Learning by Surfing: Issue 5

Here’s some health care reading.

Dr. Benjamin Brewer in The Wall Street Journal on pricing difficulties:

Why can’t you find out how much medical care costs before you’re treated? Even though I’m a doctor, I can’t get that information when I need it either.

A fall on our family’s spring vacation trip sent my daughter to a Tennessee ER for 13 stitches. The bill was $827. I figured the ER bill would be high, but I didn’t quite expect $63.62 a stitch. After insurance paid, my out-of-pocket costs came to $291 six weeks later.

Nobody I know would be willing to buy gas at an unknown price, only to find out the damage when the tab comes a month and a half later. But between the mind-numbing complexity of health-care charges and the reluctance of many in the health system to reveal their prices up front, you don’t have much of a choice.

BusinessWeek on the myth of retirees:

Other industries have jumped aboard, too. There are target-date mutual funds, investment funds that buy up retirement businesses, and expanded offerings from a variety of leisure industries, all counting on legions of retirees to fuel their growth.

There’s just one problem: The pundits are wrong. Through at least the next 25 years (i.e., past the time the last baby boomer turns 65), the retirement market will be far smaller than the oft-cited 78 million—regardless of whether one is referring to the number of people retiring or the number of living retirees. In fact, compared with today, the growth rate of either of those two measures will be less than 4% annually for the next 25 years—and could very well be zero.

Payment reform announcement from HealthBlawg:

The federales are now pushing the latest CMS demo promoting physician hospital collaboration. In other words, CMS is having another go at gainsharing from a slightly different angle. The information available on the demo at CMS website includes the formal solicitation (applications due August 15). It’s known as ACE – the Acute Care Episode demo.

Another attempt at payment reform from Fierce Healthcare:

The project, dubbed Prometheus–for payment reform for outcomes, margins, evidence, transparency, hassle-reduction, understandability and sustainability–is funded by the Robert Wood Johnson Foundation. Payments will be built around a total amount to be paid to all providers for a patient’s condition. The project includes 12 evidence-based case rates, which included input from health insurers, employers, physicians and others through a not-for-profit collaboration.

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