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Kaiser Health News reported on one elected official's campaign to reduce health expenses for the state. North Carolina's treasurer has been trying to secure a better deal for the insurance that the state pays for its over 700,000 employees and their dependents. Apparently, the hospital association has felt threatened enough by the treasurer's efforts that it lobbied for legislation to prevent reference pricing and has not resorted to contributing to the campaign of the treasurer's challenger.

Kaiser Health News reported on one elected official's campaign to reduce health expenses for the state. North Carolina's treasurer has been trying to secure a better deal for the insurance that the state pays for its over 700,000 employees and their dependents. Apparently, the hospital association has felt threatened enough by the treasurer's efforts that it lobbied for legislation to prevent reference pricing and has not resorted to contributing to the campaign of the treasurer's challenger.

The article suggests that the size of the hospital networks has made it difficult for the treasurer to extract pricing concessions, although the treasurer has resisted further expansions of those chains. When a payer is too reliant on a few large provider networks, the payer has little leverage given how its members may be out of realistic options for providers. In this situation, it is perhaps surprising that the treasurer expected to be able to willingly give up tens of millions of dollars in annual revenue.

Addressing a claim by the presidential challenger that the incumbent will "slash Medicare benefits," Kaiser Health News published a piece that consulted various health policy experts and reported on their opinions. The current White House administration has supported a challenge to overturn the Affordable Care Act (ACA); the Supreme Court is schedule to hear oral arguments in November. The presidential challenger's staff has taken that as evidence that the current president will slash Medicare benefits, a potentially helpful charge in this political climate. Independent of the political effectiveness of charge, Kaiser Health News' reporting on what might happen if the ACA is indeed overturned is interesting.

Addressing a claim by the presidential challenger that the incumbent will "slash Medicare benefits," Kaiser Health News published a piece that consulted various health policy experts and reported on their opinions. The current White House administration has supported a challenge to overturn the Affordable Care Act (ACA); the Supreme Court is schedule to hear oral arguments in November. The presidential challenger's staff has taken that as evidence that the current president will slash Medicare benefits, a potentially helpful charge in this political climate. Independent of the political effectiveness of charge, Kaiser Health News' reporting on what might happen if the ACA is indeed overturned is interesting.

For example, the ACA mandated that certain preventive services such as an annual wellness visit would not cost Medicare patients anything. In theory, those benefits could be at risk. There is also a question of whether repealing ACA will cause Medicare to spend more, and whether that would ultimately lead to the slashing of benefits (versus, say, an increase of funding from Congress).

Even after so many years, there seems to still be some doubt regarding the legal viability of the ACA. If the Supreme Court finds the ACA unconstitutional, undoubtedly, the health insurance industry will experience much commotion, at a time that is less than ideal for such confusion.

Earlier this year, California passed legislation to create an all payer claims database, where health insurers are required to submit claims data to a centralized database for analysis. The initiative is exciting from a health policy perspective; many, but not all, other states already have such a database, and health policy analysts can gain insight into pricing and trending procedures. The legislation appears to have become law at the end of June.

Earlier this year, California passed legislation to create an all payer claims database, where health insurers are required to submit claims data to a centralized database for analysis. The initiative is exciting from a health policy perspective; many, but not all, other states already have such a database, and health policy analysts can gain insight into pricing and trending procedures. The legislation appears to have become law at the end of June.

The rollout is expected to take three years, and the current plan is for only highlights or summaries of the data to become publicly available. Additionally, the legislation only funds the start of the initiative, expecting that the agency around this database will find its own funding for ongoing maintenance costs. Nevertheless, this initiative is a step in providing better insight into healthcare expenditures that might eventually lead to better health policies.

Another user-facing feature that we have been working on recently has been profile summary pages, which show highlights from various tabs on all one page. Currently, highlights include aggregate statistics about Medicare patient panel demographics (e.g. the number of Medicare patients served in a year, and popular conditions among those patients), procedures performed for Medicare patients, and payments from pharmaceutical and medical device companies (Open Payments).

Another user-facing feature that we have been working on recently has been profile summary pages, which show highlights from various tabs on all one page. Currently, highlights include aggregate statistics about Medicare patient panel demographics (e.g. the number of Medicare patients served in a year, and popular conditions among those patients), procedures performed for Medicare patients, and payments from pharmaceutical and medical device companies (Open Payments).

We spent a fair amount of time trying to figure out how to present the information and would certainly welcome feedback. An extension of this project is harnessing some of this work to improve the general profiles.

Last month, Centers for Medicare & Medicaid Services (CMS) announced their release of a Procedure Price Look Up tool. This tool marks another step towards making more information available to patients.

Last month, Centers for Medicare & Medicaid Services (CMS) announced their release of a Procedure Price Look Up tool. This tool marks another step towards making more information available to patients.

The tool seems to give an estimate of costs for Medicare patients, since actual prices can vary by location (which is not considered in their estimates). Additionally, the tool only seems available for procedures that are performed in both ambulatory surgical centers and hospital outpatient departments. Nevertheless, this tool can provide a point of reference for patients, and perhaps more importantly, be a small step in helping foster a culture and expectation of price transparency.