The very prestigious The Health Care Blog posted this comment by CRE on its website:
Comments submitted to the THCB include:
Responses for “Understanding the Hospital Consolidation Numbers: The Centrality of Data Quality”
xyz’er says:
The DQA is an interesting approach – not sure much attention has gone into looking at this aspect of ACA …
Brad F says:
Bruce
Can you give a clearer example of why a study like the one above concerns you?
Based on the lit, hospitals consolidating and winning gains against providers goes beyond theory and is far from an anathema to those who follow the marketplace.
Qualitative in nature, the study does not have the rigor of others in the empirical literature, and constitutes one of many yes–but as I said above, carries themes familiar to many.
I understand your point on the DQA, but translate how you think purging the study results in alternate policy?
I assume you wish to set an example?
Thanks
Brad
Barry Carol says:
“The data showing that insurers overall have been keeping a greater share of consumer health care premiums is at stark odds with Berenson’s conclusions regarding declining insurer clout.”
Baloney!
Insurer claims costs consist of two components – utilization of services, tests, procedures and drugs, and PRICES for each of those. Every large insurer will tell you that prices for hospital inpatient and outpatient services, tests and procedures were the biggest single driver of their medical claims costs in recent years driven mainly by increasing hospital market power.
MLR’s declined because utilization declined and drug spending decelerated as a number of high selling drugs lost patent protection and dropped drastically in price once the six month exclusivity period expired and generic competition intensified.
There are surprisingly few economies of scale in the hospital business. There is some benefit in the purchase of supplies and access to investment capital is greater. However, since at least 60% of hospital costs are for employee wages and benefits, the large systems pay at least the same going rate as the smaller hospitals and often pay a premium for doctors which they offset by charging commercial payers higher prices based on their local or regional market power.
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