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New PRA Report: Healthcare Price Transparency Can Reduce Healthcare Costs by More than $1 Trillion Annually

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Paper co-authored by renowned economist Dr. Arthur Laffer and PRA Founder Cynthia Fisher offers solution to the American healthcare crisis

WASHINGTON /PRNewswire/ — Today, PatientRightsAdvocate.org (PRA) published a report co-authored by Founder and Chairman Cynthia Fisher and economist Dr. Arthur Laffer that concludes healthcare price transparency can reduce national healthcare spending by more than $1 trillion annually and extend American life expectancy.

The report explains how price transparency can achieve these dramatic health saving and outcome improvements by empowering patients and employers to access the best care at the best prices. Actual prices can be compared to claims data to prevent and remedy rampant overcharges, spread pricing, and to expose errors and fraud that occur in the shadows of the current opaque system. Price transparency will unleash a competitive, affordable health system that eliminates widespread overcharging. 

“The American people are paying twice as much for healthcare to die four years earlier than in other developed countries,” said Cynthia Fisher, founder and chairman of PatientRightsAdvocate.org. “Price transparency provides the opportunity to lower runaway costs and provide access to care with knowledge of quality and outcomes. The opportunity is to save lives while saving money.”

“Americans spend nearly twice as much on healthcare as other advanced countries yet have far shorter life expectancies due to hidden prices that drive up costs and scare patients from seeking care,” said economist Dr. Arthur B. Laffer. “Healthcare price transparency can save Americans more than $1 trillion a year on healthcare spending and lengthen lifespans by ushering in a pro-consumer healthcare marketplace that empowers patients to choose affordable care when they need it. That’s what makes the current effort in Congress to strengthen healthcare price transparency one of the most crucial public policy actions legislators can take to improve American wellbeing.”

Click here to read the report.

Top Takeaways

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  • The top 10 biggest Organization for Economic Cooperation and Development (OECD) healthcare spenders, excluding the U.S., spent an average of 11.9% of their GDPs on healthcare in 2021.
  • The U.S. spent 17.4% of its GDP on healthcare in 2021.
  • 2019 JAMA paper estimated that at least 25% of the more than $4 trillion in annual U.S. healthcare spending is administrative waste, errors, overcharging, and fraud.
  • If the U.S. could match other top ten OECD nations’ 11.9% of GDP spending performance through price transparency reforms, it would cut its annual healthcare spending from $4.1 trillion to $2.8 trillion, saving $1.3 trillion.
  • With true healthcare price transparency, annual savings could amount to $4,000 per person in the country.

PatientRightsAdvocate.org (PRA) is a leading national healthcare price transparency organization dedicated to ushering in systemwide transparency through advocacy, testimony, media, legal research, and grassroots campaigns. PRA believes that the availability and visibility of actual, upfront healthcare prices will greatly lower costs for patients and employers through a functional, competitive healthcare marketplace. In its latest Hospital Price Transparency Compliance report, PRA found that only 36% of American hospitals reviewed are fully complying with the law after almost three years of its implementation.

SOURCE Patient Rights Advocate

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Lifestyle

5 Things to Know About Medicare Open Enrollment

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Medicare

Medicare Open Enrollment

(Family Features) Medicare Open Enrollment, which runs from Oct. 15-Dec. 7 each year, is the one time you can review, compare and make changes to your Medicare health and prescription drug plans for the next year. Because plans – and your health – can change, it’s important to compare plans every year. Visit Medicare.gov to see what’s new for 2025, including a $2,000 cap on out-of-pocket costs for covered prescription drugs, get extra help with prescription drug costs and more.

Medicare


SOURCE:
Centers for Medicare & Medicaid Services

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Lifestyle

CareerBuilder and Monster close combination, creating stronger job board for talent and employers

CareerBuilder and Monster have finalized their merger, creating a stronger job board to capitalize on market trends. Jeff Furman leads the team, and further branding details will follow.

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concentrated female entrepreneur typing on laptop in workplace. CareerBuilder
Photo by Andrea Piacquadio on Pexels.com

CHICAGO, Sept. 16, 2024 /PRNewswire/ — We are excited to announce that with the completion of all customary regulatory approvals, the agreement to combine CareerBuilder and Monster is now finalized. As previously announced, the combination of CareerBuilder and Monster brings together two strong, trusted, complementary brands to create a job board with greater scale and reach. Together, both companies can more effectively capitalize on prevailing trends in the market to deliver enhanced growth.

CareerBuilder

Jeff Furman, CEO of the combined company, said: “I could not be more excited to bring these two celebrated brands together. We are able to leverage the best-in-class solutions, capabilities, and expertise from both companies to better serve both our candidates and employers and help them navigate the evolving talent marketplace.” 

In addition, we are excited to announce the new leadership team of the organization:

Dinesh Arora, Chief Technology Officer

Scott Blumsack, Chief Marketing and Strategy Officer

Brian Burbrink, Chief People Officer

Leslie Cope, Chief Product Officer

Ahern Dull, Chief Operating Officer

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Mark Pacioni, General Counsel

Mike Suhajda, Chief Financial Officer

More details about the company, including branding, will be announced in due course. For now, the company will be referred to as CareerBuilder + Monster, and both websites will continue to operate.

PJT Partners Inc. served as financial advisor and Sidley Austin LLC served as legal counsel to CareerBuilder on the transaction. Jefferies LLC served as financial advisor and Jones Day served as legal counsel to Monster on the transaction.

about CareerBuilder
For over 25 years, CareerBuilder has been a leading global talent marketplace providing innovative solutions to help employers find, hire, and onboard great people, and help job seekers build new skills and progressive careers as the modern world of work changes. CareerBuilder is majority-owned by funds managed by affiliates of Apollo Global Management, Inc. For more information, visit careerbuilder.com, and to learn more about our solutions for employers, visit hiring.careerbuilder.com.

about Monster
Monster is a global leader in connecting the right people to the right jobs. Every day, Monster aims to make every workplace happier and more productive by transforming the way employers find talent and candidates find careers. For 30 years, Monster has worked to transform the recruiting industry. Today, the company leverages innovative digital, social, and mobile solutions and proprietary data and insights to enable employers and candidates to see each other more clearly. For more information, visit monster.com.

SOURCE CareerBuilder + Monster

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Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.


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Preventive care is free by law, but many Americans get incorrectly billed − especially if you’re poor, a person of color or don’t have a college degree

Preventive care costs exacerbate health disparities, disproportionately affecting marginalized communities. Insurance claim denials are higher for minority and low-income patients despite legal exemptions.

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preventive care
Unexpected bills for preventive care can worsen existing racial and socioeconomic health disparities. Maskot/Getty Images

Alex Hoagland, University of Toronto and Michal Horný, UMass Amherst

Even though preventive care is supposed to be free by law for millions of Americans thanks to the Affordable Care Act, many don’t receive recommended preventive services, especially racial and ethnic minorities and other at-risk patient groups.

The Affordable Care Act exempted preventive services from patient cost-sharing for large chunks of the population. This means that if you receive preventive screening and have private insurance, including through the ACA Marketplace, there should be no copay at time of service, and you shouldn’t get a bill later on. Easy enough, right?

Wrong. Our team of health economists has shown that patients spend millions of dollars every year on unexpected bills for preventive care. The main reason for this is that no specific regulations were put in place to determine exactly which services should be exempted, or for whom, or how often. This omission has left many people on the hook to pay for valuable health care they thought would be free.

Now, in our recently published research in the journal JAMA Network Open, we’ve found that the burden of paying for what should be free preventive care disproportionately falls on some patient groups.

Close-up of hand filling out health insurnace claim form with a pen
Which health care services should be exempted from cost-sharing often isn’t clear. Tetra Images/Getty Images

Inequitable claim denials

Looking at data from over 1.5 million patients, our study demonstrates that insurers deny preventive claims for patients from marginalized communities at higher rates than for those from majority groups.

For example, low-income patients were 43% more likely than high-income patients to have their claims denied. In addition, Asian, Hispanic and non-Hispanic Black patients were each roughly twice as likely as non-Hispanic white patients to have claims denied.

Not only were these patients denied routine benefits, but they also saw large differences in rates of billing errors. For example, patients with a high school diploma or less experienced denials due to this kind of billing error almost twice as often than patients with college degrees. All of these services should have been covered by an insurer.

Research on preventive care access is commonly based only on claims data, which doesn’t typically have information on patient demographics. This limits a study’s ability to detect differences across patient groups. Our study, however, uses a combination of linked claims data, remittance data containing information on why claims were denied and whether they were resubmitted, and demographic data from self-reports, purchase transactions and voter registries. Together, this richer dataset allowed us to examine differences in denials based on race and ethnicity, education and income, including reasons why patients were denied care.

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Preventive care is essential

Equitable access to preventive health care is about more than just physicals, although those are important, too. Preventive health care includes key screenings for cancers, cardiovascular disease and diabetes, access to contraceptives, and mental health checkups, among other services. Ensuring that insurers provide equal coverage for these services for all patients is important to improve health outcomes and quality of life for everyone while reducing future health care costs.

Our results paint a picture of the kinds of hurdles patients face when they seek health screenings. Patients from underrepresented groups were not only more likely to be told their care wouldn’t be covered. They were also more likely to have their claims processed incorrectly, leading to more frequent denials and, ultimately, larger medical bills. https://www.youtube.com/embed/Uc2uG6LhFQQ?wmode=transparent&start=0 Few patients appeal claim denials, even though rejections may be unjustified.

Unexpected bills can affect both a patient’s current health and their future use of health care services. These hurdles can exacerbate an already tenuous trust in a fragmented health care system, making patients less likely to return for follow-up screenings.

Stacked coverage denials for patients who live with multiple marginalized identities or who are less able to advocate for themselves can further entrench racial and socioeconomic inequities.

Ensuring equitable access

Our study paints a compelling picture of where different patients may face hurdles for getting preventive care, but more research is necessary to identify how to ensure equitable access.

As our study looked only at preventive services, we will also need to see how our findings generalize to other forms of health care. More research is also needed to understand how other vulnerable patient groups, such as LGBTQ+ patients or patients with multiple chronic conditions, fare when trying to access care.

Our team is currently studying how actual bills for care differ across patient groups and how patients respond when bills arrive. In our study, more than two-thirds of denied claims were never resubmitted to insurers, meaning that many billing errors go uncorrected at patients’ expense.

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Equitable policy on multiple fronts can help rectify the way preventive care is inconsistently and inequitably provided. These include uniform coverage of preventive care by insurers, standardized billing practices for physicians and improved means for patients to advocate for themselves. This can help ensure that everyone has appropriate access to lifesaving health care.

Alex Hoagland, Assistant Professor of Health Economics, University of Toronto and Michal Horný, Assistant Professor of Health Policy and Management, UMass Amherst

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.

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