Chemo more expensive in hospital than physician's office...

[drusso]

I predict that these findings will be replicated for ESI's, SCS's, etc.

Rise In Oncologists Working For Hospitals Spurs Higher Chemo Costs: Study
Michelle Andrews; Kaiser Health News

If you have cancer, chances are your outpatient chemotherapy treatment costs are higher if your oncologist works for a health care system than if she has her own practice, a recent study found.

The study by researchers at the University of Chicago analyzed private health insurance claims data from the Health Care Cost Institute, a nonprofit research organization, and national data about consolidation among doctors and hospitals between 2008 and 2013.

It found significant consolidation between outpatient oncology practices and health care systems in the decade leading up to 2013. The researchers linked that to a rise in spending on drug-based cancer care. Each 1-percentage-point increase in the proportion of medical providers who were affiliated with a hospital or health system was associated with a 34 percent increase in annual average spending per person on outpatient cancer drug treatment, they reported.

Part of the rise was fueled by the facility fees that hospitals and their outpatient clinics routinely add on to the bill, the researchers said.

“Provider consolidation must be changing the ability of providers in a market to extract higher prices [from insurers] for outpatient cancer therapy,” said Rena Conti, an assistant professor at the University of Chicago and lead author of the study, which was published by the Health Care Cost Institute in February. The study controlled for the volume of patients and the mix of cancers, among other things, she noted.

Spending on chemotherapy drugs has been in the news lately as some cancer specialists and patient advocacy groups have strenuously objected to a proposal by Medicare to change how it pays for drugs that are covered under Part B, the program’s outpatient benefit.

This study suggests that for patients, it may be more cost-effective to get chemotherapy treatments at a community-based practice rather than a hospital or hospital-affiliated clinic, Conti said.

“Patients are increasingly shifting toward high-deductible health plans, and that suggests they’re paying a higher percentage of the costs for these therapies as the prices are going up,” she said.

This story was updated to make clear that the study was written by researchers at the University of Chicago.

Apr 16 2016

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[Stim4me]

I predict that these findings will be replicated for ESI's, SCS's, etc.

Rise In Oncologists Working For Hospitals Spurs Higher Chemo Costs: Study
Michelle Andrews; Kaiser Health News

If you have cancer, chances are your outpatient chemotherapy treatment costs are higher if your oncologist works for a health care system than if she has her own practice, a recent study found.

The study by researchers at the University of Chicago analyzed private health insurance claims data from the Health Care Cost Institute, a nonprofit research organization, and national data about consolidation among doctors and hospitals between 2008 and 2013.

It found significant consolidation between outpatient oncology practices and health care systems in the decade leading up to 2013. The researchers linked that to a rise in spending on drug-based cancer care. Each 1-percentage-point increase in the proportion of medical providers who were affiliated with a hospital or health system was associated with a 34 percent increase in annual average spending per person on outpatient cancer drug treatment, they reported.

Part of the rise was fueled by the facility fees that hospitals and their outpatient clinics routinely add on to the bill, the researchers said.

“Provider consolidation must be changing the ability of providers in a market to extract higher prices [from insurers] for outpatient cancer therapy,” said Rena Conti, an assistant professor at the University of Chicago and lead author of the study, which was published by the Health Care Cost Institute in February. The study controlled for the volume of patients and the mix of cancers, among other things, she noted.

Spending on chemotherapy drugs has been in the news lately as some cancer specialists and patient advocacy groups have strenuously objected to a proposal by Medicare to change how it pays for drugs that are covered under Part B, the program’s outpatient benefit.

This study suggests that for patients, it may be more cost-effective to get chemotherapy treatments at a community-based practice rather than a hospital or hospital-affiliated clinic, Conti said.

“Patients are increasingly shifting toward high-deductible health plans, and that suggests they’re paying a higher percentage of the costs for these therapies as the prices are going up,” she said.

This story was updated to make clear that the study was written by researchers at the University of Chicago.

Apr 16 2016

And rheum infusion meds as well... Everything is more costly in a hospital, and why exactly is that allowed in this cost containment environment?

 

[drpainfree]

Hospital cost is the driving force of escalating healthcare care expenditure in this country.

Instead they are blaming doctors over-prescribing, etc.

 

[Stim4me]

Hospital cost is the driving force of escalating healthcare care expenditure in this country.

Instead they are blaming doctors over-prescribing, etc.

I agree.. the premise of the AcA was that pp and specifically specialists were the issue, and the wonderful ACOs would save the day(and costs).

 

[Doctodd]

big oncology practice just got bought out by the hospital....and then the hospital promptly constructed a huge building fit with it's own parking garage. Yea times must be tough.

 

[Ducttape]

im not sure anyone is saying that the cost increases are due to physician charges.

in this article, this organization proved their null hypothesis and "justified" their continued existence. no real news here, but i find it interesting that you did not post a different articles:

first: http://www.healthcostinstitute.org/...4-percent-2014-more-dollars-going-brand-drugs

Use of Health Care Services Falling

Spending is influenced by both utilization and prices. In recent years, utilization of health care services has been declining, while the average prices have been rising. In 2014, the largest decline in use (-2.7%) was for acute admissions, which fell by 1 admission per 1,000 individuals. The smallest decline in use (-0.9%) was for outpatient visits, which fell by 3 visits per 1,000 individuals.

Other highlights:

• Prices increased for all services: The smallest average price increase was for professional services (3.1%), an increase of $3 per service. The largest average price increase was for acute inpatient admissions (4.6%), an increase of $831 per admission.
• Out-of-pocket spending decreased for some services: Spending out of pocket on acute inpatient admissions (–$1) and on brand (–$9) and generic (–$4) prescriptions decreased by $14 per capita in 2014 compared to the previous year, while spending out of pocket on outpatient ($16) and professional ($15) services increased by a total of $31 per capita in 2014.
• Women spending more out of pocket each year: Every year between 2010 and 2014, out-of-pocket spending was higher by women than by men. This difference grew every year, reaching $237 in 2014.
• Gap in spending between young and old increasing: The difference in spending between the oldest and youngest age groups studied increased every year studied: from $6,281 in 2010 to $6,806 in 2014. In 2014, spending was $2,660 for children ages 0-18 and $9,466 for pre-Medicare adults, ages 55-64 (the oldest age group in HCCI’s datas

(i underlined the point of emphasis)

Or this study: http://www.healthcostinstitute.org/...t-derived-when-consumers-shop-non-urgent-care

Modest Benefit Derived When Consumers Shop For Non-Urgent Care, Says HCCI
Study Shows Less than 7 Percent of What Is Spent on Health Care Is For Shoppable Services

Washington, D.C. — Contrary to expectations, giving consumers prices so they can shop for the best value for non-urgent medical services may only have a modest effect on reducing health spending, says a new analysis from the Health Care Cost Institute (HCCI). Although a large portion (43%) of annual health care spending is for services in which consumers could shop for based on price, less than 7 percent of total spending is actually paid out-of-pocket by consumers for shoppable services. That means for the vast majority of health care spending, providing incentives or information to steer consumer behavior will have limited effects on improving the value of the health care dollar, says the researchers.

Health insurance benefit design strongly influences what a consumer pays out of pocket. However, HCCI shows that consumers hoping to use price shopping to lower their coinsurance and deductible payments could influence only about 65 percent of their out of pocket payments per year. Price shopping will generally have little effect on copayments since these are typically set amounts and will not vary.
Researchers also found that consumers may gain little from shopping for many outpatient services, and they found more price variation in inpatient services than in outpatient services. The study found that prices varied more for the non-shoppable inpatient services than for the shoppable ones.