Robert Whitcomb

As  physician groups’ market share increases, they gain bargaining power with payers, which may in turn drive up medical costs, says a study in Health Affairs.

Becker’s Hospital Review reports on the study that “Researchers from the Stanford University School of Medicine found orthopedic surgeons in concentrated markets charged 7 percent more for knee replacements than surgeons in less concentrated markets between 2001 and 2010, even as the average cost of knee replacements nationwide dropped $261. In the most concentrated markets, fees for knee replacements increased $168 on average compared to the least concentrated physician markets.”

Researchers looked at the 50 U.S.  hospitals with the highest charge-to-cost ratios in 2012.

The researchers, whose study appeared in HealthAffairs, found that these hospitals had markups (ratios of charges over Medicare-allowable costs) about 10 times their Medicare-allowable costs compared to a national average of 3.4 and a mode of 2.4. Analysis of the 50 hospitals showed that 49  are for profit (98 percent), 46 were owned by for-profit hospital systems (92 percent), and  20 (40 percent) operate in Florida.

The researchers concluded: “While most public and private health insurers do not use hospital charges to set their payment rates, uninsured patients are commonly asked to pay the full charges, and out-of-network patients and casualty and workers’ compensation insurers are often expected to pay a large portion of the full charges. Because it is difficult for patients to compare prices, market forces fail to constrain hospital charges. Federal and state governments may want to consider limitations on the charge-to-cost ratio, some form of all-payer rate setting, or mandated price disclosure to regulate hospital markups.”

Figuring out your health might be a lot simpler than undergoing all those tests and wearing those new devices. Indeed, as MedScape notes,  it doesn’t have to be digital at all.

“For persons of middle age (40 to 70 years), self-reported overall health and walking speed were the best predictors of death in the next 5 years, according to a new study  in the Lancet.

“In an analysis of nearly 500,000 UK citizens followed for 5 years, these two simple questions outperformed 655 measurements of demographics, health, and lifestyle. Is your health excellent, good, average, or poor? Is your walking pace slow, average, or brisk? Along with smoking, those two basic questions, inquiries that hardly require a digital device, were the best predictors of staying alive in the next 5 years.

“Pause for a moment here and ponder the beauty of that top-line result. Half a million people followed for 5 years; 655 measures of health, including heart rate, blood pressure, and lab tests, and the best predictors were that simple.”

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