An analysis of the pressure to reduce healthcare costs

Individuals and families are facing higher deductibles and healthcare expenses that are eating into their household budgets. Many quality experts say readmission rates are a key measure of quality of care, though not everyone agrees. Recurring drivers of healthcare costs Demographics: Physician consolidation and employment More doctors are practicing as employees of hospitals, health systems and medical groups.

With as many asacute and nonemergency PCIs performed each year, experts say there should be some uniformity in what it costs, what devices are used and how well patients will recover.

The cost-to-charge ratio is an estimate of true cost for all patients, not only those on Medicare. Otherwise, payers and patients may take their business elsewhere.

Healthcare prices rise alongside economywide input prices. Watch this video on the role of Physicians Leading Change and their role in reducing the cost of healthcare.

Many states have their own hospital-ratings sites. Yet their costs are high enough to affect employer healthcare spending. There is a growing movement to make cost and quality data on hospitals and other healthcare providers publicly available and accessible to insurers, employers and consumers.

About 1 in 5 Americans now has a high-deductible plan, a dramatic increase sinceaccording to the Kaiser Family Foundation. Poor wellness and prevention habits are drivers of ill health.

Rather than check published data comparing hospital quality and costs, the computer analyst did what many Americans do. To date, efforts to control healthcare costs have taken a primarily top-down approach.

You don't always get what you pay for

High-performance networks These limited provider networks emphasize high-quality care and customer satisfaction alongside cost savings.

Unaddressed social factors of health, such as economic stability and education, can impact utilization patterns and care decisions. Leah Binder, president and CEO of hospital-ratings firm Leapfrog Group, said the lack of a consistent link between what hospitals spend to provide care and how they perform on quality measures holds true for every procedure and every hospital in the country.

Government sites such as Hospital Compare regularly add new dimensions of patient-safety data.

While limited in scope, the analysis suggests there is no consistent relationship between hospitals spending more to perform a procedure and their achieving better patient outcomes. Still, Woodrich agreed that increasing transparency in hospital costs would affect hospital negotiations with insurers.

In the other five cities, hospitals with a higher average cost had lower readmission rates. Medical technology and innovation: A Modern Healthcare analysis found that in seven of 12 cities examined, the hospital with the lower average cost for inpatient and outpatient PCI procedures also had a lower readmission rate for PCI patients.

He questioned whether the readmission rate is a valid measure of quality. Share information on costs, prices and outcomes with government agencies and organizations publishing cost and quality information for consumers. For its analysis, Modern Healthcare used hospital PCI readmissions data that are voluntarily submitted by hundreds of U.

Educate patients and their family members on the discharge plan. Inthe industry may experience more uninsured and underinsured individuals due to the elimination of the individual mandate penalty, efforts to expand the use of plans that sidestep Affordable Care Act consumer protections, and the proliferation of state-based Medicaid work requirements.Increasing pressure to control health care costs necessitates that limited healthcare resources be used equitably and judiciously.

Healthcare expenditures must be correlated with high • Reduce costs from medical malpractice and defensive medicine.

Medical cost trend

Key Process Analysis (KPA) PMPM Analyzer. Provider Productivity.

The following compelling statistics illustrate the need to reduce healthcare costs: Average healthcare spending per capita in the U.S. exceeds $8, Learn More about How Healthcare Analytics Reduce Costs and Waste.

pressure to reduce program costs (Boyd ;[7] State Budget Crisis Task Force [37]). One of the most championed initiatives to reduce government healthcare expenditures is to switch beneficiaries from the fee-for-service (FFS) system to managed care plans.

But I see payment reform as having major potential over time to reduce costs and increase quality. So my advice is to proceed with payment reform but also take steps to foster competition. Oct 26,  · A Modern Healthcare analysis found that in seven of 12 cities examined, hospitals with lower average costs for a common inpatient and outpatient heart procedure also had lower.

According to a PwC report, healthcare costs will remain a challenge in as costs are expected to outpace general economic inflation with a % growth rate. There is no single culprit in the battle against rising healthcare costs; rather, there are many drivers contributing to the increase.

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An analysis of the pressure to reduce healthcare costs
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