Why Market Power Matters for Patients, Insurers, and Hospitals “Overall, our data show that the largest health systems have, on average, a combined 43.1% of the market share (as measured by total inpatient hospital discharges) in each state, while the top three large-group insurers hold an average of 82.2% of the market share in each state…
When the market share of an insurer far exceeds the market share of an individual health system — as is the case in most states, according to our analysis — that can negatively impact the amount that insurers are willing to pay hospitals and health systems for patient care.”
About healthcare quality
A National Quality Improvement Collaborative to Improve Antibiotic Use in Pediatric Infections “This multisite collaborative increased appropriate antibiotic use for community-acquired pneumonia, skin and soft tissue infections, and urinary tract infection among diverse hospitals.”
Comment: Read the methods and look at the Figures. This effort shows it is possible to improve quality on a national scale with projects across multiple unrelated pediatric institutions.
About health insurance/insurers
Payers ranked by medical loss ratios in Q1 FYI
and in a related story: Here's how major payers fared in a Q1 dragged by a cyberattack, MA challenges
Medicare Advantage extras on the chopping block in 2025 “Medicare Advantage insurers are planning to pare down their plan offerings in 2025.
Facing lower reimbursement rates from CMS and higher medical costs, many plan executives said they will prioritize margins over growing their membership numbers.”
NORC Report Highlights Strong Satisfaction with Access to Care Through Employer-Provided Coverage [EPC] “Key takeaways from the report include:
89% of survey respondents said their EPC has a provider network that includes options that are convenient for them.
88% of respondents agreed their plan offered tools that helped them find in-network providers.
82% of respondents said they had access to high-quality providers through their EPC.
The majority of respondents across all geographic areas reported high levels of satisfaction with their access to high-quality providers – even rural respondents, who can often face more barriers to care.”
About hospitals and healthcare systems
How HCA, Tenet, CHS and UHS performed in Q1 FYI
15 health system projects worth $500M or more FYI
About the public’s health
Three health foundations tackle biggest disease threats in $300mn deal “The three largest charitable foundations focused on public health are to join forces for the first time to tackle climate change’s impact, infectious diseases and measures to improve nutrition and wellbeing. Denmark’s Novo Nordisk Foundation, the Bill & Melinda Gates Foundation and UK-based Wellcome will commit an initial total of $300mn over three years and aim to expand their collaboration to other public, private and philanthropic partners.”
Nitrogen dioxide exposure, health outcomes, and associated demographic disparities due to gas and propane combustion by U.S. stoves “Gas and propane stoves increase long-term NO2 exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization’s exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO2 exposure alone. Short-term NO2exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft2 in size incur four times more long-term NO2 exposure than people in residences >3000 ft2 in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO2 exposure, respectively, than the national average.”