March 12, 2019
Dive Brief:
- Healthcare prices vary widely
depending on U.S. location, according to a new interactive report from
the Health Care Cost Institute. Despite huge variations between
cities and towns, one trend held true: Over the four-year period, the
average area saw healthcare prices rise 13% and utilization drop by 17%.
- Metropolitan areas with high use
tended to have lower prices, but that trend wasn't consistent throughout.
For example, Baltimore had the highest overall use in the country
(34% above the U.S. median in 2016) but the lowest prices (26% below). By
comparison, San Jose, California, had prices 84% above the national
average though healthcare utilization there was 19% lower.
- HCCI launched a set of tools allowing
users to compare prices and use of healthcare services across 112
metropolitan areas in 43 states. The Healthy Marketplace Index (HMI),
funded by the Robert Wood Johnson Foundation, used more than 1.8 billion
commercial healthcare claims from 2012 to 2016 to chart prices and use of
inpatient, outpatient and professional services.
Dive Insight:
The
analysis comes as healthcare players — from providers and payers to
policymakers — are exploring how to bend the cost curve without limiting access
or raising out-of-pocket costs. CMS has been pushing hospitals to provide more transparency on prices and
promoting the use of price compare apps. Some
states have also mounted initiatives to help consumers compare prices.
The
HMI tools are the latest to try and shed light on how healthcare dollars are
used and spent throughout the country. A report last year by
the Network for Regional Healthcare Improvement also looked at pricing and
utilization and found wide cost variations between five states: Colorado,
Maryland, Minnesota, Oregon and Utah, as well as St. Louis, Missouri.
By
and large, high use areas had lower prices and vice versa. Baltimore had the
lowest overall prices and the highest utilization of services of any metro area
in the country. By contrast, while San Francisco and Green Bay, Wisconsin, had
some of the highest prices, they ranked below average for use.
But
that wasn't always the case. New York City and Milwaukee ranked in the top 10
for areas with highest overall prices, but also had high service use.
Among
the highest-priced areas were San Jose, California, and Anchorage, Alaska, at
82% above the national median. Baltimore, however, was 26% below the
median in 2016.
HCCI
found metro areas along the coast tended to have higher prices than in the
Midwest, but there were a lot of examples of neighboring areas with
"starkly different" price levels.
The
analysis also found variations within localities across different service
categories. For example, Orlando, Florida, had outlier price levels in
inpatient services 29% above the average, while Green Bay and El Paso, Texas,
had outliers in professional services at 58% above and 10% below the U.S.
median, respectively.
"Our
findings underscore the need to dive into the data and understand the local
factors explaining health care costs, as there is not one overall narrative,
but many individual ones from metro to metro," Bill Johnson, lead
author and senior researcher at HCCI, said in a statement.
HCCI
said future HMI tools will delve into such issues as geographic differences in
prices for select services, wasteful spending and provider competition.
https://www.healthcaredive.com/news/healthcare-prices-rose-but-use-fell-across-us-from-2012-16/550264/
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