Dear Forum Friends,
We are excited to kick off summer with this May issue of the Employers’ Voice. A sincere thank you to our amazing presenters, speakers, and staff who helped bring the National Healthcare Price Transparency Conference to life. We truly appreciate all those who were able to attend either in person or virtually. During the conference, the Employer Price Transparency Study (PT5) results were unveiled to show that while the Indiana rankings have improved slightly…we continue to have two price problems: high hospital prices and low physician payment.
Indiana PT5.0 stats:
- 8th Highest for Total Facility Plus Physician (297%)
- 8th Lowest for Total Physician (142%)
- 6th Highest for Total Facility (341%)
Below, you can find additional information about the study, instructions for watching the conference recordings, articles of interest, and much more. Enjoy!
Gloria Sachdev
President and CEO, Employers’ Forum of Indiana
Inside the Forum
View price, cost, and quality data for over 4,000 hospitals and price data for over 2,000 ASCs with the click of a button on Sage Transparency 2.0! The May 2024 update includes graphs and tables from our first iteration of Sage Transparency, PLUS new data metrics, graphs, and dashboards. Also included in the tool are hospital system and state-level prices for physician-administered medications from the PT5 Study conducted by Rand.
Watch a Recording of the National Healthcare Price Conference
Thank you to those who were able to join us on May 13, 2024, for our National Healthcare Price Transparency Conference! We had a fantastic lineup of speakers and over 500 attendees, both in person and virtually, representing 37 states. The presentations and recordings from the conference are now available here.
A special congratulations to Senator Mike Braun as the recipient of EFI’s Champion of Healthcare Price Transparency award!
Mark Your Calendar for Upcoming All – Stakeholder Meetings
Details will be distributed to members one month prior to each meeting.
- June 25th: Virtual, Hypertension in the Workplace (Agenda)
- August 22nd – 23rd: Two day Conference, a partnership between the National Association of Worksite Health Centers and EFI
- November 7th: In Person, Agenda TBD
If interested in reviewing past meeting materials, click here.
Findings of the latest Employer Price Transparency Study (aka RAND 5.0)
On May 13th, RAND Corporation released the results of the 5th round of the Employer Price Transparency Study. Key findings of the report include:
254%
of Medicare for Total Hospital Services
Employers and private insurers paid, on average, 254% of Medicare for hospital inpatient and outpatient services (including facility and related professional claims).
170%
of Medicare for Outpatient ASC Services
Employers and private insurers paid, on average, 170% of Medicare for common outpatient services performed in ASCs*.
278%
of ASP for Physician-Administered Meds
Weighting each state’s prices equally, employers and private insurers paid, on average, 278% of the average sales price (ASP), compared with 106% of the ASP paid by Medicare.
*Due to differences in Medicare payment models between ASCs and HOPDs, prices would have averaged approximately 107% of Medicare if paid using Medicare payment rates for HOPDs.
Indiana Top Health Plans Event
Register Today – August 6, 2024 Conference
Kynexions invites you to the Indiana Top Health Plans event on August 6th at the Forum Events Center. This gathering is dedicated to showcasing award-winning benefits plans offered by Indiana employers and municipalities. Register today at this link.
This event will also include the inaugural Regional Rosie Awards, celebrating top performers in healthcare transparency and quality. These awards will be given to Indiana-based Plan Sponsors who are taking proactive steps to lower costs and enhance benefits for their workforce, and leading healthcare transformation in their businesses, communities, and industry. If interested in learning more about nominating your health plan, go here.
CDC: National Center for Health Stats
Provisional Drug Overdose Count
Based on data available for analysis on May 5, 2024, the CDC’s National Center for Health Statistics released an update to show the number of reported deaths due to drug overdose. According to the data, from December 2022 to December 2023, Indiana reported a nearly 18% drop in reported overdose deaths.
National Association of Worksite Health Centers (NAWHC) 12th Annual Forum
Directions and Success Factors in Onsite, Near-site and Virtual Health Centers
NAWHC and EFI invite you to participate in the 12th Annual Forum, August 22 & 23, 2024, at the Conrad Hotel in Indianapolis, IN.
NAWHC is the nation’s only trade organization focused on helping employers and others understand the potential and value of onsite health services, as well to enable existing employer clinics to increase their capabilities and integration of other worksite programs and benefits. Members include employers and their vendor and provider partners. The conference is expected to have nearly 200 participants. For more information, click here.
In the News
EFI In the News:
- Many Indiana Hospitals Struggling Financially Amid Rising Expenses, Report Says (IBJ)
- Indiana Hospital Prices 8th-Highest in Nation, Study Finds, but Hospitals Dismiss Analysis (ICC)
- Indiana Hospital Prices Remain Among Highest in Nation, Report Says (IBJ)
- Hospitals Charged Private Insurers 254% of Medicare in 2022: Rand (Modern Healthcare)
- New Study Finds Indiana Hospital Prices 8th Highest in the Nation (WFYI)
- RAND: Hospital Prices 254% Higher Than Medicare Rates (RevCycle Intelligence)
- Employers Paid Hospitals 254% More Than Medicare, Study Says (Bloomberg Law)
- Sage Transparency Relaunches With New Features and New RAND Hospital Price Data (Yahoo Finance)
- Price Transparency: Private Plans Pay More, A Lot More (Health Leaders Media)
Employers:
- Retailers Retreat From Health Care Delivery (AXIOS)
- I’m a Former Surgeon General and I Couldn’t Believe My $10k Medical Bill (MedPage)
- The 18 Health Systems Walmart Sends its Employees to for Care in 2024 (Becker’s)
- Hospital Cost Gaps Puzzle Employers Armed With New Rate Data (Bloomberg)
Public Health:
- Preventable Premature Deaths from the Five Leading Causes of Death in Nonmetropolitan and Metropolitan Counties, United States, 2010–2022 (CDC)
- COVID Data Tracker (CDC)
Mental Health:
- Workplace Mental Health Toolkit (MHA)
- Surgeon General’s Framework for Workplace Mental Health and Well-Being (HHS)
- SHRM Mental Health and the Workplace (SHRM)
Hospitals
- Hospitals Are Refusing to Do Surgeries Unless You Pay in Full First (WSJ)
- N.C. State Treasurer Report Says that Some Hospitals Overcharged State Employees for Drugs (WECT)
- Indiana Hospital Margins Lag Behind Nation, With Some Budgets In The Red (WFYI)
- Why One New York Health System Stopped Suing Its Patients (KFF)
- IHA Names Interim President Blake Dye (ICC)
- Surging Hospital Prices Are Helping Keep Inflation High (WSJ)
- Bluffton and Peru Hospitals Ending Planned Inpatient Childbirth Services (LHN)
- After Appalachian Hospitals Merged Into a Monopoly, Their ERs Slowed to a Crawl (KFF)
- Hospital to Union: Pay Up or You’re Stuck With Us in Your Health Plan (WSJ)
Providers & Physicians
- Transcarent Banks $126M Series D Round as it Puts Focus on AI (Fierce Healthcare)
- Dobbs-Era Abortion Bans and Restrictions: Early Insights about Implications for Pregnancy Loss (KFF)
- Surgeons From Across The U.S. come to Indiana Spine Group to Learn the Latest Techniques (IBJ)
- Medical Residents are Increasingly Avoiding States with Abortion Restrictions (KFF)
- Senate Ramps Up Push to Reform Doctors’ Medicare Pay (Modern Healthcare)
- Report Shows Dispute Resolution Process in No Surprises Act Favors Providers (Commonwealth Fund)
Private Equity
- States Strengthen Defense Against Private Equity Healthcare Deals (Modern Healthcare)
- Evidence On Private Equity Suggests that Containing Costs And Improving Outcomes May Go Hand-In-Hand (Health Affairs)
- Private Equity Bankruptcies in Healthcare Explode 112% in 5 Years (Health Exec)
- Private Equity State Risk Index (PERI)
- An Indiana Hospital Chain Used Investor Money to Grow Fast. But has that Come at a Cost? (Indy Star)
- You Can Thank Private Equity for that Enormous Doctor’s Bill (WSJ)
Insurance
- Payers’ Q1 Revenues, Profits (Beckers)
Pharmacy
- FTC Expands Patent Listing Challenges, Targeting More Than 300 Junk Listings for Diabetes, Weight Loss, Asthma and COPD Drugs (FTC)
- Hims & Hers Stock Spikes. It’s Taking on Big Pharma With Cheap Obesity Shots (Barrons)
Policy:
- 50-State Noncompete Survey (Epstein Becker Green)
- Hospitals, Physicians Submit Opposing Views to FTC Ruling on Noncompetes (Healthcare Finance)
- Updated Federal Workplace Guidelines Protect Pronouns, Bathrooms and Abortion (The Hill)
- 2024 Annual Report: Additional Opportunities to Reduce Fragmentation, Overlap, and Duplication and Achieve Billions of Dollars in Financial Benefits (GAO)
- Biden Administration Finalizes Rule to Support Reproductive Health Care Privacy (Health Affairs)
- Washington Takes Long, Angry Look at Healthcare Consolidation (Modern Healthcare)
Other Healthcare News
- Digital Diabetes Management Solutions (PHTI)
- Ten Things to Know About Consolidation in Health Care Provider Markets (KFF)
- OMB Publishes Revisions to Statistical Policy Directive No. 15: Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (White House)
- Statewide Hospital Price Level Variation (WACCU)
Do you have a suggestion or contribution for our next newsletter? Contact us.