IHA Daily Briefing: May 13

Monday, May 13, 2019
RAND Study Focuses on Hospital Prices
Illinois’ Preparedness Level Meets National Average
May 30 Pre-Diabetes & Diabetes Management Webinar
Briefly Noted

RAND Study Focuses on Hospital Prices
A RAND Corporation study on 2017 U.S. hospital prices released on Thursday shows that the prices paid to hospitals for privately insured patients averaged 241% higher than Medicare payments, with wide variation in prices among states.

Hospital prices in 25 states for nearly 1,600 hospitals were analyzed for the study. Researchers reviewed healthcare claims for more than 4 million people, with information coming from self-insured employers, two state all payer claims databases and records from health insurance plans that chose to participate. For each private claim, researchers re-priced the service using Medicare's grouping and pricing formulas.

Illinois data included approximately 3,200 inpatient claims and 68,000 outpatient claims from 109 hospitals of all types—urban, rural, academic, safety net and critical access. Illinois’ overall relative price (225%) is 9th lowest of the 25 states with Indiana (311%) being the highest.

Some states (Kentucky, Michigan, New York, and Pennsylvania) had average relative prices that were 150% to 200% of what Medicare paid, while other states (Colorado, Indiana, Maine, Montana, Wisconsin, and Wyoming) had average relative prices that were 250% to 300% of what Medicare would have paid.

AHA issued a statement critiquing the flaws of the study, including its small sample size—“less than 5% of all covered persons in about half of all states, and just 2% of the 181 million Americans with employer-sponsored insurance nationally.” In addition, AHA says that, “Medicare payment rates, which reimburse below the cost of care, should not be held as a standard benchmark for hospital prices.”

The full RAND report is available here.

Illinois’ Preparedness Level Meets National Average
According to the National Health Security Preparedness Index, Illinois’ 2018 overall preparedness level was 6.6 out of 10. That’s an 11.9% increase since 2013. The national average was 6.7.

Six state domain scores are analyzed to determine the overall score. Illinois’ lowest score—4.6—was in community planning and engagement coordination; the national average was 5.2. The state’s highest score—9.0—was in the incident and information management domain, surpassing the national average of 8.7.

The National Health Security Preparedness Index annually analyzes 64 data sources to measure health security and preparedness.  

IHA is asking members to complete a brief survey by May 31 on your organization's preparedness needs. Survey results will be used to help shape this year's IHA Emergency Preparedness Exercise. All member input is welcome.

May 30 Pre-Diabetes & Diabetes Management Webinar
The Midwest Business Group on Health (MBGH), in collaboration with the Illinois Dept.of Public Health, invites employers and healthcare stakeholders to join a webinar to learn about no-cost resources and education opportunities available on pre-diabetes and diabetes management to support workplace efforts. The webinar takes place on May 30 from 9 to 10:30 a.m. (CT).

During the webinar, MBGH member Tara Sherman, Well Being Strategy Leader, The Boeing Company, will provide a first-hand perspective on the impact their Diabetes Prevention Program (DPP) has had on reducing the risk of type 2 diabetes with their workforce through an evidence-based lifestyle change program.

The webinar will focus on steps an employer can take to:

  • Better understand diabetes risk within your covered population;
  • Learn effective pre-diabetes and diabetes management strategies;
  • Update benefit plan design to proactively impact coverage and treatment compliance;
  • Develop communication campaigns to inform and engage employees; and
  • Evaluate and measure the impact of your diabetes interventions.

How to use the Diabetes Management in the Workplace Toolkit will be discussed as well.

Register today.

Briefly Noted
May 12-18 is National Hospital Week. IHA salutes our more than 200 hospital and health system members who work unceasingly to improve the health of patients and the lives of residents in the communities that they serve.

Read a blog post from Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma on how CMS has made significant improvements in administering the Medicaid program, including streamlining the review process and reducing approval times.