
Vilsa Curto on Vertical Integration's Effect on Health Care Prices
05/10/22 • 27 min
The health care sector has gone through various waves of consolidation with hospitals purchasing physician practices and hospitals, physicians, and health insurers merging with each other.
We're in the midst of a wave of consolidation.
Two years ago, Health Affairs published a paper that found more than half of US physicians and 72 percent of surveyed hospitals were affiliated with one of 637 health systems in 2018. More recently, some have estimated that the 10 largest health systems now control about a quarter of the health care market.
Consolidation brings with it various opportunities for savings and efficiency but it also concentrates market power and creates opportunities to raise prices.
Vilsa Curto from Harvard University joins A Health Podyssey to discuss the effects of consolidation and integration.
Curto and colleagues published a paper in the May 2022 issue of Health Affairs assessing trends in vertical integration and joint contracting between physicians and hospitals in Massachusetts and exploring the affects on prices for physician services.
They found notable price affects that varied according to system size and physician type.
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The health care sector has gone through various waves of consolidation with hospitals purchasing physician practices and hospitals, physicians, and health insurers merging with each other.
We're in the midst of a wave of consolidation.
Two years ago, Health Affairs published a paper that found more than half of US physicians and 72 percent of surveyed hospitals were affiliated with one of 637 health systems in 2018. More recently, some have estimated that the 10 largest health systems now control about a quarter of the health care market.
Consolidation brings with it various opportunities for savings and efficiency but it also concentrates market power and creates opportunities to raise prices.
Vilsa Curto from Harvard University joins A Health Podyssey to discuss the effects of consolidation and integration.
Curto and colleagues published a paper in the May 2022 issue of Health Affairs assessing trends in vertical integration and joint contracting between physicians and hospitals in Massachusetts and exploring the affects on prices for physician services.
They found notable price affects that varied according to system size and physician type.
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Brian Powers on How Humana Understands Medicare Advantage Enrollees' Social Needs
More than 40 percent of Medicare enrollees are enrolled in Medicare Advantage (MA) plans, privately-sponsored health plans that provide Medicare benefits often along with other benefits not included in the standard Medicare package such as eye exams, hearing aids, and dental coverage.
Medicare Advantage is growing rapidly. On the current trajectory, it's likely that the majority of Medicare enrollees will be in MA plans within a year or two.
Since MA plans are paid on a capitated basis, insurers have a financial incentive to control health care costs. Recently, much attention has been focused on how addressing social needs can yield health benefits, which save MA plans money.
In order to address those needs, health plans need to know the social needs of their enrollees.
Brian Powers from Humana joins A Health Podyssey to discuss understanding the unmet social needs of Medicare enrollees.
Powers and colleagues published a paper in the April 2022 issue of Health Affairs assessing the health related social needs of enrollees in Humana's MA plans. They found significant needs including financial strain, food and utility insecurity, poor housing quality, and unreliable transportation. These needs were distributed unevenly across enrollees by race, socioeconomic status, and sex.
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Caitlin Hicks on Telemedicine and Care Inequities
When medical offices shut down due to the COVID-19 pandemic and people were encouraged or required to avoid public spaces, there was a dramatic and rapid increase in the use of telemedicine.
Telemedicine has the potential to open up access to care, particularly to people who are geographically isolated or have mobility limitations, but it can also exacerbate existing inequities given its relevance upon broadband internet access and other technologies.
Caitlin Hicks from Johns Hopkins School of Medicine joins A Health Podyssey to discuss whether telemedicine expands or narrows care inequities.
Hicks and colleagues published a paper in the May 2022 issue of Health Affairs examining the impact of Medicare's pandemic-era telemedicine coverage waiver on utilization by geographic area.
They found that Medicare's telemedicine access expansion increased utilization overall and that those beneficiaries in areas of greater depravation, as measured by the Area Depravation Index, had greater odds of utilization than those who live in areas with more resources.
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