Healthcare Costs Hurting Individuals and the US Healthcare System
The healthcare landscape is under growing scrutiny due to rising drug expenses, disparities in hospital pricing, and increasing medical debt. Is technology the key?
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By - Today’s roundup focuses on pricing disparities of drugs and hospital services, the burden of medical debt on middle-class Americans, and the financial implications of data breaches caused by technology use in healthcare.
Exorbitant US Prices for Weight Loss Drug Raise Eyebrows
A report by the Peterson–KFF Health System Tracker highlights that weight loss drugs like Ozempic, Wegovy, and Mounjaro are considerably more expensive in the United States than in other developed nations. The study analyzed drug list prices across 10 developed countries and found that the cost of these weight loss drugs in the US is over five times higher than in countries like Japan and France. The study underscores the significant pricing gap in drug costs among developed nations, which can pose a financial burden on both patients and the US healthcare system. The US's higher rates of obesity also contribute to the potential impact of these costly drugs on health spending. READ MORE
Commercial Plan Hospital Prices 5x Higher Than Medicare Advantage
A new Health Affairs study reveals that insurers negotiate hospital prices for their commercial health plans that can be up to five times higher than Medicare Advantage prices. The study utilized hospital price transparency data from 2022 and found that commercial market prices consistently exceeded Medicare Advantage prices across various service types. The price difference ranged from 1.8 times to 2.7 times, with commercial plans paying $660 to $707 more on average than Medicare Advantage plans. Laboratory and imaging services were particularly likely to be significantly more expensive in commercial plans. The geographical location and insurer size also impacted price ratios. READ MORE
Middle-Class Americans Bear Highest Medical Debt Rates Across Income Levels
A recent report from the think tank organization Third Way reveals that middle-class Americans face the highest rates of medical debt compared to lower and higher-income groups. The study used Census data to analyze medical debt across income levels and found that almost a quarter (23.5%) of middle-class families, with incomes between $50,000 to $100,000, had medical bills they couldn't fully pay in 2020. This was 1.5 percentage points higher than lower-income families and 9 points higher than higher-income families. The report suggests that even with higher rates of insurance coverage, middle-class families are more likely to accumulate medical debt due to high deductibles and out-of-pocket costs. READ MORE
Tracking Pixels Pose More Than Ethical Risks at Advocate Aurora
Advocate Aurora Health has reached a $12.25 million settlement to address a data breach lawsuit resulting from a breach last year that affected 3 million people. The breach was caused by the health system's use of tracking pixels on its website. These pixels exposed sensitive information like IP addresses, appointment details, and communications. Following the breach notification, multiple lawsuits were filed and consolidated into a class action complaint, alleging privacy violations due to tracking pixel use. The settlement covers affected individuals, legal fees, and expenses, reflecting a growing trend of lawsuits and settlements related to data breaches caused by tracking technologies. READ MORE
Role of Medical Community in LLM Development, Use
Stanford researchers have highlighted the importance of the medical community shaping the use of large language models (LLMs) in healthcare, cautioning against deploying LLM-based tools without proper medical training data and verification of benefits. In a recent special communication in JAMA, the trio of researchers urged healthcare stakeholders to actively guide LLM development, provide relevant training data, and evaluate real-world benefits. They emphasized the significance of validating value propositions and cautioned against pitfalls like dataset contamination, especially relevant advice with healthcare systems already adopting LLMs for various applications to predict clinical outcomes. READ MORE
SNFs See Boost in Psychiatric Visits Thanks to Telehealth
Telehealth saw a rapid increase in adoption at skilled nursing facilities (SNFs) during the COVID-19 pandemic, leading to improved access to psychiatric care, according to a team of Boston-based researchers. The Centers for Medicare and Medicaid Services waived the requirement for a three-day hospitalization prior to SNF stays, boosting telehealth use. Although telehealth usage dropped from its peak in 2020, it significantly increased access to psychiatry visits within SNFs. The authors also highlighted that high telehealth use SNFs provided more psychiatry visits and outpatient visits for residents with limited mobility, showcasing the potential benefits of telehealth in enhancing patient-clinician connections. READ MORE
