public employers with three or more workers. This is the eighteenth Kaiser/HRET survey and reflects employer-sponsored health benefits in 2016.
Better Patient Care at High-Quality Hospitals May Save Medicare Money and Bolster Episode-Based Payment Models
by Thomas C. Tsai, Felix Greaves, Jie Zheng, E. John Orav, Michael J. Zinner, and Ashish K. Jha
Researchers looked at how much Medicare pays for five major surgical procedures, from the time patients are admitted to the hospital through 90 days after discharge. Patients who had their surgeries at high quality hospitals—that is, those with low mortality rates and high patient satisfaction scores—were found to cost Medicare less than patients at low-quality hospitals. The majority of the savings achieved can be attributed to lower use of skilled nursing facilities and other postacute care services.
WalletHub Lists States With the Best and Worst Health Care
WalletHub, a personal finance website, has listed the best and worst health care states based on 29 metrics including average premiums, coverage rates and physicians per capita. The top five are: Minnesota, Maryland, South Dakota, Iowa and Utah, respectively. The bottom five: Arkansas, Nevada, Mississippi, Louisiana and Alaska.
Cesarean birth trends: Where you live significantly impacts how you give birth
by Blue Cross Blue Shield: Blue Health Intelligence
The likelihood that an expectant mother will have a cesarean delivery1 is determined in large part by where she lives. An analysis of Blue Cross and Blue Shield (BCBS) companies’ data taken from 3 million deliveries by BCBS commercially-insured members shows that the rate of cesarean deliveries is more than twice as high in some parts of the country than in other parts and that even rates by U.S. Census Division vary by as much as 35 percent.
While geographic variation in cesarean deliveries is stark, the trend nationally may be shifting back toward vaginal deliveries. During a five-year period between July 2010 and June 2015, the cesarean rate decreased slightly each year within the BCBS population, to 33.7 percent from 35.2 percent.
Spending for the major government healthcare programs will rise by $55 billion, or about 6 percent, in 2016, and Medicare will account for more than half of that increase, according to budget projections from the Congressional Budget Office.
A year after paying nearly $1.5 billion to more than a third of U.S. hospitals to resolve longstanding Medicare billing disputes, the Obama administration has disclosed who got paid.
NewYork-Presbyterian Hospital, one of the nation’s largest academic medical centers, received nearly $16 million, more than any other hospital, according to data released by the Centers for Medicare & Medicaid Services.
Now that ICD-10 is in full swing, we are seeing a lot of activity with providers, payers, consultants and regulators who need to understand how Acute Inpatient and Long Term Care Hospital claims "behave" when the claim is coded in ICD-10. This includes both prospective and retrospective review of claims scenarios to understand MS-DRG grouping. This article offers a basic primer on MS-DRG grouping logic, and research techniques for using related MediRegs Coding Suite tools. If you'd like a personalized training on these tools, or a demonstration of them in action to see if they are a good fit for your research scenarios, please let us know!
OVERVIEW OF THE FY 2016 IPPS FINAL RULE: SUMMARY OF CALCULATION ELEMENTS
New Health Analytics, a national healthcare software developer and data analytics firm, is pleased to announce that it has released a special report with an concise review of the FY 2016 Hospital Inpatient Prospective Payment System (IPPS) Final Rule recently posted by the Centers for Medicare & Medicaid Services.