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She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_361432":{"type":"posts","id":"stateofhealth_361432","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"361432","score":null,"sort":[1507570058000]},"guestAuthors":[],"slug":"gov-brown-opens-new-front-in-war-on-drug-prices-profits-are-soaring","title":"Gov. Brown Opens New Front in War on Drug Prices: 'Profits are Soaring'","publishDate":1507570058,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>California Gov. Jerry Brown defied the drug industry Monday, signing the most comprehensive drug price transparency bill in the nation, one which will force drug makers to publicly justify big price hikes.\u003c/p>\n\u003cp>“Californians have a right to know why their medical costs are out of control, especially when pharmaceutical profits are soaring,” Brown said. “This measure is a step at bringing transparency, truth, exposure to a very important part of our lives, that is the cost of prescription drugs.”\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">Brown said the bill was part of a broader push toward correcting growing economic inequities in the U.S., and called on the pharmaceutical leaders “at the top” to consider doing business in a way that helps those with a lot less. \u003c/span>\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">“The rich are getting richer. \u003c/span>The powerful are getting more powerful,” Brown said. “So this is just another example where the powerful get more power and take more… We've got to point to the evils, and there's a real evil when so many people are suffering so much from rising drug profits.”\u003c/p>\n\u003cp>The drug lobby fiercely opposed the bill, SB 17, hiring 45 firms to try to defeat it and spending $16.8 million on lobbying against the full range of drug legislation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new law will shine light into the mystery of how drugs are priced, requiring pharmaceutical companies to notify the state and health insurers anytime they plan to raise the price of a medication by 16 percent or more over two years. And, companies will have to provide justification for the increase.\u003c/p>\n\u003cp>The legislation was supported by a diverse coalition, including labor and consumer groups, hospital groups and even health insurers, who agreed to share some of their own data under the bill. They will have to report what percentage of premium increases are due to drug prices.\u003c/p>\n\u003cp>“Health coverage premiums directly reflect the cost of providing medical care, and prescription drug prices have become one of the main factors driving up these costs,” said Charles Bacchi, CEO of the California Association of Health Plans. “SB 17 will help us understand why, so we can prepare for and address the unrelenting price increases.”\u003c/p>\n\u003cp>Drug companies criticized the governors move, saying the new law focuses too narrowly on just one part of the drug distribution chain and won't help consumers afford their medicine.\u003c/p>\n\u003cp>“It is disappointing that Gov. Brown has decided to sign a bill that is based on misleading rhetoric instead of what’s in the best interest of patients,” said Priscilla VanderVeer, spokesperson for the Pharmaceutical Research and Manufacturers of America. “There is no evidence that SB 17 will lower drug costs for patients because it does not shed light on the large rebates and discounts insurance companies and pharmacy benefit managers are receiving that are not always being passed on to patients.”\u003c/p>\n\u003cp>Policy experts are clear that this law is part of a long game toward developing a stronger web of drug laws across the country. In that respect, it makes sense to start with the source of the drug prices: the drug makers themselves, said Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health who tracks drug legislation in the states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The manufacturers get most of the money – probably about three quarters or more of the money that you pay for a drug, and they're the ones that set the price initially,” he said. “So they are not the only piece of the drug supply chain, but they are the key piece to this.”\u003c/p>\n\n","blocks":[],"excerpt":"Drug manufacturers must notify the state and health insurance companies anytime they plan to raise the price of a medication by 16 percent or more, over two years. Then they must explain why. ","status":"publish","parent":0,"modified":1507672251,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":12,"wordCount":617},"headData":{"title":"Gov. Brown Opens New Front in War on Drug Prices: 'Profits are Soaring' | KQED","description":"Drug manufacturers must notify the state and health insurance companies anytime they plan to raise the price of a medication by 16 percent or more, over two years. Then they must explain why. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Gov. Brown Opens New Front in War on Drug Prices: 'Profits are Soaring'","datePublished":"2017-10-09T17:27:38.000Z","dateModified":"2017-10-10T21:50:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"361432 https://ww2.kqed.org/stateofhealth/?p=361432","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/10/09/gov-brown-opens-new-front-in-war-on-drug-prices-profits-are-soaring/","disqusTitle":"Gov. Brown Opens New Front in War on Drug Prices: 'Profits are Soaring'","path":"/stateofhealth/361432/gov-brown-opens-new-front-in-war-on-drug-prices-profits-are-soaring","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Gov. Jerry Brown defied the drug industry Monday, signing the most comprehensive drug price transparency bill in the nation, one which will force drug makers to publicly justify big price hikes.\u003c/p>\n\u003cp>“Californians have a right to know why their medical costs are out of control, especially when pharmaceutical profits are soaring,” Brown said. “This measure is a step at bringing transparency, truth, exposure to a very important part of our lives, that is the cost of prescription drugs.”\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">Brown said the bill was part of a broader push toward correcting growing economic inequities in the U.S., and called on the pharmaceutical leaders “at the top” to consider doing business in a way that helps those with a lot less. \u003c/span>\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">“The rich are getting richer. \u003c/span>The powerful are getting more powerful,” Brown said. “So this is just another example where the powerful get more power and take more… We've got to point to the evils, and there's a real evil when so many people are suffering so much from rising drug profits.”\u003c/p>\n\u003cp>The drug lobby fiercely opposed the bill, SB 17, hiring 45 firms to try to defeat it and spending $16.8 million on lobbying against the full range of drug legislation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new law will shine light into the mystery of how drugs are priced, requiring pharmaceutical companies to notify the state and health insurers anytime they plan to raise the price of a medication by 16 percent or more over two years. And, companies will have to provide justification for the increase.\u003c/p>\n\u003cp>The legislation was supported by a diverse coalition, including labor and consumer groups, hospital groups and even health insurers, who agreed to share some of their own data under the bill. They will have to report what percentage of premium increases are due to drug prices.\u003c/p>\n\u003cp>“Health coverage premiums directly reflect the cost of providing medical care, and prescription drug prices have become one of the main factors driving up these costs,” said Charles Bacchi, CEO of the California Association of Health Plans. “SB 17 will help us understand why, so we can prepare for and address the unrelenting price increases.”\u003c/p>\n\u003cp>Drug companies criticized the governors move, saying the new law focuses too narrowly on just one part of the drug distribution chain and won't help consumers afford their medicine.\u003c/p>\n\u003cp>“It is disappointing that Gov. Brown has decided to sign a bill that is based on misleading rhetoric instead of what’s in the best interest of patients,” said Priscilla VanderVeer, spokesperson for the Pharmaceutical Research and Manufacturers of America. “There is no evidence that SB 17 will lower drug costs for patients because it does not shed light on the large rebates and discounts insurance companies and pharmacy benefit managers are receiving that are not always being passed on to patients.”\u003c/p>\n\u003cp>Policy experts are clear that this law is part of a long game toward developing a stronger web of drug laws across the country. In that respect, it makes sense to start with the source of the drug prices: the drug makers themselves, said Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health who tracks drug legislation in the states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The manufacturers get most of the money – probably about three quarters or more of the money that you pay for a drug, and they're the ones that set the price initially,” he said. “So they are not the only piece of the drug supply chain, but they are the key piece to this.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/361432/gov-brown-opens-new-front-in-war-on-drug-prices-profits-are-soaring","authors":["3205"],"categories":["stateofhealth_2442","stateofhealth_14","stateofhealth_1"],"tags":["stateofhealth_2808","stateofhealth_482","stateofhealth_2942","stateofhealth_2519","stateofhealth_3103"],"featImg":"stateofhealth_361443","label":"stateofhealth"},"stateofhealth_321772":{"type":"posts","id":"stateofhealth_321772","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"321772","score":null,"sort":[1493053947000]},"guestAuthors":[],"slug":"why-slashing-federal-health-spending-could-be-a-job-killer","title":"Why Slashing Federal Health Spending Could Be a Job Killer","publishDate":1493053947,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In many ways, the health care industry has been a great friend to the U.S. economy. Its plentiful jobs helped lift the country out of the Great Recession and, partly due to the Affordable Care Act, it now employs 1 in 9 Americans — up from 1 in 12 in 2000.\u003c/p>\n\u003cp>As President Donald Trump seeks to fulfill his campaign pledge to create millions more jobs, the industry would seem a promising place to turn. But the business mogul also campaigned to repeal Obamacare and lower health care costs — a potentially serious job killer. It’s a dilemma: One promise could run headlong into the other.\u003c/p>\n\u003cp>“The goal of increasing jobs in health care is incompatible with the goal of keeping health care affordable,” said Harvard University economist Katherine Baicker, who sees advantages in trimming the industry’s growth. “There’s a lot of evidence we can get more bang for our buck in health care. We should be aiming for a health care system that operates more efficiently and effectively. That might mean better outcomes for patients and fewer jobs.”\u003c/p>\n\u003cp>But the country has grown increasingly dependent on the health sector to power the economy — and it will be a tough habit to break. Thirty-five percent of the nation’s job growth has come from health care since the recession hit in late 2007, the single-biggest sector for job creation.\u003c/p>\n\u003cp>Hiring rose even more as coverage expanded in 2014 under the health law and new federal dollars flowed in. It gave hospitals, universities and companies even more reason to invest in new facilities and staff. Training programs sprang up to fill the growing job pool. Cities welcomed the development — and the revenue. Simply put, rising health spending has been good for some economically distressed parts of the country, many of which voted for Trump last year.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In Morgantown, W.Va., the West Virginia University health system just opened a 10-story medical tower and hired 2,000 employees last year. In Danville, Pa., the Geisinger Health System has added more than 2,200 workers since July and is trying to fill 2,000 more jobs across its 12 hospital campuses and a health plan. Out West, the UCHealth system in Colorado expanded its Fort Collins hospital and is building three hospitals in the state.\u003c/p>\n\u003cp>In cities such as Pittsburgh, Cleveland and St. Louis, health care has replaced dying industries like coal and heavy manufacturing as a primary source of new jobs. “The industry accounts for a lot of good middle-class jobs and, in many communities, it’s the single-largest employer,” said Sam Glick, a partner at the Oliver Wyman consulting firm in San Francisco. “One of the hardest decisions for the new Trump administration is how far do they push on health care costs at the expense of jobs in health care.”\u003c/p>\n\u003cp>House Republicans, with backing from Trump, took the first swipe. Their American Health Care Act sought to roll back the current health law’s Medicaid expansion and cut federal subsidies for private health insurance. The GOP plan faltered in the House, but Republican lawmakers and the Trump administration are still trying to craft a replacement for Obamacare.\u003c/p>\n\u003cp>Neither the ACA nor the latest Republican attempt at an overhaul tackle what some industry experts and economists see as a serious underlying reason for high health care costs: a system bloated by redundancy, inefficiency and a growing number of jobs far removed from patient care.\u003c/p>\n\u003cp>Labor accounts for more than half of the $3.4 trillion spent on U.S. health care, and medical professionals from health aides to nurse practitioners are in high demand. But the sheer complexity of the system also has spawned jobs for legions of data-entry clerks, revenue-cycle analysts and medical billing coders who must decipher arcane rules to mine money from human ills.\u003c/p>\n\u003cp>For every physician, there are 16 other workers in U.S. health care. And half of those 16 are in administrative and other nonclinical roles, said Bob Kocher, a former Obama administration official who worked on the Affordable Care Act. He’s now a partner at the venture capital firm Venrock in Palo Alto, Calif.\u003c/p>\n\u003cp>“I find super-expensive drugs annoying and hospital market power is a big problem,” Kocher said. “But what’s driving our health insurance premiums is that we are paying the wages of a whole bunch of people who aren’t involved in the delivery of care. Hospitals keep raising their rates to pay for all of this labor.”\u003c/p>\n\u003cp>Take medical coders. Membership in the American Academy of Professional Coders has swelled to more than 165,000, up 10,000 in the past year alone. The average salary has risen to nearly $50,000, offering a path to the American Dream.\u003c/p>\n\u003cp>“The coding profession is a great opportunity for individuals seeking their first job, and it’s attractive to a lot of medical professionals burned out on patient care,” said Raemarie Jimenez, a vice president at the medical coding group. “There is a lot of opportunity once you’ve got a foot in the door.”\u003c/p>\n\u003cp>Some of these back-office workers wage battle every day in clinics and hospitals against an army of claims administrators filling up cubicles inside insurance companies. Overseeing it all are hundreds of corporate vice presidents drawing six-figure salaries.\u003c/p>\n\u003cp>Administrative costs in U.S. health care are the highest in the developed world, according to a January report from the Organization for Economic Cooperation and Development. More than 8 percent of U.S. health spending is tied up in administration while the average globally is 3 percent. America spent $631 for every man, woman and child on health insurance administration for 2012 compared with $54 in Japan.\u003c/p>\n\u003cp>America’s huge investment in health care and related jobs hasn’t always led to better results for patients, data show. But it has provided good-paying jobs, which is why the talk of deep cuts in federal health spending has many people concerned.\u003c/p>\n\u003cp>Linda Gonzalez, a 31-year-old mother of two, was among the thousands of enrollment counselors hired to help sign up Americans for health insurance as Obamacare rolled out in 2014. The college graduate makes more than $40,000 a year working at an AltaMed enrollment center, tucked between a Verizon Wireless store and a nail salon on a busy street in Los Angeles.\u003c/p>\n\u003cp>In her cramped cubicle, families pull up chairs and sort through pay stubs and tax returns, often relying on her to sort out enrollment glitches with Medicaid. As the sole breadwinner for her two children, ages 9 and 10, she counts on this job but isn’t sure how long it will last.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“A lot of people depend on this,” she said one recent weekday. “It’s something I do worry about.”\u003c/p>\n\n","blocks":[],"excerpt":"President Trump campaigned on lowering health care costs and creating jobs. But the country has grown increasingly dependent on the health sector to power the economy.","status":"publish","parent":0,"modified":1493053947,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":1184},"headData":{"title":"Why Slashing Federal Health Spending Could Be a Job Killer | KQED","description":"President Trump campaigned on lowering health care costs and creating jobs. But the country has grown increasingly dependent on the health sector to power the economy.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why Slashing Federal Health Spending Could Be a Job Killer","datePublished":"2017-04-24T17:12:27.000Z","dateModified":"2017-04-24T17:12:27.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"321772 https://ww2.kqed.org/stateofhealth/?p=321772","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/24/why-slashing-federal-health-spending-could-be-a-job-killer/","disqusTitle":"Why Slashing Federal Health Spending Could Be a Job Killer","nprByline":"\u003cstrong>\u003ca href=\"http://californiahealthline.org/news/author/Chad-Terhune/\">Chad Terhune\u003c/strong>\u003c/a>\u003c/br>California HealthLine","path":"/stateofhealth/321772/why-slashing-federal-health-spending-could-be-a-job-killer","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In many ways, the health care industry has been a great friend to the U.S. economy. Its plentiful jobs helped lift the country out of the Great Recession and, partly due to the Affordable Care Act, it now employs 1 in 9 Americans — up from 1 in 12 in 2000.\u003c/p>\n\u003cp>As President Donald Trump seeks to fulfill his campaign pledge to create millions more jobs, the industry would seem a promising place to turn. But the business mogul also campaigned to repeal Obamacare and lower health care costs — a potentially serious job killer. It’s a dilemma: One promise could run headlong into the other.\u003c/p>\n\u003cp>“The goal of increasing jobs in health care is incompatible with the goal of keeping health care affordable,” said Harvard University economist Katherine Baicker, who sees advantages in trimming the industry’s growth. “There’s a lot of evidence we can get more bang for our buck in health care. We should be aiming for a health care system that operates more efficiently and effectively. That might mean better outcomes for patients and fewer jobs.”\u003c/p>\n\u003cp>But the country has grown increasingly dependent on the health sector to power the economy — and it will be a tough habit to break. Thirty-five percent of the nation’s job growth has come from health care since the recession hit in late 2007, the single-biggest sector for job creation.\u003c/p>\n\u003cp>Hiring rose even more as coverage expanded in 2014 under the health law and new federal dollars flowed in. It gave hospitals, universities and companies even more reason to invest in new facilities and staff. Training programs sprang up to fill the growing job pool. Cities welcomed the development — and the revenue. Simply put, rising health spending has been good for some economically distressed parts of the country, many of which voted for Trump last year.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In Morgantown, W.Va., the West Virginia University health system just opened a 10-story medical tower and hired 2,000 employees last year. In Danville, Pa., the Geisinger Health System has added more than 2,200 workers since July and is trying to fill 2,000 more jobs across its 12 hospital campuses and a health plan. Out West, the UCHealth system in Colorado expanded its Fort Collins hospital and is building three hospitals in the state.\u003c/p>\n\u003cp>In cities such as Pittsburgh, Cleveland and St. Louis, health care has replaced dying industries like coal and heavy manufacturing as a primary source of new jobs. “The industry accounts for a lot of good middle-class jobs and, in many communities, it’s the single-largest employer,” said Sam Glick, a partner at the Oliver Wyman consulting firm in San Francisco. “One of the hardest decisions for the new Trump administration is how far do they push on health care costs at the expense of jobs in health care.”\u003c/p>\n\u003cp>House Republicans, with backing from Trump, took the first swipe. Their American Health Care Act sought to roll back the current health law’s Medicaid expansion and cut federal subsidies for private health insurance. The GOP plan faltered in the House, but Republican lawmakers and the Trump administration are still trying to craft a replacement for Obamacare.\u003c/p>\n\u003cp>Neither the ACA nor the latest Republican attempt at an overhaul tackle what some industry experts and economists see as a serious underlying reason for high health care costs: a system bloated by redundancy, inefficiency and a growing number of jobs far removed from patient care.\u003c/p>\n\u003cp>Labor accounts for more than half of the $3.4 trillion spent on U.S. health care, and medical professionals from health aides to nurse practitioners are in high demand. But the sheer complexity of the system also has spawned jobs for legions of data-entry clerks, revenue-cycle analysts and medical billing coders who must decipher arcane rules to mine money from human ills.\u003c/p>\n\u003cp>For every physician, there are 16 other workers in U.S. health care. And half of those 16 are in administrative and other nonclinical roles, said Bob Kocher, a former Obama administration official who worked on the Affordable Care Act. He’s now a partner at the venture capital firm Venrock in Palo Alto, Calif.\u003c/p>\n\u003cp>“I find super-expensive drugs annoying and hospital market power is a big problem,” Kocher said. “But what’s driving our health insurance premiums is that we are paying the wages of a whole bunch of people who aren’t involved in the delivery of care. Hospitals keep raising their rates to pay for all of this labor.”\u003c/p>\n\u003cp>Take medical coders. Membership in the American Academy of Professional Coders has swelled to more than 165,000, up 10,000 in the past year alone. The average salary has risen to nearly $50,000, offering a path to the American Dream.\u003c/p>\n\u003cp>“The coding profession is a great opportunity for individuals seeking their first job, and it’s attractive to a lot of medical professionals burned out on patient care,” said Raemarie Jimenez, a vice president at the medical coding group. “There is a lot of opportunity once you’ve got a foot in the door.”\u003c/p>\n\u003cp>Some of these back-office workers wage battle every day in clinics and hospitals against an army of claims administrators filling up cubicles inside insurance companies. Overseeing it all are hundreds of corporate vice presidents drawing six-figure salaries.\u003c/p>\n\u003cp>Administrative costs in U.S. health care are the highest in the developed world, according to a January report from the Organization for Economic Cooperation and Development. More than 8 percent of U.S. health spending is tied up in administration while the average globally is 3 percent. America spent $631 for every man, woman and child on health insurance administration for 2012 compared with $54 in Japan.\u003c/p>\n\u003cp>America’s huge investment in health care and related jobs hasn’t always led to better results for patients, data show. But it has provided good-paying jobs, which is why the talk of deep cuts in federal health spending has many people concerned.\u003c/p>\n\u003cp>Linda Gonzalez, a 31-year-old mother of two, was among the thousands of enrollment counselors hired to help sign up Americans for health insurance as Obamacare rolled out in 2014. The college graduate makes more than $40,000 a year working at an AltaMed enrollment center, tucked between a Verizon Wireless store and a nail salon on a busy street in Los Angeles.\u003c/p>\n\u003cp>In her cramped cubicle, families pull up chairs and sort through pay stubs and tax returns, often relying on her to sort out enrollment glitches with Medicaid. As the sole breadwinner for her two children, ages 9 and 10, she counts on this job but isn’t sure how long it will last.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“A lot of people depend on this,” she said one recent weekday. “It’s something I do worry about.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/321772/why-slashing-federal-health-spending-could-be-a-job-killer","authors":["byline_stateofhealth_321772"],"categories":["stateofhealth_15"],"tags":["stateofhealth_482","stateofhealth_3084","stateofhealth_2519","stateofhealth_365","stateofhealth_3002"],"featImg":"stateofhealth_321775","label":"stateofhealth"},"stateofhealth_225405":{"type":"posts","id":"stateofhealth_225405","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"225405","score":null,"sort":[1471320114000]},"guestAuthors":[],"slug":"arbitrate-or-else-sutter-health-drives-a-hard-bargain","title":"Arbitrate or Else: Sutter Health Drives a Hard Bargain","publishDate":1471320114,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Bay Area companies say \u003ca href=\"http://www.sutterhealth.org/\" target=\"_blank\">Sutter Health\u003c/a> is strong-arming them into a contract that would help the medical system secure its power over prices and potentially raise the cost of medical care for their employees in the future.\u003c/p>\n\u003cp>Dozens of companies received a letter in recent months, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don’t, \u003ca href=\"https://www.scribd.com/document/321381559/Anthem-Sutter-Letter\" target=\"_blank\">the letter\u003c/a> says, the companies’ employees who get care at Sutter will no longer have access to discounted in-network prices.\u003c/p>\n\u003cp>“In both choices, Castlight and our employees lose,” says Jennifer Chaloemtiarana, general counsel for \u003ca href=\"http://www.castlighthealth.com/\" target=\"_blank\">Castlight Health\u003c/a>, a tech company in San Francisco that received one of these letters this spring. She thought it was strange.\u003c/p>\n\u003cp>Castlight is self-insured, meaning it hires an insurance company -- in their case, it's \u003ca href=\"https://www.anthem.com/health-insurance/home/overview\" target=\"_blank\">Anthem Blue Cross\u003c/a> -- to manage the administrative details of its health coverage. But when an employee gets sick, Castlight, not Anthem, pays the bill. Anthem basically functions like a middleman, including negotiating discounted prices with providers like Sutter.\u003c/p>\n\u003cp>\"We don’t have a direct relationship with Sutter Health,” Chaloemtiarana said. “So the letter was unusual in that regard because it asked us to make certain legal agreements with Sutter.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The letter is from Anthem, but it says if Castlight has any disputes with Sutter, Castlight has to agree to arbitrate with Sutter Health. It can’t sue. And if it doesn’t sign, Castlight’s employees will lose their in-network medical rates. As a lawyer, this makes Chaloemtiarana uncomfortable.\u003c/p>\n\u003cp>“Arbitration provisions are pretty common among companies, but it usually occurs when you can sit down at a table and have a discussion and negotiation,” she says. “This has just been handed to us as a one-sided, unilateral provision.”\u003c/p>\n\u003cp>As an employer that pays its employees' medical claims, Castlight doesn’t like the idea that it will never be able to challenge Sutter over its prices in open court. To Chaloemtiarana, waiving that right would only help strengthen the power of Sutter’s “already dominant” provider network.\u003c/p>\n\u003cp>Sutter is the largest medical system in Northern California, with roughly 30 percent market share of hospitals, surgical centers and doctors’ groups, according to a data analysis by Christopher Whaley, a research economist at UC Berkeley. For comparison, Whaley says, the largest medical system in the Los Angeles area has 5 percent market share.\u003c/p>\n\u003cp>Economists have long argued that Sutter uses this power to charge more for its services. Sutter’s hospital prices are about 25 percent higher than other hospitals around the state, according to a \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">recent study\u003c/a> from the University of Southern California.\u003c/p>\n\u003cp>“Having a very strong, dominant provider system will reduce choice for our employees,” Chaloemtiarana says. “We want them, over the long term, to have choices in high-quality, low-cost providers.”\u003c/p>\n\u003cp>Not signing the letter, she says, allows her company to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”\u003c/p>\n\u003cp>Sutter rejects these claims and the research findings.\u003c/p>\n\u003cp>“Recent academic studies have been one-sided and misrepresent the competitive environment of Northern California,” said Bill Gleeson, vice president of communications for Sutter, adding that the studies “unjustly inflate the so-called market share of Sutter. There’s competition all around.”\u003c/p>\n\u003cp>Castlight and the other self-insured companies believe they’re receiving this letter \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/16/blue-shield-sutter-impasse-about-more-than-money/\" target=\"_blank\">because of a lawsuit\u003c/a> Sutter is facing from \u003ca href=\"https://www.ufcwtrust.com/\" target=\"_blank\">UFCW & Employers Benefit Trust \u003c/a>(UEBT), which funds health coverage for 60,000 members of a grocery workers’ union. UEBT is alleging that Sutter uses unfair business practices to maintain its power over prices.\u003c/p>\n\u003cp>[contextly_sidebar id=\"71H0Ojb2GH2PmTeKnFMAoSO20SXx8Yvn\"]“They’ve put a stranglehold on the competitive process in the Northern California health care market,” said Richard Grossman, UEBT’s attorney. “And therefore they’re free to raise prices without limit, and they have.”\u003c/p>\n\u003cp>Sutter rejects these claims, too, and argued that the health trust should have to arbitrate its disputes behind closed doors. The company said that the arbitration agreement Sutter has with Blue Shield, the trust's insurance administrator, also applies to the trust. But the judge in the case disagreed and so did \u003ca href=\"https://www.scribd.com/document/321382189/Sutter-Health-Arbitration-Opinion\" target=\"_blank\">an appeals court\u003c/a>.\u003c/p>\n\u003cp>“My client had never agreed to arbitration, had never seen a contract that included an arbitration clause. And so we opposed that,” said Grossman. “The judge agreed with us and said, 'Sutter you cannot force them into arbitration.'”\u003c/p>\n\u003cp>Grossman says that’s why Sutter now wants other self-insured companies like Castlight to actively sign the arbitration agreement and give up any future right to sue over prices or claim anti-competitive practices in open court. Again, if they don’t, their employees will have to pay higher out-of-network rates at Sutter hospitals and doctors’ offices.\u003c/p>\n\u003cp>“They want to force any disputes into confidential arbitration so their misdeeds cannot be exposed in a public courtroom, as is our constitutional right,” Grossman says.\u003c/p>\n\u003cp>To Sutter, the goal of the letter is transparency.\u003c/p>\n\u003cp>“We've taken a very proactive, very transparent approach, to making sure that the health plans provide these important clients of theirs with all the key terms of their agreements, and that includes rates,” says Gleeson.\u003c/p>\n\u003cp>Pressed to comment on the decision Sutter is asking self-insured companies to make -- to give up their right to sue or give up their lower prices for medical care -- Gleeson said companies “can’t accept deep discounts and make up their own rules.”\u003c/p>\n\u003cp>Castlight’s Jennifer Chaloemtiarana says there’s nothing transparent about one company forcing another company to sign a contract it hasn’t negotiated.\u003c/p>\n\u003cp>\"Having been put in this position without any activity or triggering event of our own feels very unfair,\" she says.\u003c/p>\n\u003cp>So Castlight has made the difficult decision not to sign the letter -- even though it’s going to have negative consequences for its employees who go to Sutter for care.\u003c/p>\n\u003cp>“They can stay with that provider and face substantially increased prices. Or, if they feel that they cannot handle that financial burden, they’ll have to find another provider,” she says. \"In many cases, that's going to mean traveling further, or moving to another provider network entirely.”\u003c/p>\n\u003cp>Castlight itself is in the business of trying to make health care more transparent -- it makes a software platform where employees get information about their health benefits, service costs and quality, so they can make better decisions about their care. Chaloemtiarana says, out of principle, and for the long-term mission of improving health care, it has to \"stand up against\" Sutter.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Sutter’s Gleeson says if companies don’t sign the letter, Sutter will ask health insurers to find another way to convince companies to agree to the arbitration terms.\u003c/p>\n\n","blocks":[],"excerpt":"Some companies are balking at health giant's move to have disputes argued behind closed doors.","status":"publish","parent":0,"modified":1471385604,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1212},"headData":{"title":"Arbitrate or Else: Sutter Health Drives a Hard Bargain | KQED","description":"Some companies are balking at health giant's move to have disputes argued behind closed doors.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Arbitrate or Else: Sutter Health Drives a Hard Bargain","datePublished":"2016-08-16T04:01:54.000Z","dateModified":"2016-08-16T22:13:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"225405 http://ww2.kqed.org/stateofhealth/?p=225405","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/08/15/arbitrate-or-else-sutter-health-drives-a-hard-bargain/","disqusTitle":"Arbitrate or Else: Sutter Health Drives a Hard Bargain","path":"/stateofhealth/225405/arbitrate-or-else-sutter-health-drives-a-hard-bargain","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bay Area companies say \u003ca href=\"http://www.sutterhealth.org/\" target=\"_blank\">Sutter Health\u003c/a> is strong-arming them into a contract that would help the medical system secure its power over prices and potentially raise the cost of medical care for their employees in the future.\u003c/p>\n\u003cp>Dozens of companies received a letter in recent months, via their insurance administrators, asking them to waive their rights to sue Sutter. If they don’t, \u003ca href=\"https://www.scribd.com/document/321381559/Anthem-Sutter-Letter\" target=\"_blank\">the letter\u003c/a> says, the companies’ employees who get care at Sutter will no longer have access to discounted in-network prices.\u003c/p>\n\u003cp>“In both choices, Castlight and our employees lose,” says Jennifer Chaloemtiarana, general counsel for \u003ca href=\"http://www.castlighthealth.com/\" target=\"_blank\">Castlight Health\u003c/a>, a tech company in San Francisco that received one of these letters this spring. She thought it was strange.\u003c/p>\n\u003cp>Castlight is self-insured, meaning it hires an insurance company -- in their case, it's \u003ca href=\"https://www.anthem.com/health-insurance/home/overview\" target=\"_blank\">Anthem Blue Cross\u003c/a> -- to manage the administrative details of its health coverage. But when an employee gets sick, Castlight, not Anthem, pays the bill. Anthem basically functions like a middleman, including negotiating discounted prices with providers like Sutter.\u003c/p>\n\u003cp>\"We don’t have a direct relationship with Sutter Health,” Chaloemtiarana said. “So the letter was unusual in that regard because it asked us to make certain legal agreements with Sutter.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The letter is from Anthem, but it says if Castlight has any disputes with Sutter, Castlight has to agree to arbitrate with Sutter Health. It can’t sue. And if it doesn’t sign, Castlight’s employees will lose their in-network medical rates. As a lawyer, this makes Chaloemtiarana uncomfortable.\u003c/p>\n\u003cp>“Arbitration provisions are pretty common among companies, but it usually occurs when you can sit down at a table and have a discussion and negotiation,” she says. “This has just been handed to us as a one-sided, unilateral provision.”\u003c/p>\n\u003cp>As an employer that pays its employees' medical claims, Castlight doesn’t like the idea that it will never be able to challenge Sutter over its prices in open court. To Chaloemtiarana, waiving that right would only help strengthen the power of Sutter’s “already dominant” provider network.\u003c/p>\n\u003cp>Sutter is the largest medical system in Northern California, with roughly 30 percent market share of hospitals, surgical centers and doctors’ groups, according to a data analysis by Christopher Whaley, a research economist at UC Berkeley. For comparison, Whaley says, the largest medical system in the Los Angeles area has 5 percent market share.\u003c/p>\n\u003cp>Economists have long argued that Sutter uses this power to charge more for its services. Sutter’s hospital prices are about 25 percent higher than other hospitals around the state, according to a \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">recent study\u003c/a> from the University of Southern California.\u003c/p>\n\u003cp>“Having a very strong, dominant provider system will reduce choice for our employees,” Chaloemtiarana says. “We want them, over the long term, to have choices in high-quality, low-cost providers.”\u003c/p>\n\u003cp>Not signing the letter, she says, allows her company to “maintain our flexibility in fighting against what we consider to be difficult, anti-consumer provisions in provider networks.”\u003c/p>\n\u003cp>Sutter rejects these claims and the research findings.\u003c/p>\n\u003cp>“Recent academic studies have been one-sided and misrepresent the competitive environment of Northern California,” said Bill Gleeson, vice president of communications for Sutter, adding that the studies “unjustly inflate the so-called market share of Sutter. There’s competition all around.”\u003c/p>\n\u003cp>Castlight and the other self-insured companies believe they’re receiving this letter \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/16/blue-shield-sutter-impasse-about-more-than-money/\" target=\"_blank\">because of a lawsuit\u003c/a> Sutter is facing from \u003ca href=\"https://www.ufcwtrust.com/\" target=\"_blank\">UFCW & Employers Benefit Trust \u003c/a>(UEBT), which funds health coverage for 60,000 members of a grocery workers’ union. UEBT is alleging that Sutter uses unfair business practices to maintain its power over prices.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“They’ve put a stranglehold on the competitive process in the Northern California health care market,” said Richard Grossman, UEBT’s attorney. “And therefore they’re free to raise prices without limit, and they have.”\u003c/p>\n\u003cp>Sutter rejects these claims, too, and argued that the health trust should have to arbitrate its disputes behind closed doors. The company said that the arbitration agreement Sutter has with Blue Shield, the trust's insurance administrator, also applies to the trust. But the judge in the case disagreed and so did \u003ca href=\"https://www.scribd.com/document/321382189/Sutter-Health-Arbitration-Opinion\" target=\"_blank\">an appeals court\u003c/a>.\u003c/p>\n\u003cp>“My client had never agreed to arbitration, had never seen a contract that included an arbitration clause. And so we opposed that,” said Grossman. “The judge agreed with us and said, 'Sutter you cannot force them into arbitration.'”\u003c/p>\n\u003cp>Grossman says that’s why Sutter now wants other self-insured companies like Castlight to actively sign the arbitration agreement and give up any future right to sue over prices or claim anti-competitive practices in open court. Again, if they don’t, their employees will have to pay higher out-of-network rates at Sutter hospitals and doctors’ offices.\u003c/p>\n\u003cp>“They want to force any disputes into confidential arbitration so their misdeeds cannot be exposed in a public courtroom, as is our constitutional right,” Grossman says.\u003c/p>\n\u003cp>To Sutter, the goal of the letter is transparency.\u003c/p>\n\u003cp>“We've taken a very proactive, very transparent approach, to making sure that the health plans provide these important clients of theirs with all the key terms of their agreements, and that includes rates,” says Gleeson.\u003c/p>\n\u003cp>Pressed to comment on the decision Sutter is asking self-insured companies to make -- to give up their right to sue or give up their lower prices for medical care -- Gleeson said companies “can’t accept deep discounts and make up their own rules.”\u003c/p>\n\u003cp>Castlight’s Jennifer Chaloemtiarana says there’s nothing transparent about one company forcing another company to sign a contract it hasn’t negotiated.\u003c/p>\n\u003cp>\"Having been put in this position without any activity or triggering event of our own feels very unfair,\" she says.\u003c/p>\n\u003cp>So Castlight has made the difficult decision not to sign the letter -- even though it’s going to have negative consequences for its employees who go to Sutter for care.\u003c/p>\n\u003cp>“They can stay with that provider and face substantially increased prices. Or, if they feel that they cannot handle that financial burden, they’ll have to find another provider,” she says. \"In many cases, that's going to mean traveling further, or moving to another provider network entirely.”\u003c/p>\n\u003cp>Castlight itself is in the business of trying to make health care more transparent -- it makes a software platform where employees get information about their health benefits, service costs and quality, so they can make better decisions about their care. Chaloemtiarana says, out of principle, and for the long-term mission of improving health care, it has to \"stand up against\" Sutter.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Sutter’s Gleeson says if companies don’t sign the letter, Sutter will ask health insurers to find another way to convince companies to agree to the arbitration terms.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/225405/arbitrate-or-else-sutter-health-drives-a-hard-bargain","authors":["3205"],"categories":["stateofhealth_2442"],"tags":["stateofhealth_2808","stateofhealth_482","stateofhealth_2519","stateofhealth_2859"],"featImg":"stateofhealth_225429","label":"stateofhealth"},"stateofhealth_205822":{"type":"posts","id":"stateofhealth_205822","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"205822","score":null,"sort":[1467334618000]},"guestAuthors":[],"slug":"northern-california-has-highest-costs-in-the-u-s-to-deliver-a-baby","title":"Northern California Has Highest Costs in the U.S. to Deliver a Baby","publishDate":1467334618,"format":"aside","headTitle":"Price Check | State of Health | KQED News","labelTerm":{"term":2492,"site":"stateofhealth"},"content":"\u003cp>Sacramento and the San Francisco Bay Area ranked as the most expensive places to have a baby of 30 major metropolitan regions in the U.S. according to \u003ca href=\"http://www.castlighthealth.com/press-releases/new-study-shows-huge-cost-differences-for-having-a-baby-often-in-the-same-city/\" target=\"_blank\">an analysis\u003c/a> released Thursday.\u003c/p>\n\u003cp>Sacramento came in first (congrats to you) where a vaginal birth cost $15,420 on average. The San Francisco Bay Area was a close second at $15,204. Minneapolis trailed in third place by almost $4,000, coming in at $11,527, and the least expensive of the 30 largest metropolitan areas surveyed was Kansas City, Missouri, where a vaginal delivery costs an avery $6,075.\u003c/p>\n\u003cp>These are \"routine vaginal deliveries,\" folks. Again, those are \"average\" costs. We'll get to the variation within regions further down.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-206296\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/VaginalRoutine-e1467324299747.jpg\" alt=\"VaginalRoutine\" width=\"1920\" height=\"1484\">\u003c/p>\n\u003cp>The numbers were crunched by San Francisco-based Castlight, a health care information company. They looked at medical claims data as well as other information. Since Castlight primarily works with self-insured large companies, it says the costs it crunched include both the employee's out-of-pocket costs and what the employer paid for the delivery.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Birth by Cesarean section typically cost more than vaginal deliveries and did in this survey as well. Sacramento was first at $27,067; the Bay Area was second at $21,799. Portland, Oregon trailed in third at $18,066. The least expensive of the metropolitan areas was Pittsburgh, Penn. at $6,891.\u003c/p>\n\u003cp>Here's the national C-section map:\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-206320\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/top_30_cities_delivery_maps_csection-e1467325171879.jpg\" alt=\"top_30_cities_delivery_maps_csection\" width=\"1920\" height=\"1484\">\u003c/p>\n\u003cp>But Castlight didn't actually stop at the 30 biggest metropolitan areas. They surveyed 190 areas across the country, including 13 in California.\u003c/p>\n\u003cp>While Sacramento and the Bay Area are the most expensive major regions to have a baby, other, smaller, California cities rank even higher.\u003c/p>\n\u003cp>Here's the list for routine vaginal deliveries in California:\u003c/p>\n\u003cp>Merced $19,191\u003cbr>\nSalinas $17,772\u003cbr>\nSacramento-Yolo $15,420\u003cbr>\nSF-Oakland-San Jose $15,204\u003cbr>\nStockton-Lodi $13,972\u003cbr>\nSan Luis Obispo-Atascadero-Paso Robles $13,926\u003cbr>\nSanta Barbara-Santa Maria-Lompoc $12,219\u003cbr>\nBakersfield $11,055\u003cbr>\nLos Angeles-Riverside-Orange $10,285\u003cbr>\nModesto $9,903\u003cbr>\nSan Diego $9,709\u003cbr>\nChico-Paradise $7,839\u003cbr>\nFresno $7,278\u003c/p>\n\u003cp>In addition to the cost difference between areas, there's tremendous cost variation within regions, too. In the Bay Area, the range for a vaginal delivery is $7,700 to $28,000, a four-fold difference. In Sacramento, it's $4,560 to $24,549, a five-fold difference.\u003c/p>\n\u003cp>Feeling ill yet?\u003c/p>\n\u003cp>If you're wondering why this happens, Kristin Torres Mowat, senior vice president at Castlight, chalked it up to the \"obscure, dysfunctional and inefficient health care market.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"smGr7FZlFDM9IcWYJVq0A3jdEsPJrPIH\"]In Northern California, consolidation on the provider side -- both doctors and hospitals -- helps them to wield market power and drive up costs.\u003c/p>\n\u003cp>The most recent evidence came earlier this month \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">in a study\u003c/a> from USC health economists who pointed, again, to the market power of Sutter Health and Dignity Health.\u003c/p>\n\u003cp>\"Over time, they have acquired physician practices, outpatient clinics, hospitals and have a disproportionate share in the market,\" Mowat said.\u003c/p>\n\u003cp>(Disclaimer that data from Kaiser Permanente was not included in the USC study.)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mowat advised that consumers ask for an estimate of costs early in their pregnancy, but that estimate is not always easy to get.\u003c/p>\n\n","blocks":[],"excerpt":"A new analysis finds that the Bay Area and Sacramento are the two most expensive places in 30 major metropolitan areas nationwide to give birth.","status":"publish","parent":0,"modified":1467336735,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":545},"headData":{"title":"Northern California Has Highest Costs in the U.S. to Deliver a Baby | KQED","description":"A new analysis finds that the Bay Area and Sacramento are the two most expensive places in 30 major metropolitan areas nationwide to give birth.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Northern California Has Highest Costs in the U.S. to Deliver a Baby","datePublished":"2016-07-01T00:56:58.000Z","dateModified":"2016-07-01T01:32:15.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"205822 http://ww2.kqed.org/stateofhealth/?p=205822","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/06/30/northern-california-has-highest-costs-in-the-u-s-to-deliver-a-baby/","disqusTitle":"Northern California Has Highest Costs in the U.S. to Deliver a Baby","path":"/stateofhealth/205822/northern-california-has-highest-costs-in-the-u-s-to-deliver-a-baby","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sacramento and the San Francisco Bay Area ranked as the most expensive places to have a baby of 30 major metropolitan regions in the U.S. according to \u003ca href=\"http://www.castlighthealth.com/press-releases/new-study-shows-huge-cost-differences-for-having-a-baby-often-in-the-same-city/\" target=\"_blank\">an analysis\u003c/a> released Thursday.\u003c/p>\n\u003cp>Sacramento came in first (congrats to you) where a vaginal birth cost $15,420 on average. The San Francisco Bay Area was a close second at $15,204. Minneapolis trailed in third place by almost $4,000, coming in at $11,527, and the least expensive of the 30 largest metropolitan areas surveyed was Kansas City, Missouri, where a vaginal delivery costs an avery $6,075.\u003c/p>\n\u003cp>These are \"routine vaginal deliveries,\" folks. Again, those are \"average\" costs. We'll get to the variation within regions further down.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-206296\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/VaginalRoutine-e1467324299747.jpg\" alt=\"VaginalRoutine\" width=\"1920\" height=\"1484\">\u003c/p>\n\u003cp>The numbers were crunched by San Francisco-based Castlight, a health care information company. They looked at medical claims data as well as other information. Since Castlight primarily works with self-insured large companies, it says the costs it crunched include both the employee's out-of-pocket costs and what the employer paid for the delivery.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Birth by Cesarean section typically cost more than vaginal deliveries and did in this survey as well. Sacramento was first at $27,067; the Bay Area was second at $21,799. Portland, Oregon trailed in third at $18,066. The least expensive of the metropolitan areas was Pittsburgh, Penn. at $6,891.\u003c/p>\n\u003cp>Here's the national C-section map:\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-206320\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/top_30_cities_delivery_maps_csection-e1467325171879.jpg\" alt=\"top_30_cities_delivery_maps_csection\" width=\"1920\" height=\"1484\">\u003c/p>\n\u003cp>But Castlight didn't actually stop at the 30 biggest metropolitan areas. They surveyed 190 areas across the country, including 13 in California.\u003c/p>\n\u003cp>While Sacramento and the Bay Area are the most expensive major regions to have a baby, other, smaller, California cities rank even higher.\u003c/p>\n\u003cp>Here's the list for routine vaginal deliveries in California:\u003c/p>\n\u003cp>Merced $19,191\u003cbr>\nSalinas $17,772\u003cbr>\nSacramento-Yolo $15,420\u003cbr>\nSF-Oakland-San Jose $15,204\u003cbr>\nStockton-Lodi $13,972\u003cbr>\nSan Luis Obispo-Atascadero-Paso Robles $13,926\u003cbr>\nSanta Barbara-Santa Maria-Lompoc $12,219\u003cbr>\nBakersfield $11,055\u003cbr>\nLos Angeles-Riverside-Orange $10,285\u003cbr>\nModesto $9,903\u003cbr>\nSan Diego $9,709\u003cbr>\nChico-Paradise $7,839\u003cbr>\nFresno $7,278\u003c/p>\n\u003cp>In addition to the cost difference between areas, there's tremendous cost variation within regions, too. In the Bay Area, the range for a vaginal delivery is $7,700 to $28,000, a four-fold difference. In Sacramento, it's $4,560 to $24,549, a five-fold difference.\u003c/p>\n\u003cp>Feeling ill yet?\u003c/p>\n\u003cp>If you're wondering why this happens, Kristin Torres Mowat, senior vice president at Castlight, chalked it up to the \"obscure, dysfunctional and inefficient health care market.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In Northern California, consolidation on the provider side -- both doctors and hospitals -- helps them to wield market power and drive up costs.\u003c/p>\n\u003cp>The most recent evidence came earlier this month \u003ca href=\"http://inq.sagepub.com/content/53/0046958016651555.full\" target=\"_blank\">in a study\u003c/a> from USC health economists who pointed, again, to the market power of Sutter Health and Dignity Health.\u003c/p>\n\u003cp>\"Over time, they have acquired physician practices, outpatient clinics, hospitals and have a disproportionate share in the market,\" Mowat said.\u003c/p>\n\u003cp>(Disclaimer that data from Kaiser Permanente was not included in the USC study.)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mowat advised that consumers ask for an estimate of costs early in their pregnancy, but that estimate is not always easy to get.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/205822/northern-california-has-highest-costs-in-the-u-s-to-deliver-a-baby","authors":["240"],"series":["stateofhealth_2492"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_482","stateofhealth_2519"],"featImg":"stateofhealth_206296","label":"stateofhealth_2492"},"stateofhealth_138635":{"type":"posts","id":"stateofhealth_138635","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"138635","score":null,"sort":[1452758539000]},"guestAuthors":[],"slug":"as-bay-area-hospitals-consolidate-will-costs-go-up-or-down","title":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down?","publishDate":1452758539,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The Bay Area's health care systems -- think Stanford, Sutter, John Muir and more -- are continuing to align and consolidate in different ways to expand across the region, \u003ca href=\"http://stage.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\">a new analysis shows\u003c/a>, and it's unclear if this will lead to lower or higher health care costs.\u003c/p>\n\u003cp>The report, from the Oakland-based California HealthCare Foundation (CHCF), serves as a summary of the transformation in the Bay Area's health care market over the last few years since the foundation's last report on the subject in 2012.\u003c/p>\n\u003cp>Maribeth Shannon, director at CHCF, referred to \"an arms race.\"\u003c/p>\n\u003cp>\"Providers see health plans consolidating and they want to have a similar level of leverage when they negotiate\" with health insurers, she said. \"The idea [is] that you have to be strong to get a good price in this market.\"\u003c/p>\n\u003cp>The analysis, conducted for the foundation by Mathematica Policy Research, called out three specific health system regionalization efforts and the different ways they were achieving their goals:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Stanford Health Care\u003c/strong> reached across San Francisco Bay to acquire ValleyCare, based in Pleasanton. The goal of such an expansion, the report says, is for Stanford \"to support an expansion of its health plan.\"\u003c/li>\n\u003cli>\u003cstrong>UCSF and John Muir Health\u003c/strong> -- also on opposite sides of San Francisco Bay -- formed a partnership aimed at building a \"network large enough to compete with systems like Kaiser and Sutter\" throughout the Bay Area.\u003c/li>\n\u003cli>\u003cstrong>Sutter Health,\u003c/strong> meanwhile, is consolidating its own operations. The foundation's report cites multiple rounds of reorganization over the past few years, and says Sutter now is attempting to merge its three Bay Area foundations with the goal of extending the successful Palo Alto Medical Foundation model to other sites. But the analysts predict that will be a tall order, given the foundations' different \"histories and physician cultures.\"\u003c/li>\n\u003c/ul>\n\u003cp>And what of patients? Ha Tu, senior health researcher of Mathematica Policy Research and lead author of the study, predicts the increasing consolidation, \"at least in the short term, will result in more provider competition and more choices for consumers, but over the longer term, it remains to be seen whether it's a sustainable thing.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Glenn Melnick, a health economist at USC, flatly rejects that the consolidation will ever benefit consumers.\u003c/p>\n\u003cp>\"What's happening,\" he said, \"is they're getting together to negotiate contracts, and that's it. I'm very cynical.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\" rel=\"attachment wp-att-138796\">\u003cimg class=\"alignright wp-image-138796 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/EmpireBuildingByBayTeaser.jpg\" alt=\"\" width=\"291\" height=\"400\">\u003c/a>Northern California as a whole has \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/03/why-health-insurance-in-the-bay-area-costs-more-than-in-southern-california-hospital-prices/\" target=\"_blank\">long had higher health care prices\u003c/a> than Southern California. Melnick described \"monstrous health care enterprises who are just building on existing market power to expand and protect it in the future.\"\u003c/p>\n\u003cp>Both the foundation's Shannon and lead author Tu stressed that future cost savings are unknown. While more consolidation can lead to higher prices, efficiencies can improve, Shannon said, but she added it's not clear now if those efficiencies would be robust enough to offset price hikes.\u003c/p>\n\u003cp>Tu pointed to a desire by many health systems to be more competitive against health giant Kaiser.\u003c/p>\n\u003cp>At both Sutter and UCSF/John Muir \"they are very well aware they need to lower their cost structures significantly and do population health effectively,\" Tu said in reference to the push to move away from fee-for-service medicine, which can lead to unnecessary care and waste. \"Whether they can do that is a big challenge and an open question.\"\u003c/p>\n\u003cp>In the report, analysts also looked at safety net providers and the challenge posed by increased demand as millions more Californians have coverage, in the wake of the full implementation of the Affordable Care Act. Just over \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/01/07/browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment/\" target=\"_blank\">one-third of Californians are now covered by Medi-Cal\u003c/a>, and primary care providers are in short supply, the report said.\u003c/p>\n\u003cp>\"The primary care physicians that are needed to serve that population just don't exist,\" Shannon said. \"What we need are innovative ways of meeting the health care needs of that population.\"\u003c/p>\n\u003cp>Providing behavioral health care to patients in the face of expanded health insurance access and regulations requiring coverage \"\u003ca href=\"http://www.dol.gov/ebsa/mentalhealthparity/\" target=\"_blank\">parity\u003c/a>\" -- that health insurers \u003ca href=\"https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Understanding-Health-Insurance/What-is-Mental-Health-Parity\" target=\"_blank\">must provide equal coverage\u003c/a> for mental health conditions -- is an \"enormous problem,\" Shannon said, and many patients are facing long wait times to access care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's a significant problem,\" she said, \"and it's long been simmering, it's been below the surface for a long time, and now parity has brought it up to the top.\"\u003c/p>\n\n","blocks":[],"excerpt":"New report shows increasingly regionalization may lead to short-run cost savings. But in the long run, no one knows.","status":"publish","parent":0,"modified":1452819481,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":738},"headData":{"title":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down? | KQED","description":"New report shows increasingly regionalization may lead to short-run cost savings. But in the long run, no one knows.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down?","datePublished":"2016-01-14T08:02:19.000Z","dateModified":"2016-01-15T00:58:01.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"138635 http://ww2.kqed.org/stateofhealth/?p=138635","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/14/as-bay-area-hospitals-consolidate-will-costs-go-up-or-down/","disqusTitle":"As Bay Area Hospitals Consolidate, Will Costs Go Up or Down?","path":"/stateofhealth/138635/as-bay-area-hospitals-consolidate-will-costs-go-up-or-down","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Bay Area's health care systems -- think Stanford, Sutter, John Muir and more -- are continuing to align and consolidate in different ways to expand across the region, \u003ca href=\"http://stage.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\">a new analysis shows\u003c/a>, and it's unclear if this will lead to lower or higher health care costs.\u003c/p>\n\u003cp>The report, from the Oakland-based California HealthCare Foundation (CHCF), serves as a summary of the transformation in the Bay Area's health care market over the last few years since the foundation's last report on the subject in 2012.\u003c/p>\n\u003cp>Maribeth Shannon, director at CHCF, referred to \"an arms race.\"\u003c/p>\n\u003cp>\"Providers see health plans consolidating and they want to have a similar level of leverage when they negotiate\" with health insurers, she said. \"The idea [is] that you have to be strong to get a good price in this market.\"\u003c/p>\n\u003cp>The analysis, conducted for the foundation by Mathematica Policy Research, called out three specific health system regionalization efforts and the different ways they were achieving their goals:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Stanford Health Care\u003c/strong> reached across San Francisco Bay to acquire ValleyCare, based in Pleasanton. The goal of such an expansion, the report says, is for Stanford \"to support an expansion of its health plan.\"\u003c/li>\n\u003cli>\u003cstrong>UCSF and John Muir Health\u003c/strong> -- also on opposite sides of San Francisco Bay -- formed a partnership aimed at building a \"network large enough to compete with systems like Kaiser and Sutter\" throughout the Bay Area.\u003c/li>\n\u003cli>\u003cstrong>Sutter Health,\u003c/strong> meanwhile, is consolidating its own operations. The foundation's report cites multiple rounds of reorganization over the past few years, and says Sutter now is attempting to merge its three Bay Area foundations with the goal of extending the successful Palo Alto Medical Foundation model to other sites. But the analysts predict that will be a tall order, given the foundations' different \"histories and physician cultures.\"\u003c/li>\n\u003c/ul>\n\u003cp>And what of patients? Ha Tu, senior health researcher of Mathematica Policy Research and lead author of the study, predicts the increasing consolidation, \"at least in the short term, will result in more provider competition and more choices for consumers, but over the longer term, it remains to be seen whether it's a sustainable thing.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Glenn Melnick, a health economist at USC, flatly rejects that the consolidation will ever benefit consumers.\u003c/p>\n\u003cp>\"What's happening,\" he said, \"is they're getting together to negotiate contracts, and that's it. I'm very cynical.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.chcf.org/publications/2016/01/regional-market-san-francisco\" target=\"_blank\" rel=\"attachment wp-att-138796\">\u003cimg class=\"alignright wp-image-138796 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/EmpireBuildingByBayTeaser.jpg\" alt=\"\" width=\"291\" height=\"400\">\u003c/a>Northern California as a whole has \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/03/why-health-insurance-in-the-bay-area-costs-more-than-in-southern-california-hospital-prices/\" target=\"_blank\">long had higher health care prices\u003c/a> than Southern California. Melnick described \"monstrous health care enterprises who are just building on existing market power to expand and protect it in the future.\"\u003c/p>\n\u003cp>Both the foundation's Shannon and lead author Tu stressed that future cost savings are unknown. While more consolidation can lead to higher prices, efficiencies can improve, Shannon said, but she added it's not clear now if those efficiencies would be robust enough to offset price hikes.\u003c/p>\n\u003cp>Tu pointed to a desire by many health systems to be more competitive against health giant Kaiser.\u003c/p>\n\u003cp>At both Sutter and UCSF/John Muir \"they are very well aware they need to lower their cost structures significantly and do population health effectively,\" Tu said in reference to the push to move away from fee-for-service medicine, which can lead to unnecessary care and waste. \"Whether they can do that is a big challenge and an open question.\"\u003c/p>\n\u003cp>In the report, analysts also looked at safety net providers and the challenge posed by increased demand as millions more Californians have coverage, in the wake of the full implementation of the Affordable Care Act. Just over \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/01/07/browns-budget-plan-new-managed-care-tax-increase-ssi-benefits-more-medi-cal-enrollment/\" target=\"_blank\">one-third of Californians are now covered by Medi-Cal\u003c/a>, and primary care providers are in short supply, the report said.\u003c/p>\n\u003cp>\"The primary care physicians that are needed to serve that population just don't exist,\" Shannon said. \"What we need are innovative ways of meeting the health care needs of that population.\"\u003c/p>\n\u003cp>Providing behavioral health care to patients in the face of expanded health insurance access and regulations requiring coverage \"\u003ca href=\"http://www.dol.gov/ebsa/mentalhealthparity/\" target=\"_blank\">parity\u003c/a>\" -- that health insurers \u003ca href=\"https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Understanding-Health-Insurance/What-is-Mental-Health-Parity\" target=\"_blank\">must provide equal coverage\u003c/a> for mental health conditions -- is an \"enormous problem,\" Shannon said, and many patients are facing long wait times to access care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's a significant problem,\" she said, \"and it's long been simmering, it's been below the surface for a long time, and now parity has brought it up to the top.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/138635/as-bay-area-hospitals-consolidate-will-costs-go-up-or-down","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_482","stateofhealth_73","stateofhealth_2519"],"featImg":"stateofhealth_138795","label":"stateofhealth"},"stateofhealth_53555":{"type":"posts","id":"stateofhealth_53555","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"53555","score":null,"sort":[1438153378000]},"guestAuthors":[],"slug":"autism-costs-could-reach-500-billion-by-2025-uc-davis-study-finds","title":"Autism Costs Could Reach $500 Billion by 2025, UC Davis Study Finds","publishDate":1438153378,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Autism costs to the United States as a whole are expected to reach nearly half a trillion dollars annually in the year 2025, according to an analysis from health economists at UC Davis Medical Center.\u003c/p>\n\u003cp>Researchers looked at medical, non-medical and lost productivity costs. They said costs for 2015 total $268 billion and in 10 years will reach $461 billion. Researchers said their estimates were \"conservative,\" and that it was the first time the economic burden for the U.S. had been calculated.\u003c/p>\n\u003cp>[contextly_sidebar id=\"iC6D3rqatMOXaW6SyV76Bbh1tVGG1xMm\"]\"The economic burden of autism is more than double the economic burden for stroke and hypertension -- combined,\" said lead author Paul Leigh, a health economist at UC Davis Medical Center.\u003c/p>\n\u003cp>And while these costs are very high, research funding lags, he said.\u003c/p>\n\u003cp>\"The economic burden of autism is on par with the costs of diabetes,\" Leigh said. \"And yet the federal government is funding diabetes [research] at about five times the rate that it is funding research into autism.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study was published online in the \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26183723\" target=\"_blank\">Journal of Autism and Developmental Disorders\u003c/a>.\u003c/p>\n\u003cp>Leigh says more intensive services that can help people with autism to have jobs and live independently can reduce societal costs later.\u003c/p>\n\u003cp>\"There are definitely cost-effective interventions for children and adults,\" Leigh said, \"and these can yield big dividends in a few years ... when people with autism become functional and compete in the workforce.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"EJWRnp2pQbcXu9jpCWywxGE6g6IdQUS7\"]Costs associated with autism have been calculated in other studies, the authors noted, but those have primarily focused on per-person lifetime costs. Because universal costs were not tallied until now, it made comparison with other diseases difficult.\u003c/p>\n\u003cp>Kristin Jacobson, executive director of Autism Deserves Equal Coverage, an advocacy group, said the study's findings validate what the autism community had long known.\u003c/p>\n\u003cp>\"Autism is one of the largest and the fastest growing health crises in the United States and the world,\" she said by email. \"Unfortunately it still remains dramatically underresearched and underfunded. If California and the U.S. continue to underinvest in research and therapy, the financial and social costs will be catastrophic.\"\u003c/p>\n\u003cp>She noted that her own organization had previously calculated that California could save $46 billion to $64 billion over 10 years by providing behavior health treatment to individuals with autism.\u003c/p>\n\u003cp>\"If the state and federal government does not wake up and significantly invest in understanding ASD [Autism Spectrum Disorder] and making ASD treatment accessible, the societal and financial burden will be devastating,\" she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the study, Leigh and co-author Juan Du called for research into possible \"modifiable causes\" of ASD at a level \"as great as other major diseases,\" as well as new research into the cost effectiveness of different therapies.\u003c/p>\n\n","blocks":[],"excerpt":"The researchers say better access to intensive services and job counseling could save money later. ","status":"publish","parent":0,"modified":1438216462,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":460},"headData":{"title":"Autism Costs Could Reach $500 Billion by 2025, UC Davis Study Finds | KQED","description":"The researchers say better access to intensive services and job counseling could save money later. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Autism Costs Could Reach $500 Billion by 2025, UC Davis Study Finds","datePublished":"2015-07-29T07:02:58.000Z","dateModified":"2015-07-30T00:34:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"53555 http://ww2.kqed.org/stateofhealth/?p=53555","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/07/29/autism-costs-could-reach-500-billion-by-2025-uc-davis-study-finds/","disqusTitle":"Autism Costs Could Reach $500 Billion by 2025, UC Davis Study Finds","path":"/stateofhealth/53555/autism-costs-could-reach-500-billion-by-2025-uc-davis-study-finds","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Autism costs to the United States as a whole are expected to reach nearly half a trillion dollars annually in the year 2025, according to an analysis from health economists at UC Davis Medical Center.\u003c/p>\n\u003cp>Researchers looked at medical, non-medical and lost productivity costs. They said costs for 2015 total $268 billion and in 10 years will reach $461 billion. Researchers said their estimates were \"conservative,\" and that it was the first time the economic burden for the U.S. had been calculated.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"The economic burden of autism is more than double the economic burden for stroke and hypertension -- combined,\" said lead author Paul Leigh, a health economist at UC Davis Medical Center.\u003c/p>\n\u003cp>And while these costs are very high, research funding lags, he said.\u003c/p>\n\u003cp>\"The economic burden of autism is on par with the costs of diabetes,\" Leigh said. \"And yet the federal government is funding diabetes [research] at about five times the rate that it is funding research into autism.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study was published online in the \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26183723\" target=\"_blank\">Journal of Autism and Developmental Disorders\u003c/a>.\u003c/p>\n\u003cp>Leigh says more intensive services that can help people with autism to have jobs and live independently can reduce societal costs later.\u003c/p>\n\u003cp>\"There are definitely cost-effective interventions for children and adults,\" Leigh said, \"and these can yield big dividends in a few years ... when people with autism become functional and compete in the workforce.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Costs associated with autism have been calculated in other studies, the authors noted, but those have primarily focused on per-person lifetime costs. Because universal costs were not tallied until now, it made comparison with other diseases difficult.\u003c/p>\n\u003cp>Kristin Jacobson, executive director of Autism Deserves Equal Coverage, an advocacy group, said the study's findings validate what the autism community had long known.\u003c/p>\n\u003cp>\"Autism is one of the largest and the fastest growing health crises in the United States and the world,\" she said by email. \"Unfortunately it still remains dramatically underresearched and underfunded. If California and the U.S. continue to underinvest in research and therapy, the financial and social costs will be catastrophic.\"\u003c/p>\n\u003cp>She noted that her own organization had previously calculated that California could save $46 billion to $64 billion over 10 years by providing behavior health treatment to individuals with autism.\u003c/p>\n\u003cp>\"If the state and federal government does not wake up and significantly invest in understanding ASD [Autism Spectrum Disorder] and making ASD treatment accessible, the societal and financial burden will be devastating,\" she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the study, Leigh and co-author Juan Du called for research into possible \"modifiable causes\" of ASD at a level \"as great as other major diseases,\" as well as new research into the cost effectiveness of different therapies.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/53555/autism-costs-could-reach-500-billion-by-2025-uc-davis-study-finds","authors":["240"],"categories":["stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_155","stateofhealth_482"],"featImg":"stateofhealth_53559","label":"stateofhealth"},"stateofhealth_53405":{"type":"posts","id":"stateofhealth_53405","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"53405","score":null,"sort":[1438102346000]},"guestAuthors":[],"slug":"happy-50th-birthday-medicare-your-patients-are-getting-healthier","title":"Happy 50th Birthday, Medicare. Your Patients Are Getting Healthier","publishDate":1438102346,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Here's a bit of good news for Medicare, the popular government program that's turning 50 this week. Older Americans on Medicare are spending less time in the hospital; they're living longer; and the cost of a typical hospital stay has actually come down over the past 15 years, according to a\u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.8035\" target=\"_blank\"> study\u003c/a> in the \u003cem>Journal of the American Medical Association\u003c/em>.\u003c/p>\n\u003cp>Doctors, hospitals and government administrators have put a lot of effort into making Medicare more efficient in the past 15 years. \u003ca href=\"https://medicine.yale.edu/intmed/people/harlan_krumholz.profile\" target=\"_blank\">Dr. Harlan Krumholz\u003c/a> and colleagues at Yale University took on a study to see whether that effort has paid off.\u003c/p>\n\u003cp>[contextly_sidebar id=\"d6fBr9xMRQXiy0cpNzqihfUmFxAiuvKG\"]\"The results were rather remarkable,\" says Krumholz, a cardiologist and leading health care researcher. \"We found jaw-dropping improvements in almost every area that we looked at.\"\u003c/p>\n\u003cp>The researchers looked at the experience of 60 million older Americans covered by traditional Medicare between 1999 and 2013. They found that mortality rates dropped steadily during that time, and people were much less likely to end up in the hospital.\u003c/p>\n\u003cp>\"If the rates had stayed the same in 2013 as they had been in 1999, we would have seen almost 3.5 million more hospitalizations in 2013,\" Krumholz says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"People who were being hospitalized were having much better outcomes after the hospitalization,\" he says. \"They had a much better chance of survival.\"\u003c/p>\n\u003cp>And the average cost of a hospital stay dropped too, he says, from $3,290 to $2,801 in inflation-adjusted dollars over the 15-year-period for patients in the traditional Medicare program. (Researchers couldn't quantify the experience in Medicare Advantage, the managed-care alternative to Medicare).\u003c/p>\n\u003cp>Krumholz attributes the improvement to a wide variety of measures designed to boost patients' health, from prevention programs to advances in medical care. He says some of the savings also came about because medical care shifted from hospitals to less expensive outpatient clinics.\u003c/p>\n\u003cp>\"They're pointing out a very good thing in the medical system,\" says economist \u003ca href=\"https://www.kellogg.northwestern.edu/faculty/directory/garthwaite_craig.aspx\" target=\"_blank\">Craig Garthwaite\u003c/a> at the Kellogg School of Management at Northwestern University. He says the recession, which helped slow rising health care costs overall, apparently played a minor role in this story of Medicare.\u003c/p>\n\u003cp>Costs really are being contained, Garthwaite says. One other reason that's happening is that the federal government is reimbursing hospitals and doctors less for treating Medicare patients.\u003c/p>\n\u003cp>\"That's an easy way to get control of medical spending in Medicare,\" Garthwaite says, but \"it's just not something we can do in the private market, and we have to worry about how sustainable it is for the Medicare program overall.\"\u003c/p>\n\u003cp>With the post-World War II baby boom now reaching retirement age, more and more people are turning 65 and becoming eligible for Medicare. That growth continues to drive up the overall cost of the program, even as that average cost per illness or hospitalization comes down. And as older Americans live longer lives, they use Medicare for more years than previous generations did.\u003c/p>\n\u003cp>Medicare is still running a bit of a deficit, but the situation is improving. The program's trustees say its trust fund will be solvent through 2030. Some adjustments would be needed to keep the program in good financial health beyond that date.\u003c/p>\n\u003cp>Garthwaite says other recent trends could make matters worse, with one especially worrisome example being sharply rising drug prices.\u003c/p>\n\u003cp>\"Some of these [new cancer] products are providing only a few months of life for several hundred thousand dollars,\" he says. And the system doesn't do a good job of making difficult judgments in situations like that.\u003c/p>\n\u003cp>\u003ca href=\"https://www.aei.org/scholar/joseph-antos/\" target=\"_blank\">Joseph Antos\u003c/a>, an economist in health policy at the American Enterprise Institute, agrees that the good news from the Yale study doesn't assure a rosy future. He's concerned about the financial health of Medicare if, for example, an effective drug for Alzheimer's disease is developed.\u003c/p>\n\u003cp>\"I would argue that if anybody came up with an effective treatment for Alzheimer's today, that treatment would be hailed as a major breakthrough and we wouldn't be looking at the cost.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And that would almost certainly break the pattern that's been documented over the past 15 years, where improving health has actually helped drive down the cost of medical care.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Happy+50th+Birthday%2C+Medicare.+Your+Patients+Are+Getting+Healthier&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"\"We found jaw-dropping improvements in almost every area that we looked at,\" says lead author of analysis.","status":"publish","parent":0,"modified":1438102896,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":726},"headData":{"title":"Happy 50th Birthday, Medicare. Your Patients Are Getting Healthier | KQED","description":""We found jaw-dropping improvements in almost every area that we looked at," says lead author of analysis.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Happy 50th Birthday, Medicare. Your Patients Are Getting Healthier","datePublished":"2015-07-28T16:52:26.000Z","dateModified":"2015-07-28T17:01:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"53405 http://ww2.kqed.org/stateofhealth/?p=53405","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/07/28/happy-50th-birthday-medicare-your-patients-are-getting-healthier/","disqusTitle":"Happy 50th Birthday, Medicare. Your Patients Are Getting Healthier","nprByline":"Richard Harris","nprStoryId":"426740179","nprApiLink":"http://api.npr.org/query?id=426740179&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/07/28/426740179/happy-50th-birthday-medicare-your-patients-are-getting-healthier?ft=nprml&f=426740179","nprRetrievedStory":"1","nprPubDate":"Tue, 28 Jul 2015 11:15:00 -0400","nprStoryDate":"Tue, 28 Jul 2015 11:01:00 -0400","nprLastModifiedDate":"Tue, 28 Jul 2015 11:15:55 -0400","path":"/stateofhealth/53405/happy-50th-birthday-medicare-your-patients-are-getting-healthier","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here's a bit of good news for Medicare, the popular government program that's turning 50 this week. Older Americans on Medicare are spending less time in the hospital; they're living longer; and the cost of a typical hospital stay has actually come down over the past 15 years, according to a\u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.8035\" target=\"_blank\"> study\u003c/a> in the \u003cem>Journal of the American Medical Association\u003c/em>.\u003c/p>\n\u003cp>Doctors, hospitals and government administrators have put a lot of effort into making Medicare more efficient in the past 15 years. \u003ca href=\"https://medicine.yale.edu/intmed/people/harlan_krumholz.profile\" target=\"_blank\">Dr. Harlan Krumholz\u003c/a> and colleagues at Yale University took on a study to see whether that effort has paid off.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"The results were rather remarkable,\" says Krumholz, a cardiologist and leading health care researcher. \"We found jaw-dropping improvements in almost every area that we looked at.\"\u003c/p>\n\u003cp>The researchers looked at the experience of 60 million older Americans covered by traditional Medicare between 1999 and 2013. They found that mortality rates dropped steadily during that time, and people were much less likely to end up in the hospital.\u003c/p>\n\u003cp>\"If the rates had stayed the same in 2013 as they had been in 1999, we would have seen almost 3.5 million more hospitalizations in 2013,\" Krumholz says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"People who were being hospitalized were having much better outcomes after the hospitalization,\" he says. \"They had a much better chance of survival.\"\u003c/p>\n\u003cp>And the average cost of a hospital stay dropped too, he says, from $3,290 to $2,801 in inflation-adjusted dollars over the 15-year-period for patients in the traditional Medicare program. (Researchers couldn't quantify the experience in Medicare Advantage, the managed-care alternative to Medicare).\u003c/p>\n\u003cp>Krumholz attributes the improvement to a wide variety of measures designed to boost patients' health, from prevention programs to advances in medical care. He says some of the savings also came about because medical care shifted from hospitals to less expensive outpatient clinics.\u003c/p>\n\u003cp>\"They're pointing out a very good thing in the medical system,\" says economist \u003ca href=\"https://www.kellogg.northwestern.edu/faculty/directory/garthwaite_craig.aspx\" target=\"_blank\">Craig Garthwaite\u003c/a> at the Kellogg School of Management at Northwestern University. He says the recession, which helped slow rising health care costs overall, apparently played a minor role in this story of Medicare.\u003c/p>\n\u003cp>Costs really are being contained, Garthwaite says. One other reason that's happening is that the federal government is reimbursing hospitals and doctors less for treating Medicare patients.\u003c/p>\n\u003cp>\"That's an easy way to get control of medical spending in Medicare,\" Garthwaite says, but \"it's just not something we can do in the private market, and we have to worry about how sustainable it is for the Medicare program overall.\"\u003c/p>\n\u003cp>With the post-World War II baby boom now reaching retirement age, more and more people are turning 65 and becoming eligible for Medicare. That growth continues to drive up the overall cost of the program, even as that average cost per illness or hospitalization comes down. And as older Americans live longer lives, they use Medicare for more years than previous generations did.\u003c/p>\n\u003cp>Medicare is still running a bit of a deficit, but the situation is improving. The program's trustees say its trust fund will be solvent through 2030. Some adjustments would be needed to keep the program in good financial health beyond that date.\u003c/p>\n\u003cp>Garthwaite says other recent trends could make matters worse, with one especially worrisome example being sharply rising drug prices.\u003c/p>\n\u003cp>\"Some of these [new cancer] products are providing only a few months of life for several hundred thousand dollars,\" he says. And the system doesn't do a good job of making difficult judgments in situations like that.\u003c/p>\n\u003cp>\u003ca href=\"https://www.aei.org/scholar/joseph-antos/\" target=\"_blank\">Joseph Antos\u003c/a>, an economist in health policy at the American Enterprise Institute, agrees that the good news from the Yale study doesn't assure a rosy future. He's concerned about the financial health of Medicare if, for example, an effective drug for Alzheimer's disease is developed.\u003c/p>\n\u003cp>\"I would argue that if anybody came up with an effective treatment for Alzheimer's today, that treatment would be hailed as a major breakthrough and we wouldn't be looking at the cost.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And that would almost certainly break the pattern that's been documented over the past 15 years, where improving health has actually helped drive down the cost of medical care.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Happy+50th+Birthday%2C+Medicare.+Your+Patients+Are+Getting+Healthier&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/53405/happy-50th-birthday-medicare-your-patients-are-getting-healthier","authors":["byline_stateofhealth_53405"],"categories":["stateofhealth_14"],"tags":["stateofhealth_482","stateofhealth_105"],"featImg":"stateofhealth_53406","label":"stateofhealth"},"stateofhealth_50811":{"type":"posts","id":"stateofhealth_50811","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"50811","score":null,"sort":[1437696032000]},"guestAuthors":[],"slug":"pricecheck-how-much-does-it-cost-to-have-a-baby-in-northern-california","title":"PriceCheck: How Much Does It Cost to Have a Baby in Northern California?","publishDate":1437696032,"format":"standard","headTitle":"Price Check | State of Health | KQED News","labelTerm":{"term":2492,"site":"stateofhealth"},"content":"\u003cp>Childbirth is the most common reason for hospitalization in the U.S. In California, about\u003ca href=\"http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf\" target=\"_blank\"> half a million babies \u003c/a>are born every year. Given how common it is -- and that most births are fairly uncomplicated, medically -- you'd think there would be some predictability in prices.\u003c/p>\n\u003cp>But there isn't. The price of delivery varies dramatically, both nationwide and across California. A\u003ca href=\"http://bmjopen.bmj.com/content/4/1/e004017.abstract?sid=a32193cf-85b1-4f07-b2d1-cba35214aa0a\" target=\"_blank\"> study last year\u003c/a> of more than 109,000 births at 198 hospitals statewide found a stunning 11-fold variation in prices charged for vaginal delivery -- from $3,296 to $37,227 -- and more than 8-fold for cesarean section -- from $8,312 to $70,908.\u003c/p>\n\u003caside class=\"pullquote alignright\">Share what you paid to deliver your baby. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Help us make health costs transparent. Visit PriceCheck!\u003c/a>\u003c/aside>\n\u003cp>\"This type of variation is not unique to obstetrics,\" said the study's lead author, Renee Hsia, a physician and professor of health policy at UC San Francisco. \"This is unfortunately the state of our health care in the United States.\"\u003c/p>\n\u003cp>That's why we're turning next to childbirth in our PriceCheck project. On \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>, we're crowdsourcing the price of common medical tests and procedures. We're asking people to share what they paid -- in this case -- for childbirth. More on how you can share further below, but first, some things you should know if you're pregnant now to make sure you can minimize your bills.\u003c/p>\n\u003cp>\u003cstrong>No Co-pay for Prenatal Care ...\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under the Affordable Care Act, many preventive services -- including routine prenatal care -- \u003ca href=\"http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen\" target=\"_blank\">must be covered at no cost to the patient\u003c/a>: no deductible, no co-insurance, no co-payment.\u003c/p>\n\u003cp>\"So the first thing they should be looking for and demanding is no cost-sharing for prenatal care,\" said Susan Berke Fogel, with the National Health Law Program. Common screenings like gestational diabetes and Rh incompatibility are just two of the \u003ca href=\"http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen\" target=\"_blank\">tests included\u003c/a> at no cost to the patient.\u003c/p>\n\u003cp>The only exception is if you have a \"grandfathered\" plan. This is a plan that predated the Affordable Care Act and has not been changed much since. These grandfathered plans are not subject to many of the Affordable Care Act mandates and may not include the same benefits.\u003c/p>\n\u003cp>\u003cstrong>... But There Is for Labor and Delivery\u003c/strong>\u003c/p>\n\u003cp>While your costs will depend on your plan, you will almost certainly pay something for labor and delivery. Consumers should contact their plan to try to estimate their costs and check other requirements.\u003c/p>\n\u003cp>\"Understand specifics,\" says Lisa Zamosky, author of \"\u003ca href=\"http://lisazamosky.com/about/\" target=\"_blank\">Healthcare, Insurance and You: The Savvy Consumer's Guide\u003c/a>.\" She also worked for a large managed-care organization before becoming a writer. \"Are pre-authorizations required? Do you need to call the insurance company when you are admitted to the hospital?\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"dSK0x9dmZALaarFtZERECULWv88aushi\"]The good news is that you have time to sort this all out. Both Zamosky and Fogel stressed to make sure both your doctor and the hospital are in network. Some women prefer to deliver at a birth center, but you need to make sure the center is in network, too. If not, do the math to see how an out-of-network birth center pencils out compared with an in-network hospital. (My PriceCheck colleague Rebecca Plevin at KPCC \u003ca href=\"http://www.scpr.org/blogs/health/2015/07/22/18049/pricecheck-how-much-does-it-cost-to-have-a-baby-at/\" target=\"_blank\">looked closely at this issue\u003c/a>.)\u003c/p>\n\u003cp>Even if you are at an in-network facility, it doesn't mean all the providers are also in network. I know this from my own experience. When I delivered my daughter in 2001 at an in-network hospital, I got a $1,200 bill months later for the anesthesiologist. (It was ultimately paid by my insurer.)\u003c/p>\n\u003cp>These \"surprise bills\" are not uncommon. A\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/07/nearly-1-in-4-californians-hit-by-surprise-medical-bills/\" target=\"_blank\"> Consumers Union survey \u003c/a>earlier this year found almost one in four Californians who had gone to a hospital or ER got an out-of-network bill from a doctor they had thought was in network.\u003c/p>\n\u003cp>There are steps you can take before you get to the hospital to try to avoid this, Zamosky says, \"but you should know there is a risk.\"\u003c/p>\n\u003cp>She recommends having a pointed conversation with your obstetrician. \"I would be forceful about it and be clear,\" Zamosky says. Tell the doctor: \"'Don't bring anyone in the room who is not participating [in the network]' so that you're not surprised by bills.\"\u003c/p>\n\u003cp>But she also adds that \"you don't have total control.\"\u003c/p>\n\u003cp>It's easy to imagine that you might need an anesthesiologist, but the only one available is out of network. A bill making its way through the California legislature, \u003ca href=\"https://legiscan.com/CA/bill/AB533/2015\" target=\"_blank\">AB533\u003c/a>, would end surprise bills by prohibiting consumers from paying out-of-network rates to doctors (or other providers) as long as they receive care at an in-network facility. If approved, the law would take effect in January.\u003c/p>\n\u003cp>\u003cstrong>What if You're Uninsured?\u003c/strong>\u003c/p>\n\u003cp>If you're pregnant, uninsured and outside the annual sign-up period for health insurance, you are out of luck for signing up for private insurance, including on Covered California. But you \u003cem>may\u003c/em> be eligible for Medi-Cal, the state's version of Medicaid, which is open for sign up year-round.\u003c/p>\n\u003cp>Pregnant women can qualify for Medi-Cal at \u003ca href=\"https://dpss.lacounty.gov/dpss/health/pregnant/medical.cfm?persona=pregnant\" target=\"_blank\">higher incomes\u003c/a> than if they were not pregnant. \"They shouldn't assume they're over income without filing an application,\" says Fogel. Medi-Cal providers may also be able to see a pregnant woman while she is waiting for her application to be processed under a program called \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/PE_Info_women.aspx\" target=\"_blank\">Presumptive Eligibility\u003c/a>.\u003c/p>\n\u003cp>Once your baby is born, there's still more to think about, insurance-wise:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Contraception:\u003c/strong> Many women choose to have an IUD inserted after they have delivered their baby, but are still in the hospital. Under the Affordable Care Act, contraception -- including the IUD, which can be expensive -- is covered at no cost-sharing for the patient.\u003c/li>\n\u003cli>\u003cstrong>Catholic Hospitals:\u003c/strong> If you are considering an IUD, be sure to talk to your doctor about it in advance. Fogle noted a big \"consumer beware\" by pointing out that Catholic hospitals may not provide them. If you are considering a Catholic hospital, she says, be sure to ask your doctor if that hospital will provide the full range of reproductive services.\u003c/li>\n\u003cli>\u003cb>Breastfeeding:\u003c/b> Counseling for breastfeeding and coverage of a breast pump must also be \u003ca href=\"https://www.healthcare.gov/coverage/breast-feeding-benefits/\" target=\"_blank\">covered at no cost\u003c/a> under the Affordable Care Act. But, especially with the pump, plans may vary in coverage. You may need a specific pump or you may need to purchase from a specific provider to get the no-cost benefit.\u003c/li>\n\u003c/ul>\n\u003cp>Of course, your baby will need health insurance, too, and you have a limited time to enroll the newborn. If you have employer-based coverage, you have \u003ca href=\"http://familiesusa.org/sites/default/files/product_documents/special-enrollment-opportunity.pdf\" target=\"_blank\">30 days to add the baby\u003c/a>. If the mother of the baby has a spouse, the spouse also has the opportunity to enroll in coverage within 30 days, says Cheryl Parcham at FamiliesUSA.\u003c/p>\n\u003cp>If you have a plan through Covered California (or any marketplace plan), \u003ca href=\"https://marketplace.cms.gov/technical-assistance-resources/helping-new-parents-enroll.pdf\" target=\"_blank\">you have 60 days to sign up the baby\u003c/a>. The additional bonus is that the whole family can pick a new Covered California plan, if you want to.\u003c/p>\n\u003cp>\u003cstrong>PriceCheck: Share What You Paid\u003c/strong>\u003c/p>\n\u003cp>Now that you have all these tips, we'd appreciate your help! While prices charged vary dramatically, it's impossible to know the variety of what insurers and consumers actually pay. That's because the \"insured prices\" are sealed by contract.\u003c/p>\n\u003cp>You can help shine a light on true costs by getting your \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">explanation of benefits\u003c/a> and heading over to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>. There you can anonymously share the price charged, what your insurer paid and what you paid, in co-pay or deductible.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>We're primarily interested in vaginal birth, but if you had a cesarean section, we'll happily take those prices, too.\u003c/p>\n\n","blocks":[],"excerpt":"In California, prices charged for a vaginal delivery range 11-fold: $3,296 to $37,227. Share what you paid!","status":"publish","parent":0,"modified":1438035484,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1300},"headData":{"title":"PriceCheck: How Much Does It Cost to Have a Baby in Northern California? | KQED","description":"In California, prices charged for a vaginal delivery range 11-fold: $3,296 to $37,227. Share what you paid!","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"PriceCheck: How Much Does It Cost to Have a Baby in Northern California?","datePublished":"2015-07-24T00:00:32.000Z","dateModified":"2015-07-27T22:18:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"50811 http://ww2.kqed.org/stateofhealth/?p=50811","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/07/23/pricecheck-how-much-does-it-cost-to-have-a-baby-in-northern-california/","disqusTitle":"PriceCheck: How Much Does It Cost to Have a Baby in Northern California?","path":"/stateofhealth/50811/pricecheck-how-much-does-it-cost-to-have-a-baby-in-northern-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Childbirth is the most common reason for hospitalization in the U.S. In California, about\u003ca href=\"http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf\" target=\"_blank\"> half a million babies \u003c/a>are born every year. Given how common it is -- and that most births are fairly uncomplicated, medically -- you'd think there would be some predictability in prices.\u003c/p>\n\u003cp>But there isn't. The price of delivery varies dramatically, both nationwide and across California. A\u003ca href=\"http://bmjopen.bmj.com/content/4/1/e004017.abstract?sid=a32193cf-85b1-4f07-b2d1-cba35214aa0a\" target=\"_blank\"> study last year\u003c/a> of more than 109,000 births at 198 hospitals statewide found a stunning 11-fold variation in prices charged for vaginal delivery -- from $3,296 to $37,227 -- and more than 8-fold for cesarean section -- from $8,312 to $70,908.\u003c/p>\n\u003caside class=\"pullquote alignright\">Share what you paid to deliver your baby. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">Help us make health costs transparent. Visit PriceCheck!\u003c/a>\u003c/aside>\n\u003cp>\"This type of variation is not unique to obstetrics,\" said the study's lead author, Renee Hsia, a physician and professor of health policy at UC San Francisco. \"This is unfortunately the state of our health care in the United States.\"\u003c/p>\n\u003cp>That's why we're turning next to childbirth in our PriceCheck project. On \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>, we're crowdsourcing the price of common medical tests and procedures. We're asking people to share what they paid -- in this case -- for childbirth. More on how you can share further below, but first, some things you should know if you're pregnant now to make sure you can minimize your bills.\u003c/p>\n\u003cp>\u003cstrong>No Co-pay for Prenatal Care ...\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under the Affordable Care Act, many preventive services -- including routine prenatal care -- \u003ca href=\"http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen\" target=\"_blank\">must be covered at no cost to the patient\u003c/a>: no deductible, no co-insurance, no co-payment.\u003c/p>\n\u003cp>\"So the first thing they should be looking for and demanding is no cost-sharing for prenatal care,\" said Susan Berke Fogel, with the National Health Law Program. Common screenings like gestational diabetes and Rh incompatibility are just two of the \u003ca href=\"http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen\" target=\"_blank\">tests included\u003c/a> at no cost to the patient.\u003c/p>\n\u003cp>The only exception is if you have a \"grandfathered\" plan. This is a plan that predated the Affordable Care Act and has not been changed much since. These grandfathered plans are not subject to many of the Affordable Care Act mandates and may not include the same benefits.\u003c/p>\n\u003cp>\u003cstrong>... But There Is for Labor and Delivery\u003c/strong>\u003c/p>\n\u003cp>While your costs will depend on your plan, you will almost certainly pay something for labor and delivery. Consumers should contact their plan to try to estimate their costs and check other requirements.\u003c/p>\n\u003cp>\"Understand specifics,\" says Lisa Zamosky, author of \"\u003ca href=\"http://lisazamosky.com/about/\" target=\"_blank\">Healthcare, Insurance and You: The Savvy Consumer's Guide\u003c/a>.\" She also worked for a large managed-care organization before becoming a writer. \"Are pre-authorizations required? Do you need to call the insurance company when you are admitted to the hospital?\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The good news is that you have time to sort this all out. Both Zamosky and Fogel stressed to make sure both your doctor and the hospital are in network. Some women prefer to deliver at a birth center, but you need to make sure the center is in network, too. If not, do the math to see how an out-of-network birth center pencils out compared with an in-network hospital. (My PriceCheck colleague Rebecca Plevin at KPCC \u003ca href=\"http://www.scpr.org/blogs/health/2015/07/22/18049/pricecheck-how-much-does-it-cost-to-have-a-baby-at/\" target=\"_blank\">looked closely at this issue\u003c/a>.)\u003c/p>\n\u003cp>Even if you are at an in-network facility, it doesn't mean all the providers are also in network. I know this from my own experience. When I delivered my daughter in 2001 at an in-network hospital, I got a $1,200 bill months later for the anesthesiologist. (It was ultimately paid by my insurer.)\u003c/p>\n\u003cp>These \"surprise bills\" are not uncommon. A\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/05/07/nearly-1-in-4-californians-hit-by-surprise-medical-bills/\" target=\"_blank\"> Consumers Union survey \u003c/a>earlier this year found almost one in four Californians who had gone to a hospital or ER got an out-of-network bill from a doctor they had thought was in network.\u003c/p>\n\u003cp>There are steps you can take before you get to the hospital to try to avoid this, Zamosky says, \"but you should know there is a risk.\"\u003c/p>\n\u003cp>She recommends having a pointed conversation with your obstetrician. \"I would be forceful about it and be clear,\" Zamosky says. Tell the doctor: \"'Don't bring anyone in the room who is not participating [in the network]' so that you're not surprised by bills.\"\u003c/p>\n\u003cp>But she also adds that \"you don't have total control.\"\u003c/p>\n\u003cp>It's easy to imagine that you might need an anesthesiologist, but the only one available is out of network. A bill making its way through the California legislature, \u003ca href=\"https://legiscan.com/CA/bill/AB533/2015\" target=\"_blank\">AB533\u003c/a>, would end surprise bills by prohibiting consumers from paying out-of-network rates to doctors (or other providers) as long as they receive care at an in-network facility. If approved, the law would take effect in January.\u003c/p>\n\u003cp>\u003cstrong>What if You're Uninsured?\u003c/strong>\u003c/p>\n\u003cp>If you're pregnant, uninsured and outside the annual sign-up period for health insurance, you are out of luck for signing up for private insurance, including on Covered California. But you \u003cem>may\u003c/em> be eligible for Medi-Cal, the state's version of Medicaid, which is open for sign up year-round.\u003c/p>\n\u003cp>Pregnant women can qualify for Medi-Cal at \u003ca href=\"https://dpss.lacounty.gov/dpss/health/pregnant/medical.cfm?persona=pregnant\" target=\"_blank\">higher incomes\u003c/a> than if they were not pregnant. \"They shouldn't assume they're over income without filing an application,\" says Fogel. Medi-Cal providers may also be able to see a pregnant woman while she is waiting for her application to be processed under a program called \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/PE_Info_women.aspx\" target=\"_blank\">Presumptive Eligibility\u003c/a>.\u003c/p>\n\u003cp>Once your baby is born, there's still more to think about, insurance-wise:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Contraception:\u003c/strong> Many women choose to have an IUD inserted after they have delivered their baby, but are still in the hospital. Under the Affordable Care Act, contraception -- including the IUD, which can be expensive -- is covered at no cost-sharing for the patient.\u003c/li>\n\u003cli>\u003cstrong>Catholic Hospitals:\u003c/strong> If you are considering an IUD, be sure to talk to your doctor about it in advance. Fogle noted a big \"consumer beware\" by pointing out that Catholic hospitals may not provide them. If you are considering a Catholic hospital, she says, be sure to ask your doctor if that hospital will provide the full range of reproductive services.\u003c/li>\n\u003cli>\u003cb>Breastfeeding:\u003c/b> Counseling for breastfeeding and coverage of a breast pump must also be \u003ca href=\"https://www.healthcare.gov/coverage/breast-feeding-benefits/\" target=\"_blank\">covered at no cost\u003c/a> under the Affordable Care Act. But, especially with the pump, plans may vary in coverage. You may need a specific pump or you may need to purchase from a specific provider to get the no-cost benefit.\u003c/li>\n\u003c/ul>\n\u003cp>Of course, your baby will need health insurance, too, and you have a limited time to enroll the newborn. If you have employer-based coverage, you have \u003ca href=\"http://familiesusa.org/sites/default/files/product_documents/special-enrollment-opportunity.pdf\" target=\"_blank\">30 days to add the baby\u003c/a>. If the mother of the baby has a spouse, the spouse also has the opportunity to enroll in coverage within 30 days, says Cheryl Parcham at FamiliesUSA.\u003c/p>\n\u003cp>If you have a plan through Covered California (or any marketplace plan), \u003ca href=\"https://marketplace.cms.gov/technical-assistance-resources/helping-new-parents-enroll.pdf\" target=\"_blank\">you have 60 days to sign up the baby\u003c/a>. The additional bonus is that the whole family can pick a new Covered California plan, if you want to.\u003c/p>\n\u003cp>\u003cstrong>PriceCheck: Share What You Paid\u003c/strong>\u003c/p>\n\u003cp>Now that you have all these tips, we'd appreciate your help! While prices charged vary dramatically, it's impossible to know the variety of what insurers and consumers actually pay. That's because the \"insured prices\" are sealed by contract.\u003c/p>\n\u003cp>You can help shine a light on true costs by getting your \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">explanation of benefits\u003c/a> and heading over to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>. There you can anonymously share the price charged, what your insurer paid and what you paid, in co-pay or deductible.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We're primarily interested in vaginal birth, but if you had a cesarean section, we'll happily take those prices, too.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/50811/pricecheck-how-much-does-it-cost-to-have-a-baby-in-northern-california","authors":["240"],"series":["stateofhealth_2492"],"categories":["stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_482","stateofhealth_28","stateofhealth_841"],"featImg":"stateofhealth_51237","label":"stateofhealth_2492"},"stateofhealth_45967":{"type":"posts","id":"stateofhealth_45967","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"45967","score":null,"sort":[1436472102000]},"guestAuthors":[],"slug":"women-are-saving-money-thanks-to-increased-birth-control-coverage","title":"Women Are Saving Money Thanks to Increased Birth Control Coverage","publishDate":1436472102,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Women are saving a lot of money as a result of a health law requirement that insurance cover most forms of prescription contraceptives with no additional out-of-pocket costs, according to a study released Tuesday. But the amount of those savings and the speed with which those savings occurred surprised researchers.\u003c/p>\n\u003cp>The study, in the July issue of the policy journal Health Affairs, found that the average birth control pill user saved $255 in the year after the requirement took effect. The average user of an intrauterine device (IUD) saved $248. Those savings represented a significant percentage of average out-of-pocket costs.\u003c/p>\n\u003cp>“These are healthy women and this on average is their No. 1 need from the health care system,” said Nora Becker, an MD-PhD candidate at the University of Pennsylvania and lead author of the study. “On average, these women were spending about 30 to 44 percent of their total out of pocket (health) spending just on birth control.”\u003c/p>\n\u003cp>The study looked at out-of-pocket spending from nearly 800,000 women between the ages of 13 and 45 from January 2008 through June 2013. For most plans, the requirement began Aug. 1, 2012, or Jan. 1, 2013. So-called “grandfathered” health plans, those that have not substantially changed their benefits since the health law was passed in 2010, are exempt from the mandate, as are a small subset of religious-based plans.\u003c/p>\n\u003cp>Becker said that while making birth control substantially cheaper may not increase the number of women who use it, the new requirements could well shift the type of birth control they use to longer-acting, more effective methods like the IUD. “If prior to the ACA a woman was facing $10 to $30 a month for the pill but hundreds of dollars upfront for an IUD and now both are free, we might see a different choice,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Researchers also found that while out-of-pocket spending dropped dramatically for most types of prescription contraceptive methods — “the majority of women were paying nothing by June 2013” –spending barely budged for the vaginal ring or hormonal patch.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That could be because under the original rules, many insurers declined to make the ring or patch free, since, like pills, they are essentially hormone delivery methods. Earlier this year, the Obama administration issued a clarification saying that while insurers do not have to offer every brand of every method, they do have to cover at least one product in each category, including rings and patches.\u003c/p>\n\n","blocks":[],"excerpt":"Under the Affordable Care Act, contraceptives must be covered without copays. A study finds savings of around $250 per year for many women.","status":"publish","parent":0,"modified":1436547205,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":9,"wordCount":434},"headData":{"title":"Women Are Saving Money Thanks to Increased Birth Control Coverage | KQED","description":"Under the Affordable Care Act, contraceptives must be covered without copays. A study finds savings of around $250 per year for many women.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Women Are Saving Money Thanks to Increased Birth Control Coverage","datePublished":"2015-07-09T20:01:42.000Z","dateModified":"2015-07-10T16:53:25.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"45967 http://ww2.kqed.org/stateofhealth/?p=45967","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/07/09/women-are-saving-money-thanks-to-increased-birth-control-coverage/","disqusTitle":"Women Are Saving Money Thanks to Increased Birth Control Coverage","nprByline":"Julie Rovner, Kaiser Health News","path":"/stateofhealth/45967/women-are-saving-money-thanks-to-increased-birth-control-coverage","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Women are saving a lot of money as a result of a health law requirement that insurance cover most forms of prescription contraceptives with no additional out-of-pocket costs, according to a study released Tuesday. But the amount of those savings and the speed with which those savings occurred surprised researchers.\u003c/p>\n\u003cp>The study, in the July issue of the policy journal Health Affairs, found that the average birth control pill user saved $255 in the year after the requirement took effect. The average user of an intrauterine device (IUD) saved $248. Those savings represented a significant percentage of average out-of-pocket costs.\u003c/p>\n\u003cp>“These are healthy women and this on average is their No. 1 need from the health care system,” said Nora Becker, an MD-PhD candidate at the University of Pennsylvania and lead author of the study. “On average, these women were spending about 30 to 44 percent of their total out of pocket (health) spending just on birth control.”\u003c/p>\n\u003cp>The study looked at out-of-pocket spending from nearly 800,000 women between the ages of 13 and 45 from January 2008 through June 2013. For most plans, the requirement began Aug. 1, 2012, or Jan. 1, 2013. So-called “grandfathered” health plans, those that have not substantially changed their benefits since the health law was passed in 2010, are exempt from the mandate, as are a small subset of religious-based plans.\u003c/p>\n\u003cp>Becker said that while making birth control substantially cheaper may not increase the number of women who use it, the new requirements could well shift the type of birth control they use to longer-acting, more effective methods like the IUD. “If prior to the ACA a woman was facing $10 to $30 a month for the pill but hundreds of dollars upfront for an IUD and now both are free, we might see a different choice,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers also found that while out-of-pocket spending dropped dramatically for most types of prescription contraceptive methods — “the majority of women were paying nothing by June 2013” –spending barely budged for the vaginal ring or hormonal patch.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That could be because under the original rules, many insurers declined to make the ring or patch free, since, like pills, they are essentially hormone delivery methods. Earlier this year, the Obama administration issued a clarification saying that while insurers do not have to offer every brand of every method, they do have to cover at least one product in each category, including rings and patches.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/45967/women-are-saving-money-thanks-to-increased-birth-control-coverage","authors":["byline_stateofhealth_45967"],"categories":["stateofhealth_15","stateofhealth_14"],"tags":["stateofhealth_38","stateofhealth_625","stateofhealth_482"],"featImg":"stateofhealth_46010","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? 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