6 recent payer studies to know

From long COVID-19 costs to comparisons of Medicare plans, here are six recent study findings involving payers Becker's has reported on since Sept. 1. 

  1. Long COVID-19 costs are outpacing the cost of diabetes for employers, a study from healthcare provider Nomi Health found. On average, long COVID-19 cost employers $600 more per member than the average diabetes episode. Per member spending on long COVID-19 through June 2022 was $2,654.67. 
  2. Traditional Medicare enrollees are more likely to receive low-value care than Medicare Advantage enrollees, a study from Humana and Tufts University found. The study found among Medicare Advantage enrollees, those who had HMO plans were less likely to receive low-value care than those with PPO plans.
  3. Payers generally negotiated lower prices for healthcare exchange plans than commercial group rates at the same hospital, a study from researchers at the University of Southern California found. The study compared price transparency data at the nation's largest hospitals and found exchange reimbursement rates were around 89 percent of the amount paid for commercial groups. 
  4. Capping out-of-pocket costs monthly, rather than on an annual basis, couldresult in savings for patients, a study from Boston University, Emory University and Vanderbilt University researchers found. Instituting a $500 monthly limit resulted in a median 45.5 percent cost decrease for those whose monthly costs exceeded the cap, according to the study. 
  5. Medicare Advantage and traditional Medicare enrollees report similar levels of satisfaction with their care, an analysis from Kaiser Family Foundation of 62 studies comparing the two plans found. The analysis found few major differences between the two types of Medicare plans.
  6. Dual-eligible Medicare Advantage plans did not outperform typical Medicare Advantage plans on measures of equity, a study from the University of Pittsburgh and College of William and Mary found. The plans generally outperformed traditional Medicare on measures of quality and satisfaction.

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