Politicians, economists, auto industry analysts and main street business owners are closely watching the UAW strike that began at midnight last Thursday. Healthcare should also pay attention, especially hospitals. medical groups and facility operators where workforce issues are mounting.
Auto manufacturing accounts for 3% of America’s GDP and employs 2.2 million including 923,000 in frontline production. It’s high-profile sector industry in the U.S. with its most prominent operators aka “the Big Three” operating globally. Some stats:
- The US automakers sold an estimated 13.75 million new and 36.2 million used vehicles in 2022.
- The total value of the US car and automobile manufacturing market is $104.1 billion in 2023:
- 2 million US vehicles were produced in 2021–a 4.5% increase from 2020 and 11.8% of the global total ranking only behind China in total vehicle production.
- As of 2020, 91.5% of households report having access to at least one vehicle.
- There were 290.8 million registered vehicles in the United States in 2022—21% of the global market.
- Americans spend $698 billion annually on the combination of automobile loans and insurance.
By comparison, the healthcare services industry in the U.S.—those that operate facilities and services serving patients—employs 9 times more workers, is 29 times bigger ($104 Billion vs. $2.99 trillion/65% of total spend) and 6 times more integral in the overall economy (3% vs. 18.3% of GDP). Surprisingly, average hourly wages are similar ($31.07 in auto manufacturing vs. $33.12 in healthcare per BLS) though the range is wider in healthcare since it encompasses licensed professionals to unskilled support roles. There are other similarities:
- Each industry enjoys ubiquitous presence in American household’ discretionary. spending.
- Each faces workforce issues focused on pay parity and job security.
- Each is threatened by unwelcome competitors, disruptive technologies and shifting demand complicating growth strategies.
- Each is dependent on capital to remain competitive.
- And each faces heightened media scrutiny and vulnerability to misinformation/disinformation as special interests seek redress or non-traditional competitors seek advantage.
Ironically, the genesis of the UAW dispute is not about wages; it is about job security as electric-powered vehicles that require fewer parts and fewer laborers become the mainstay of the sector. CEO compensation and the corporate profits of the Big Three are talking points used by union leaders to galvanize sympathizer antipathy of “corporate greed” and unfair treatment of frontline workers. But the real issue is uncertainty about the future: will auto workers have jobs and health benefits in their new normal?
In healthcare services sectors—hospitals, medical groups, post-acute care facilities, home-care et al—the scenario is similar: workers face an uncertain future but significantly more complicated. Corporate greed, CEO compensation and workforce discontent are popular targets in healthcare services media coverage but the prominence of not-for-profit organizations in healthcare services obfuscates direct comparisons to for-profit organizations which represents less than a third of the services economy. For example, CEO compensation in NFPs—a prominent target of worker attention—is accounted differently for CEOs in investor-owned operations in which stock ownership is not treated as income until in options are exercised or shares sold. Annual 990 filings by NFPs tell an incomplete story nonetheless fodder for misinformation.
The competitive landscape and regulatory scrutiny for healthcare services are also more complicated for healthcare services. Unlike auto manufacturing where electric vehicles are forcing incumbents to change, there’s no consensus about what the new normal in U.S. healthcare services will be nor a meaningful industry-wide effort to define it. Each sector is defining its own “future state” based on questionable assumptions about competitors, demand, affordability, workforce requirements and more. Imagine an environmental scan in automakers strategy that’s mute on Tesla, or mass transit, Zoom, pandemic lock-downs or energy costs? While the outlook for U.S. automakers is guardedly favorable, per Moody’s and Fitch, for not-for-profit health services operators it’s “unsustainable” and “deteriorating.”
Nonetheless, the parallels between the current state of worker sentiment in the U.S. auto manufacturing and healthcare services sectors are instructive. Auto and healthcare workers want job security and higher pay, believing their company executives and boards but corporate profit above their interests and all else. And polls suggest the public’s increasingly sympathetic to worker issues and strikes like the UAW more frequent.
Ultimately, the UAW dispute with the Big Three will be settled. Ultimately, both sides will make concessions. Ultimately, the automakers will pass on their concession costs to their customers while continuing their transitions to electric vehicles. In health services, operators are unable to pass thru concession costs due to reimbursement constraints that, along with supply chain cost inflation, wipe out earnings and heighten labor tension.
So, the immediate imperatives for healthcare services organizations seem clear as labor issues mount and economics erode:
- Educate workers—all workers—is a priority. That includes industry trends and issues in sectors outside the organization’s current focus.
- Define the future. In healthcare services, innovators will leverage technology and data to re-define including how health is defined, where it’s delivered and by whom. Investments in future-state scenario planning is urgently needed.
- Address issues head-on: Forthrightness about issues like access, prices, executive compensation, affordability and more is essential to trustworthiness.
Stay tuned to the UAW strike and consider fresh approaches to labor issues. It’s not a matter of if, but when.
Paul
PS: I drive an electric car—my step into the auto industry future state. It took me 9 hours last Thursday to drive 275 miles to my son’s wedding because the infrastructure to support timely battery charges in route was non-existent. Ironically, after one of three self-charges for which I paid more than equivalent gas, I was prompted to “add a tip”. So, the transition to electric vehicles seems certain, but it will be bumpy and workers will be impacted. The future state for healthcare is equally frought with inadequate charging stations aka “systemness” but it’s inevitable those issues will be settled. And worker job security and labor costs will be significantly impacted in the process.
Resources
Bureau of Labor Statistics (August 2023): Average hourly earnings by industry www.bls.gov
Jack Ewing “Battle Over Electric Vehicles Is Central to Auto Strike” New York Times September 16, 2023 https://www.nytimes.com/2023/09/16/business/electric-vehicles-uaw-gm-ford-stellantis
“Tech Fears Are Showing Up on Picket Lines” September 16, 2023 https://www.nytimes.com/2023/09/16/business/dealbook/uaw-strike-tech-ai-unions.
Quotable
Re: UAW strike: “Carmakers are anxious to keep costs down as they ramp up electric vehicle manufacturing, while striking workers want to preserve jobs as the industry shifts to batteries.
A battle between Detroit carmakers and the United Auto Workers union, which escalated on Friday with targeted strikes in three locations, is unfolding amid a once-in-a-century technological upheaval that poses huge risks for both the companies and the union.
The strike has come as the traditional automakers invest billions to develop electric vehicles while still making most of their money from gasoline-driven cars. The negotiations will determine the balance of power between workers and management, possibly for years to come. That makes the strike as much a struggle for the industry’s future as it is about wages, benefits and working conditions…
For workers, the biggest concern is that electric vehicles have far fewer parts than gasoline models and will render many jobs obsolete. Plants that make mufflers, catalytic converters, fuel injectors and other components that electric cars don’t need will have to be overhauled or shut down… Still, unions and their supporters are unlikely to express much sympathy for auto executives. Ms. Barra, Mr. Farley of Ford and the chief executive of Stellantis, Carlos Tavares, have gotten tens of millions of dollars in compensation packages in recent years. The companies’ shareholders have been rewarded with dividends and share buybacks…Adjusted for inflation, wages for autoworkers in the United States have fallen 19% since 2008, according to the Economic Policy Institute, a left-leaning research group”
Jack Ewing “Battle Over Electric Vehicles Is Central to Auto Strike” New York Times September 16, 2023 https://www.nytimes.com/2023/09/16/business/electric-vehicles-uaw-gm-ford-stellantis
Re: UAW strike: The United Automobile Workers strike is in its second day, and already it’s being framed as potentially the most costly of work stoppages from the “summer of strikes. Unions aren’t just fighting for an inflation-beating wage boost. They also are campaigning for job security at a time when workers increasingly fear that shifts to new technologies, like electric vehicles and artificial intelligence, threaten their job, and tech bosses themselves say this gloomy outlook is inevitable.
“Tech Fears Are Showing Up on Picket Lines” September 16, 2023 https://www.nytimes.com/2023/09/16/business/dealbook/uaw-strike-tech-ai-unions.
Re: 2Q023 Healthcare PE deal activity: “Healthcare deal activity fell again as higher interest rates sting. Healthcare’s Q2 deal count was 13.4% lower than an already soft Q1, putting H1 2023 down 29.6% YoY at 181 total deals. Deal value fell 3.7% sequentially to place H1 down 45.6% YoY to an anemic $21 billion. This equates to a large 22.2% shortfall relative to the pre-pandemic H1 mean of $27.0 billion. Relative to other sectors, healthcare posted one of the steepest declines in deal activity during H1 2023 and now accounts for only 12.5% of deal volume, the lowest since 2014 and below its five-year average of 14.9%.
Pitchbook www.pitchbbok.com
Re: Medicare Part D: “Medicare beneficiaries can have prescription drugs covered via private insurance plans participating in the Medicare Part D program. Premiums and drug costs vary by plan, as do plans’ lists of covered drugs—known as “formularies.” Drug makers may give plans rebates in exchange for preferred placement over competitors on formularies. The rebates may lower plan premiums, but they don’t reduce beneficiaries’ payments for the drugs. We found rebates largely went to a small number of drugs, and plans paid less for highly rebated drugs than beneficiaries did. We recommended that Medicare monitor how rebates affect formularies, beneficiaries, and more.”
GAO Report: Medicare Part D: CMS Should Monitor Effects of Rebates on Plan Formularies and Beneficiary Spending September 5, 2023
Re: private equity targeting cardiology: “Coronary stenting is, by some measures, the most overused procedure in hospitals. The problem costs the health system millions and unnecessarily exposes patients to risks of blood clots, torn arteries, infections, and other life-threatening injuries.
In 2020, Medicare started paying physicians to place stents, balloons, and perform other procedures designed to open clogged coronary arteries outside of hospitals, in less expensive outpatient settings. It didn’t take long for private equity firms to catch on. They’ve been racing to buy up cardiology practices ever since, rolling them into bigger and bigger chains with an eye toward reselling them at a profit.
It’s similar to what happened with orthopedics and gastroenterology, two specialties that have become saturated with private equity money since more procedures went outpatient. Research in other specialties has shown that these financial investors tend to usher in more patients, ramp up surgeries, and jack up prices, effectively increasing spending even as government policies try to lower it. Now, experts say they fear the same thing could happen in cardiology, a field with a long track record of overuse.”
Tara Bannow “Experts fear private equity will pour gas on cardiology’s overuse problem”
Re: cardiology market growth: “cardiovascular disease is the leading cause of death both globally and in the US. Each year it accounts for about 12% of total US healthcare expenditure. Incidence of cardiovascular disease, including hypertension, vascular disease, and heart failure, increases with age. In 2019, there were 54 million people aged 65 and older in the US, 18% of which reported having at least one cardiovascular condition…These trends present a widespread need and growing opportunity for innovative cardiovascular diagnostics, treatments, and digital care solutions. As a result, cardiovascular disease & heart health startups have raised over $20 billion in VC funding since 2020…. We estimate the market size for cardiovascular care solutions at over $300 billion, including care delivery, cardiac devices, chronic condition management, patient monitoring, and other digital solutions. Demographic drivers previously discussed could bring the total direct cost of cardiovascular care up to $400 billion by 2030, assuming a conservative compound annual growth.”
Cardiovascular Disease & Heart Health VC Market Snapshot Pitchbook www.pitchbook.com
Re: Senate closed door session with Tech CEOs “If you’ve got a high school senior in the middle of applying for college right now, and you’re looking for the latest and greatest in education, you might want to consider a new school that opened recently in our hometown of Washington, DC. But beware: given how much the faculty makes, you might be in for some tuition sticker-shock. Plus, the application process is a little cumbersome. We’re talking about what one wag referred to as “Schumer University”, a series of Senate hearings intended to get lawmakers up to speed on the latest trends in technology. Class was in session this week, and more than 45 Senators filled the classroom to hear from a panel that included Elon Musk, Bill Gates, Mark Zuckerberg, Sam Altman (Open AI’s CEO), Sundar Pichai (head of Alphabet, which owns Google), and several other tech luminaries… Also, unclear whether the students were assigned homework, but no worries—they can always get ChatGPT to do it for them!”
Julie Barnes Maverick Health Policy September 14, 2023 www.maverickhealthpolicy.com
Utilization, Demand
Study: use of NPs for primary care up significantly: Harvard Medical School researchers analyzed researchers analyzed 276 million visits from a nationally representative sample of Medicare insured patients for the period 2013-2019: Findings:
“The proportion of all visits delivered by nurse practitioners and physician assistants in a year increased from 14.0% (95% confidence interval 14.0% to 14.0%) to 25.6% (25.6% to 25.6%). In 2019, the proportion of visits delivered by a nurse practitioner or physician assistant varied across conditions, ranging from 13.2% for eye disorders and 20.4% for hypertension to 36.7% for anxiety disorders and 41.5% for respiratory infections. Among all patients with at least one visit in 2019, 41.9% had one or more nurse practitioner or physician assistant visits. Compared with patients who had no visits from a nurse practitioner or physician assistant, the likelihood of receiving any care was greatest among patients who were lower income (2.9% greater), rural residents (19.7%), and disabled (5.6%).”
From 2013 to 2019 the share of U.S. health care visits delivered by non-physicians such as nurse practitioners or physician assistants increased from 14- 26%
Provision of evaluation and management visits by nurse practitioners and physician assistants in the USA from 2013 to 2019: cross-sectional time series study 2023; 382 doi: https://doi.org/10.1136/bmj-2022-073933 (Published 14 September 2023) Cite this as: BMJ 2023;382:e073933
Hospitals
Moody’s: hospital finances “unsustainable: In a Sept. 7 report, Moody’s outlined 2022 fiscal year trends based on data from 218 health systems. Highlights:
- “Median operating cash flow margin was 4.9% and median operating margin was -0.3% amid labor shortages and inconsistent patient volumes.
- Median expenses grew 8.9% in 2022, up from 8.6% in 2021. Hospitals cited rising labor costs and inflation last year, which persists in 2023.
- While expenses increased, revenue growth fell to 5.1% last year, a significant drop from its 11.3 % peak in 2021. Revenue growth returned to 2018 and 2019 rates last year after federal relief related to the COVID-19 pandemic slowed.
- The median days cash on hand hit 206 last year, down 22% year over year as losses mounted and hospitals repaid Medicare advances. The average debt to cash flow hit a five-year high last year of 3.6x, and median cash to debt dropped below 200 percent.
- Median salary and benefit expenses were up 9.7% in 2022, driven by workforce shortages and competition for talent with other industries.
- Medicare and Medicaid, which are among the lowest paying insurers, hit five-year highs as a percentage of total revenue for hospitals last year. Medicare was 47.1% of average total revenue while Medicaid was 16.6% Medicaid redeterminations will likely lower the percentage of total revenue from Medicaid this year.
- Hospitals’ median debt to cash flow hit 3.6x last year, a five-year high. Last year, inpatient admissions dropped a median rate of -0.7% on average, according to the report, while total admissions were flat.”
Moody’s Investors Service https://www.moodys.com/research/doc–PBC_1376745
Fitch: Nonprofit hospital wage growth slows: The hospital labor market may have permanently turned a corner as wage growth slows while payrolls continue to rise, according to a September. 11 Fitch Ratings report. Highlights:
- “Average hourly earnings growth for hospital and ambulatory healthcare services employees has slowed for three and four successive months. While wage growth is slowing, payrolls have increased for 19 and 31 consecutive months, respectively.”
- Healthcare and social assistance job openings fell from a high of 9.3% in March 2022 to 7% in July 2023, While still high, workers quitting healthcare and social assistance jobs fell from a peak of 2.9% in May 2023 to 2.3% as of July 2023.
Fitch Ratings www.fitchratings.com
Retail Health
Amazon: Wednesday, Amazon announced that Brad D. Smith, a former Intuit Inc. (INTU) chief executive and current Humana Inc. (HUM) director, will be joining its board of directors. Amazon shares were trading at $145.38 in Thursday’s session, up 0.4% and on track to log their highest close since April 25, 2022, according to Dow Jones Market Data. The stock closed at $146.07.
“Amazon’s stock heads for best close in 17 months as healthcare moves draw praise” September 15, 2023https://www.morningstar.com/news/marketwatch/20230915395/amazons-stock-heads-for-best-close-in-17-months-as-healthcare-moves-draw-praise
Walgreens announced a partnership with primary care enablement technology company Pearl Health to expand its push into value-based care. The companies will help clinicians transition to value-based reimbursement, starting with Accountable Care Organization Realizing Equity, Accountability and Community Health members.
Walgreens Boots Alliance www.walgreensbootsalliance.com
Consumers
Consumer Price Index (CPI) Summary for August 2023 released last Wednesday: Highlights:
- The Consumer Price Index for All Urban Consumers (CPI-U) rose 0.6% in August on a seasonally adjusted basis, after increasing 0.2% in July. Over the last 12 months, the all-items index increased 3.7% before seasonal adjustment.
- The index for gasoline was the largest contributor to the monthly all items increase, accounting for over half of the increase.
- Indexes which increased in August include rent, owners’ equivalent rent, motor vehicle insurance, medical care, and personal care. The indexes for lodging away from home, used cars and trucks, and recreation were among those that decreased over the month.
- The medical care index rose 0.2% in August, after falling 0.2% the previous month. The index for hospital services increased 0.7% over the month, and the index for physicians’ services rose 0.1%. The prescription drugs index rose 0.4% in August.
PK Note: the CPI is calculated monthly from price changes in goods (42%) and services (58%). Among goods, gasoline accounts for 3.4% with prices down 3.3% in the last 12 months (LTM), new vehicles accounts for 4.3% with prices up 2.9% in the LTM, used vehicles account for 2.8% and prices were down 6.6% in the LTM. Healthcare is accounted for both products and services: medical care commodities which include prescription and non-prescription drugs, disposables et al accounted for XX% and increased 4.5% in the LTM vs. medical services which include hospitals, medical professionals et al accounted for were down 2.1%.
BLS September 13, 2023 www.bls.gov
Study: health costs for low-income adults: Researchers analyzed data from the Medical Expenditure Panel Survey from 2011-2020 for adults aged 19 to 64 years with family incomes below 138% of the Federal Poverty Level. Finding:
- “This serial cross-sectional study of 44,482 low-income, working-age adults found that increased insurance coverage from the Medicaid expansion accompanying the Patient Protection and Affordable Care Act was associated with statistically significantly higher health care expenditures for US-born but not immigrant adults. Providing insurance to immigrants costs the health care system less than half the corresponding cost for US-born adults ($3800 vs $9428 per person per year).”
- Kaushal, Muchomba “Cost of Public Health Insurance for US-Born and Immigrant Adults” JAMA Network Open September 15,. 2023;6(9):e2334008. doi:10.1001/jamanetworkopen.2023.34008
Regulators
CMS www.cms.gov
- Hospital readmission penalties: More hospitals will face readmissions penalties in 2024 per preliminary CMS data released Thursday. For the upcoming year, 70.1% of hospitals will be charged penalties of less than 1% on their readmissions vs. 67.1% of hospitals in fiscal 2023. Meanwhile, 7.5% of hospitals will be charged penalties of 1% or more in fiscal 2024– unchanged from last year. Another 22.4%of hospitals will not be assessed penalties. For hospitals with the lowest number of dual-eligible patients—peer group one—the average penalty is 0.34%. During fiscal year 2023, groups five and one were penalized 0.23% and 0.37%, respectively, on their readmissions.
- Drug prices: Last Wednesday, CMS announced it will to lower Cost of 34 Prescription Drugs Beginning October 1. With projected savings for seniors between $1 and $618 per average dose.
FDA, CDC www.fda.gov www.
- Last Monday, the Food and Drug Administration (FDA) authorized new COVID vaccines from Moderna and Pfizer-BioNTech, and the Centers for Disease Control and Prevention followed Tuesday by recommendingthe shots be given as a single dose for most people five years of age and older. Children older than six months but younger than five, as well as completely unvaccinated people of any age, may be eligible for multiple doses.
Senate Health, Education, Labor and Pensions Committee: Last Wednesday, Senate, Health, Education, Labor, and Pensions Committee (HELP) Chair Bernie Sanders (I-Vt.) and Sen. Roger Marshall (R-Kan.) released an updated version of the Bipartisan Primary Care and Health Workforce Act, which the committee plans to markup this Thursday. Select highlights:
- Section 101: Funding would establish more than 700 new primary care residency slots, resulting in up to 2,800 additional doctors by 2031.
- Section 103: National Health Service Corps: Reauthorizes the mandatory program at $950 million per year from FY2024 to FY2026, totaling $2.85 billion. Increased funding is estimated to support 20,000 new loan repayment awards and 2,100 scholarship awards per year to qualified health care providers working in underserved urban, rural, and tribal areas.
- Section 201 – Rural Residency Planning and Development Program: Reauthorizes the discretionary program through FY2026 and increases discretionary funding levels from $12.5 million in FY2023 to $13 million in FY2024, $13.5 million in FY2025, and $14 million in FY2026. Expands the number of rural residency training programs and increases the number of physicians training and practicing in rural areas. From 2018 to 2022, this program supported 31 new residency programs with 418 new approved residency positions.
- Section 202 – Primary Care Training and Enhancement Program: Reauthorizes the discretionary program FY2024 – FY2026, totaling $148.75 million. Increased funding is allocated to support training for future primary care clinicians and faculty including those in rural and underserved areas.
- Section 203 – Expanding the Number of Primary Care Doctors: Provides a one-time, $300 million mandatory supplemental to increase the number of primary care doctors. Funds are allocated to increase class sizes at medical schools that have at least one-third of their graduates practicing primary care. Not less than 20% of the funds will be provided to Minority Serving Institutions, including medical schools at historically black institutions. Funding is estimated to support 2,000 primary care physicians by 2032.
- Section 301 – Banning anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care: Prevents hospitals from using anticompetitive contracting practices when they negotiate prices with commercial insurance companies.
- Section 303 – Banning facility fees for certain services: Prohibits hospitals from billing facility fees for telehealth services and for evaluation and management health care services.
- Section 304 – Prevention and Public Health Fund: Reduces the Prevention and Public Health Fund by $980 million.
https://www.sanders.senate.gov/wp-content/uploads/Bipartisan-Primary-Care-and-Health-Workforce-
Physicians
Physician’s Foundation Survey: The Physicians Foundation’s 2023 Survey of America’s Current and Future Physicians was conducted June 8- 28, 2023 with 2,114 responses. Findings:
- For the third year in a row, six in 10 physicians and residents often have feelings of burnout, compared to four in 10 before the pandemic in 2018.
- Three-quarters of medical students have felt inappropriate feelings of anger, tearfulness or anxiety, much more compared to residents (68%) and physicians (53%).
- More than half of medical students (55%) have felt hopeless or that they have no purpose, greater compared to residents (43%) and physicians (34%).
- Nearly two-thirds of medical students have felt levels of debilitating stress, much more compared to residents at 45%.
- Nearly eight in 10 physicians (78%), residents (79%) and medical students (76%) agree that there is stigma surrounding mental health and seeking mental health care among physicians.
- Among those physicians experiencing the respective merging/acquisition scenarios, only one- fifth have been involved in the decision process.
- Half of residents and more than four in 10 physicians expect their hospital/practice will acquire another hospital/practice within the next five years.
- One third of physicians and more than one- quarter of residents anticipate merging with another practice/hospital.
- Most physicians (71%), residents (66%) and medical students (65%) agree that a hospital/ practice’s top priority is financial gain. Furthermore, most physicians (67%), residents (63%) and students (58%) also agree that consolidation is impacting patient access to high-quality, cost-efficient care.
- Only 11-16% of physicians, residents and students agree private equity funding is good for the future of health care, with 42-53% in disagreement.
Physicians Foundation www.physiciansfoundation.org
Insurers
Study: cost comparisons across settings: Blue Health Intelligence® (BHI®) used a national commercial data set of 133 million lives insured by a PPO product to answer the following question: For the period between 2017 and 2022, how did allowed costs change over time for six services commonly delivered in hospital outpatient departments (HOPDs), ambulatory surgery centers (ASCs), and physician offices? Findings:
“Allowed costs for services rendered in an HOPDs were consistently and significantly higher than for those rendered in an ASC or office setting. These higher costs are reflected in higher insurance premiums and higher out-of-pocket costs to consumers. While some procedures have larger cost differentials than others, HOPD allowed costs were higher across all six services evaluated. HOPD allowed costs also consistently increased across the study years.” Excerpts:
- The allowed cost, or the negotiated price, for a routine colonoscopy screening was $1,124 on average in hospital outpatient departments, 32% higher than the $925 allowed in ambulatory surgery centers last year.
- The allowed cost for a diagnostic colonoscopy to investigate abnormal symptoms was $1,646 on average in outpatient departments in 2022, 58% higher than the $1,040 allowed in ambulatory surgery centers.
- For mammography, the allowed cost was $287 in hospitals, 32% higher than the $217 allowed in doctors’ offices.
- For cataract surgery, the allowed cost in outpatient departments was $3,499 in 2022, 56% higher than the $2,304 allowed in an ambulatory surgery center.
RISING PRICES FOR HOSPITAL OUTPATIENT CARE FAR OUTPACE MORE AFFORDABLE SITES Blue Health Intelligence Issue Brief September 2023 https://www.bcbs.com/sites/default/files/file-attachments/site-neutral/BHI-Site-Neutral-Issue-Brief.pdf
Commonwealth Survey: Medicare Advantage Marketing analyzed: SSRS surveyed 2,001 U.S. adults age 65 and older living in the United States November 30 through December 8, 2022. Highlights:
- “Nearly all people age 65 and older said they received some plan marketing, with three-quarters seeing one or more television or online ads per day. One in three reported receiving seven or more phone calls per week.
- Some reported experiences with Medicare marketing that would violate federal rules, including marketers asking for Social Security or Medicare numbers outside the enrollment process and advertising special, time-limited discounts, which are not permitted.
- The vast majority (96%) said that when they have what feels like too many plan options, they are likely to stick with their current plan rather than try a new plan. Most turned to friends, family, or insurance brokers or agents for advice.
- More than one in three people age 65 and older said they would like to know more about out-of-pocket costs and benefits of their coverage options, and one in four said that they would like more one-on-one help to make their coverage decision.”
The Private Plan Pitch: Seniors’ Experiences with Medicare Marketing and Advertising Commonwealth Fund September 12, 2023 Private Plan Pitch: Seniors’ Experiences Medicare Marketing | Commonwealth Fund
