Breaking News
June 23, 2018 - Teenage girls report higher degree of daytime sleepiness than boys
June 23, 2018 - Protein Data Bank at Rutgers impacts research, education and drug discovery
June 23, 2018 - Study unravels new piece of information in the Huntington’s disease puzzle
June 23, 2018 - Scientists develop new device to test cancer drug combinations quickly and cheaply
June 23, 2018 - Neural Analytics wins CE Mark for NeuralBot System
June 23, 2018 - Infant omega-3 supplementation tied to decreased waist size
June 23, 2018 - Massive analysis of genomes reveals insights into genetic overlap among psychiatric diseases
June 23, 2018 - New therapeutic approach may delay neurodegeneration in rare genetic disease
June 23, 2018 - Broken shuttle protein may hinder learning in patients with brain disorders
June 23, 2018 - Study finds increase in daily cannabis use among American adults
June 23, 2018 - Researchers create electronic skin that brings back real sense of touch to prosthetic limbs
June 23, 2018 - FIRS: Guidance Offered for Protecting Youth From E-Cigarettes
June 23, 2018 - Scientists unravel molecular mechanisms of Parkinson’s disease
June 23, 2018 - When the Heart Stops, Drugs Often to Blame
June 23, 2018 - Scientists show that a key Parkinson’s biomarker can be identified in the retina
June 23, 2018 - Study finds factors underlying current rise in radicalization among European youth
June 23, 2018 - New study finds higher heart disease risk in bisexual men
June 23, 2018 - Coconut oil diet increases vitality, lifespan of fruit flies with peroxisomal disorder
June 23, 2018 - Jumping genes or transposons and their role in the genetic code
June 23, 2018 - The Current issue of “The view from here” is concerned with Therapeutics
June 23, 2018 - Abnormal lipid metabolism in fat cells predicts future weight gain and diabetes in women
June 23, 2018 - Alcohol problems linked to sex without condom use among black gay men
June 23, 2018 - DNA patterns in circulating blood cells can help identify spastic cerebral palsy
June 23, 2018 - Unsubstantiated health claims widespread within weight loss industry
June 23, 2018 - FDA grants marketing authorization for use of two catheter-based devices in hemodialysis patients
June 23, 2018 - An ingrown toenail not the same as a bypass
June 23, 2018 - Study suggests proteinuria lowering as important target in managing pediatric CKD
June 23, 2018 - Research consortium wins £2.9 million to help tackle antibacterial resistance in Thailand
June 23, 2018 - Schizophrenia patients account for over 1 in 10 suicide deaths, study shows
June 23, 2018 - Overdose risk increases five-fold with concurrent opioid and benzodiazepine use
June 23, 2018 - FDA Alert: Kratom (mitragyna speciosa) powder products by Gaia Ethnobotanical: Recall
June 23, 2018 - Study highlights inadequate effort of health care insurers to combat opioid epidemic
June 23, 2018 - CDC chief asks for, and gets, cut to his record $375K pay
June 22, 2018 - Novel cellular pathway may clarify how arterial inflammation develops into atherosclerosis
June 22, 2018 - Pioneering exercise program improves physical, mental health of elderly people living in care homes
June 22, 2018 - Rutgers Cancer Institute educates childhood cancer survivors about late effects of treatment
June 22, 2018 - Study tests accuracy of device designed to detect heart dysfunction in childhood cancer survivors
June 22, 2018 - Study links annual haze with increased hospitalizations for respiratory problems
June 22, 2018 - Robotic surgery appears to be as effective as open surgery in treating bladder cancer
June 22, 2018 - Many Drugs Made Available Via FDA Expanded Access Programs
June 22, 2018 - Normal eye dominance is not necessary for restoring visual acuity in amblyopia
June 22, 2018 - Parent-Child Interaction Therapy can reduce depression rates in children
June 22, 2018 - Study provides insights into how components of different cells in the brain are altered
June 22, 2018 - Research does not confirm antidiabetic action of natural fatty acid derivatives
June 22, 2018 - Oxidative stress can be used against tumors to treat cancer
June 22, 2018 - Simple, cost-effective test may help improve early diagnosis of mild cognitive impairment
June 22, 2018 - New guide published to help battle fatal disease caused by kissing bugs
June 22, 2018 - Stigma Adds to Burden of Type 1 Diabetes
June 22, 2018 - In retinoblastoma survivors, oculo-visual issues tied to QoL
June 22, 2018 - Most adults with allergies do not use prescribed epinephrine even in emergency situations
June 22, 2018 - Study provides clues to how cancer cells develop resistance to chemotherapies
June 22, 2018 - New consensus paper serves as basis for uniform medical management of DSD
June 22, 2018 - Researchers work to identify areas of the brain that help us wake up
June 22, 2018 - Alcohol hangovers more significant and costly than people realize, shows research
June 22, 2018 - Targeting cells involved in blood vessel formation could hinder brain tumor growth
June 22, 2018 - Young cancer survivors need more support as they feel dissatisfied with their sexuality
June 22, 2018 - Unusual cell-to-cell communication in glioblastoma promotes aggressiveness and therapy resistance
June 22, 2018 - Turning A Phage – Drug Discovery Today
June 22, 2018 - World-first study links birth interventions and long-term childhood illness
June 22, 2018 - Improving the quality of biomedical research samples
June 22, 2018 - Researchers identify cerebral palsy using AI and DNA sequencing
June 22, 2018 - Administering nitric oxide gas after heart surgery may decrease risk of kidney problems
June 22, 2018 - Measuring levels of ethyl sulphate in hair can help assess alcohol consumption
June 22, 2018 - Researchers develop robot bloodhound that can rapidly detect odors on the ground
June 22, 2018 - AAA doses first patients in two clinical studies with PSMA-R2 for prostate cancer
June 22, 2018 - LSTM led consortium receives grant to investigate how human behavior impacts AMR
June 22, 2018 - Researchers discover drug compound that inhibits movement of cancer cells
June 22, 2018 - Normalization of ‘plus-size’ body shapes may prevent recognition of health risks of obesity
June 22, 2018 - UC San Diego launches new bacteriophage therapy center
June 22, 2018 - New review outlines current state of sex-sensitive issues linked to heart failure drugs
June 22, 2018 - Pelvic pain a major issue for women nearing mid-life, research reveals
June 22, 2018 - Researchers develop reliable DNA barcodes for biomedical research
June 22, 2018 - New risk-prediction model may help identify diabetic patients at high risk of pancreatic cancer
June 22, 2018 - Study reveals how mTORC1-driven changes in crowding could influence major diseases
June 22, 2018 - Researchers uncover new therapeutic opportunity in the treatment of malignant melanoma
June 22, 2018 - UC Riverside researcher receives grants to advance cancer, ALS research
June 22, 2018 - Radiation therapy alone may be enough to treat older, sicker patients with anal cancers
June 22, 2018 - Technical report describes how to make accurate particle size measurements on carbon black samples
June 22, 2018 - Nocdurna (desmopressin acetate) Approved by FDA as First Sublingual Tablet to Treat Nocturia due to Nocturnal Polyuria
June 22, 2018 - Neuroscientists locate neurons in the brain that respond when a visual target is found
Report: Use, Not Price, Drives State Health Costs

Report: Use, Not Price, Drives State Health Costs

image_pdfDownload PDFimage_print

In healthcare, costs of individual services and products make less of a difference in state-level spending than the overall use of those products and services, a new report indicated.

The Network for Regional Healthcare Improvement (NRHI) examined regional differences in 2015 healthcare costs, and the drivers of those costs, for private payers in Oregon, Utah, Colorado, Minnesota, and Maryland. The NRHI’s second annual report emphasized that utilization and costs must be must be examined together.

“You can’t fix what you don’t understand, but with reliable and actionable information on cost drivers, we can enable healthcare stakeholders to make the changes needed to bring down the cost of care,” said Elizabeth Mitchell, president and CEO of NRHI, in a press release.

Using a Price Index (PI) and a Resource Use Index (RUI), the NRHI analysis calculates how much of the difference in cost is due to price versus the volume of services, for example the quantity and intensity of tests and treatments used.

Of the five states, Maryland had the lowest overall total cost of care at 16% below the risk-adjusted average among private payers for “comparable populations,” while Colorado saw risk adjusted spending that was 17% above the average.

Total costs of care for the remaining states (compared with the average across the five states) was:

  • Minnesota: 7% above average
  • Utah: 4% below average
  • Oregon: 0% equal to average

Colorado’s total cost of care appeared to be highest because it had the highest overall resource use at 11% above average. Specifically, outpatient resource use was 25% above the benchmark, which was the highest of all five states. Colorado residents also showed the highest use of prescriptions at 23% above average.

Jonathan Mathieu, PhD, vice president of research and compliance and chief economist at the Center for Improving Value in Health Care (CIVHC) in Denver, said the NRHI findings are “directionally correct,” but cautioned that a “variety of factors” would have to be examined to determine the state’s high total costs.

Resource use was a more significant cost driver than price in Minnesota and Utah, but the category of resource use varied in those states. Resource use in Minnesota tipped higher because residents there saw doctors 10% more than the average, however the state also had 10% higher prices, the report noted.

In Utah, inpatient resource use was 16% higher than average as the state has the highest birth rate per capita in the country. However, some of this upward pressure on costs may have been erased by the fact that hospital prices were 14% lower on average.

Maryland’s data showed that lower prices — roughly 13% below the risk-adjusted average — played the strongest role in keeping total costs low in that state. However, resource use was also 3% below average. For 35 years, Maryland has had the only hospital rate regulation program in the country and, in 2014, the state began limiting all-payer per capita hospital growth.

In Oregon, higher prices and lower resource utilization essentially cancelled each other out.

The NHRI used the Health Partners Total Cost of Care Index to determine how spending varied across different geographical regions for similar patients “after adjusting for morbidity and minimizing the impact of catastrophic cases.”

“The underlying primary care practice level reports can support individual improvement and the development of value based payments,” according to the report.

Mylia Christensen, executive director for HealthInsight Oregon and Q Corp, explained during a webinar Tuesday how the report’s data has become actionable for practices. For example, primary care physicians who had embedded behavioral healthcare services into their clinics were excited to see that their behavioral health line item was higher than their peers, she noted.

“Because that’s what they were trying to do; to expend more resources in primary care clinics,” Christensen said, adding that patients who received these services in clinics were less likely to end up in emergency departments.

On the other hand, some oncology clinics who compared their cost data with their peers became concerned about the high costs they were seeing for MRIs and other tests.

“This information gives them a look at something that they didn’t have before,” Christensen said. “They could actually make choices … that could actually do something to affect change.”

The NRHI said it now has two complete sets of regional cost comparisons, with a third slated for release in late 2018. “With three years of data, trends will begin to emerge to support existing hypotheses and/or challenge long-held assumptions,” according to the group.

The report has some limitations. “Variations in payers contributing to multipayer databases and variation in the quality of submitted data pose a unique challenge when trying to develop a consistent sample for analysis,” according to the report. For example, some participants contributing data may treat “compliance with submission specification” differently.

Also, the sources of data, and the sample size, in many states may have changed since 2014, the report noted.

NRHI said it hopes to include data analysis for Medicare and Medicaid populations in the future.

The report was supported by the Robert Wood Johnson Foundation.

2018-02-13T17:40:48-0500

Tagged with:

About author

Related Articles