Weekly edition
The week in one place: 6 stories by section, and the figures that defined it.
The Washington Post found that routine care in offices bought by hospital systems is often billed at hospital outpatient rates plus a facility fee, raising what patients and their insurers pay for the same service.
A federal proposal would stop paying marketplace subsidies while eligibility questions are resolved, starting with 2028 coverage, and officials expect fewer people to enroll as a result.
3 min read
Once Oregon made hospitals check patients for aid without waiting for an application, the free and discounted care they gave rose sharply, a Tradeoffs analysis found, while many Texas hospitals still bill patients first.
2 min read
The Commonwealth Fund's biennial insurance survey found cost-related barriers to care rising since 2022, including among adults who had coverage all year.
3 min read
KFF's annual survey of employers found that what workers pay toward family coverage grew almost twice as fast as the total premium this year, with the heaviest bills at small firms.
2 min read
A report from the Institute for Clinical and Economic Review and West Health found that launch prices for new drugs rose sharply after 2022 and that most first prescriptions for those drugs were not filled within a month.
3 min read
10times
how much higher bills can run when office care is billed at hospital rates with a facility fee
Doctors' offices owned by hospitals can bill 10 times more, Washington Post reports
57
services HCCI compared, every one priced higher in the hospital outpatient setting from 2018 to 2022
Doctors' offices owned by hospitals can bill 10 times more, Washington Post reports
$405
average price of a cast billed as outpatient care, compared with $83 in a doctor's office
Doctors' offices owned by hospitals can bill 10 times more, Washington Post reports
27%
rise in outpatient charges from 2017 to 2022, against 2% for doctors' offices, per Blue Cross Blue Shield Association research
Doctors' offices owned by hospitals can bill 10 times more, Washington Post reports
332,500
fewer marketplace enrollees each year under the proposal, by CMS's estimate
Proposed rule would hold back ACA subsidies until eligibility is verified
$7.6billion
estimated yearly drop in federal advance premium tax credit spending starting in 2028
Proposed rule would hold back ACA subsidies until eligibility is verified
$655a month
average advance premium tax credit per enrollee used in CMS's estimate
Proposed rule would hold back ACA subsidies until eligibility is verified
0.4%
estimated rise in average premiums as healthier enrollees leave
Proposed rule would hold back ACA subsidies until eligibility is verified
