There is considerable data showing that disparities in payment across sites of service increase costs to patients, insurers and taxpayers as well as result in marketplace consolidation that limits patient choice by reducing access to care in the community-setting.

April 2, 2019

Shifting Care from Office to Outpatient Settings: Services are Increasingly Performed in Outpatient Settings with Higher Prices

Though few patients may realize it, the cost of health care varies widely across different sites of service. A new study by the Health Care Cost Institute (HCCI) adds more evidence to the growing body of literature that shows outpatient settings cost more than office settings for performing the exact same services. In the study, […]

November 1, 2018

Journal of Oncology Practice: Cost Differences Associated With Oncology Care Delivered in a Community Setting Versus a Hospital Setting: A Matched-Claims Analysis of Patients With Breast, Colorectal, and Lung Cancers

Access to high-quality cancer care remains a challenge for many patients. One such barrier is the increasing cost of treatment. With recent shifts in cancer care delivery from community-based to hospital-based clinics, we examined whether this shift could result in increased costs for patients with three common tumor types. Read the full document: Cost Differences […]

August 24, 2017

NICHM Foundation Study: How Does Hospital Ownership of Physician Practices Affect Which Hospitals Patients Use?

Hospital ownership of physician practices increased rapidly over the past decade, and by 2015 nearly 4 in 10 practices were owned by a hospital. Prior research has shown that physician integration with hospitals is associated with higher prices, but the latest evidence suggests it also affects which hospital a patient chooses to visit. A study […]

October 11, 2016

Community Oncology Alliance Practice Impact Report, October 2016

The 2016 Community Oncology Practice Impact Report documents a 121% increase in community cancer clinic closings and a 172% increase in consolidation into hospitals since 2008. In that period, 380 cancer treatment facilities have closed, and 609 community cancer practices have been acquired by or become affiliated with hospitals. Another 390 practices report that they […]

September 8, 2016

Physician Practice Acquisition Study: National and Regional Employment Changes, September 2016

Hospital ownership of physician practices has increased by 86% in the last three years, according to a new report. The analysis, conducted by healthcare consulting firm Avalere Health and the not-for-profit Physicians Advocacy Institute, found that from 2012 to 2015, hospitals acquired 31,000 physician practices in the U.S. In 2012, about one in seven physician […]

April 17, 2016

Cost Drivers of Cancer Care: A Retrospective Analysis of Medicare and Commercially Insured Population Claim Data 2004-2014, Milliman, April 2016

Nearly 14.5 million Americans with a history of cancer were alive in 2014 and that number is projected to increase to 18.1 million in 2020. A number of factors will contribute to this increase, including the growth and aging of the U.S. population, an overall reduction in mortality, the earlier detection of cancer (lead timebefore […]

March 17, 2016

National Estimates of Price Variation by Site of Care, American Journal of Managed Care, March 2016

Recently, researchers and policy makers have demonstrated growing interest in differences in payments across sites of care for the same healthcare service, such as in a hospital outpatient department (HOPD) versus a physician office (PO). Our objective was to examine the price differential for individuals with employer-sponsored insurance by site of care for 7 commonly […]

March 13, 2016

The impact of provider consolidation on outpatient prescription drug-based cancer care spending, Health Care Cost Institute, March 2016

Many policymakers (including state attorney general offices, Medicaid program directors, insurance commissioners) worry about the effects of medical provider consolidation on spending levels and trends. Medical provider consolidation’s impact on spending is an empirical question. On the one hand, consolidation may lead to the identification and dissemination of best practices and reductions in the use […]

February 17, 2016

Medicare Payment Differentials Across Outpatient Settings of Care, Avalere, February 2016

Medicare beneficiaries can receive the same services in different outpatient settings, yet various providers in those settings can receive different payments for that care and beneficiaries can face different cost-sharing amounts. For example, a Medicare beneficiary could receive a colonoscopy in the hospital outpatient department (HOPD), an ambulatory surgical center (ASC) or a physician office. […]

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