costs

AMA report: U.S. has “highly concentrated” payer markets that stifle competition  

About 73% of health insurance markets are highly concentrated, and in 46% of markets, one insurer had a share of 50% or more, a new report from the American Medical Association shows. The report comes a few months after President Joe Biden directed federal agencies to ramp up oversight of healthcare consolidation.

Lawsuit: Aetna fertility coverage policy “an illegal tax” on LGBTQ people

The lawsuit alleges that an Aetna policy discriminates against LGBTQ people by requiring them to pay thousands in out-of-pocket costs for fertility treatments before becoming eligible for coverage. Though Aetna has agreed to pay the costs incurred by the plaintiffs, the suit aims to strike down the policy as a whole.

Analysis: Cost of care for unvaccinated Covid patients spikes to $5.7B

The cost of hospital care for unvaccinated Covid-19 patients has more than doubled, jumping from about $2 billion to $5.7 billion over the summer. And this figure may still be lower than the actual cost burden unvaccinated people represent to the healthcare system.

Study: Poor care access, higher costs more likely with private than public insurance

People with private insurance report poorer access to care, higher costs and lower satisfaction as compared to those with public insurance plans, a new study shows. As the debate over health insurance reform continues, policymakers should consider efforts that expand Medicare and increase protections for those with private insurance.

Study: PE firms acquire hospitals with high operating margins, boosting them further

Hospitals acquired by PE firms tend to have higher operating margins than those that are not acquired — and that gap widens over time, a new study shows. But it is too early to say whether these glowing financial figures equate to better support for clinical care.

Mercy, Anthem ink agreement to enhance care, drive down costs

The Missouri-based health system and payer have entered into a new cooperative care agreement that aims to reduce costs while improving both outcomes and patient experience. The agreement includes a closer alignment between clinical care and reimbursement as well as increased data flow between Mercy and Anthem.

Simpler bills, more payment options can improve hospital billing experience

A new survey from healthcare revenue cycle firm Waystar shows that most patients find their medical bills confusing and delay payment because of financial constraints. But there are steps hospitals can take to improve the billing experience for patients.