iLoveBenefits: Industry News Blog

What C-Suite Executives Want in 2017

Can anyone create a understandable explanation of benefits (EOB)

According to a recent survey, 95.5% of respondents had received a medical bill from a doctor, hospital, or health care provider in the past 12 months. Of those, 60.5% rated their medical bills as confusing or very confusing. Their frustrations included the following:

  • The relationship between bills from provider and the statements from insurance company: 50.6%
  • Not sure if the total owed was correct: 49.4%
  • The amount owed was a surprise: 48.8%
  • Unexpected expenses that were thought to be covered by insurance: 46.1%
  • Not sure if the insurance company had paid yet: 43.2%
  • The bill arrived a long time after the date of service: 42.3%
  • The relationship between the bill and insurance deductible: 35.1%
  • Didn’t understand the language on the bill: 23.5%
  • Wasn’t sure if everything listed on the bill really happened: 22.0%

Source: “A BILL YOU CAN UNDERSTAND RESEARCH REPORT,” Mad*Pow, May 6, 2016, http://static1.squarespace.com/static/5715100cf8baf3c79d443859/t/5730e1c4f699bbe627603424/1462821330491/DesignChallenge_ResearchReport.pdf

50% Looked Up Health Information on the Internet in 2015

The Centers for Disease Control recently released results from the National Health Interview Survey on health information technology use. Here are some key findings from the report:

  • 3.7% used online chat groups to learn about a health topic in the past 12 months.
  • Half of everyone surveyed looked up health information on the internet in 2015.
  • 8.7% filled a prescription online in the past 12 months.
  • 1 in 10 scheduled an appointment with a healthcare provider online in 2015.
  • 11.2% communicated with a health provider by email in the past 12 months.
  • 3 in 4 with advanced degrees looked up health information online, vs. 35% of high school graduates.

Source: CDC, May 18, 2016

What revenue does a physician generate for their hospital?

According to a recent survey, the average net revenue generated on behalf of an affiliated hospital is as follows:

  • $1,560,688 by a single physician
  •  $2,746,605 by a full-time orthopedic surgeon
  •  $2,448,136 by an invasive cardiologist
  •  $2,445,810 by a neurosurgeon
  •  $2,169,693 by a general surgeon
  •  .$1,493,518 by a family physician
  • $1,830,200 by a general internist

Source: “Survey: Each Physician Generates an Average $1.56 Million a Year Per Hospital,” Merritt Hawkins News Release, April 12, 2016, http://www.merritthawkins.com/uploadedFiles/MerrittHawkins/Pdf/2016%20Merritt%20Hawkins%20-%20Inpatient-Outpatient%20Revenue-%20Press%20Release.pdf

Communication With Health Providers

Among adults who reported having poor communication with their health providers in 2012, Hispanics had the highest percentage (11 percent) followed by blacks (10 percent) and whites (7 percent). (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report, Chartbook for Hispanic Health Care.)

Reimbursement is beginning to change in important ways

Effective January 1st, the Centers for Medicare and Medicaid Services (CMS) began reimbursing providers who actively manage care delivery for Medicare patients who have two or more chronic conditions. According to a recent health care provider survey, 76% of respondents planned to organize and structure to meet Medicare’s chronic care management program requirements within the next six months.

Source: “KRYPTIQ SURVEY: NINE OF TEN PROVIDERS PLAN TO PURSUE MEDICARE’S CHRONIC CARE MANAGEMENT PROGRAM,” Kryptiq Press Release, February 26, 2015, http://www.kryptiq.com/kryptiq-survey-nine-ten-providers-plan-pursue-medicares-chronic-care-management-program/

 

What privacy?

According to a recent analysis of over 80,000 health-related web pages:

  • 91% of health-related web pages send HTTP requests to third party advertisers and data brokers
  • 70% of these requests include information about specific symptoms or diseases
  • Google collects user information from 78% of pages, comScore collects from 38% of pages, and Facebook collects from 31% of pages

Source: “Your Privacy Online: Health Information at Serious Risk of Abuse,” Annenberg School for Communication, University of Pennsylvania Press Release, February 20, 2015, https://www.asc.upenn.edu/news-events/press-releases/your-privacy-online-health-information-serious-risk-abuse

Better understanding of BP measures in frail elderly people

Study warns of risks when frail older patients take multiple BP meds Frail elderly nursing home residents with low systolic blood pressure taking two or more antihypertensive medications were at a twofold higher risk of dying within two years compared with peers, according to a study in JAMA Internal Medicine. Researchers also found a higher portion of those deaths were from cardiovascular causes — 14.5% of patients on multiple antihypertension medications, compared with 9.4% of others taking fewer than two blood pressure-lowering drugs. Medscape (free registration) (2/19)

Listening to the patient about their chronic pain

An independent panel convened by the National Institutes of Health concluded that individualized, patient-centered care is needed to treat and monitor the estimated 100 million Americans living with chronic pain. “Persons living with chronic pain have often been grouped into a single category, and treatment approaches have been generalized with little evidence to support this practice,” said Dr. David B. Reuben, panel chair and professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles. “Chronic pain spans a multitude of conditions, presents in different ways, and requires an individualized, multifaceted approach.”

Let’s get on with providing useful information to patients and their caregivers

Leapfrog is clearing the path forward and is a huge lever in our efforts to provide useful information to patients and their caregivers.

 

Healthgrades’ rankings website allows searches by experience A new version of the Healthgrades.com website that launches this week uses data from 500 million claims and patient reviews to rank physicians on complication rates, patient satisfaction and experience. Leapfrog Group CEO Leah Binder said the website is “game changing” because people can search for physicians based on experience in a specific medical area or procedure. USA Today (10/19)

 

One day, patients and their caregivers will have the important information they need to make important health decisions. Clearing that path and enabling appropriate measurement in both quality and resource utilization is among the most important things that health care stakeholders of all types need to be engaged in.

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