MedBen was recently informed of the sale of HealthSpan, which many of our clients use as a provider network in Southwest Ohio, Southeast Indiana, and Northern Kentucky. HealthSpan has agreed to sell its network and other lines of business to Medical Mutual of Ohio and will cease operations in January of 2017.
MedBen has talked with both HealthSpan and Medical Mutual of Ohio about this acquisition and has begun evaluating the best options for our clients. We have been a network partner with both organizations for over 15 years and believe this purchase will result in improved options for MedBen clients, along with a greater flexibility in benefit solutions.
Both organizations have indicated that nothing will change for the remainder of 2016, allowing us to work with brokers, consultants, and clients in the coming months to determine the best benefit solutions.
MedBen clients that currently offer the HealthSpan network can expect to hear from MedBen soon. In the meantime, clients with questions regarding the acquisition are welcome to contact MedBen President and COO Kurt Harden at (888) 633-2364.
Important news for employers looking ahead to 2017 benefit planning: The U.S. Department of Health and Human Services has raised the maximum out-of-pocket amount that health care plans can require plan members to pay next year, based on final regulations recently released by the agency.
Starting in 2017, the maximum out-of-pocket expenses employers can require employees enrolled in group plans to pick up will be $7,150 for single coverage and $14,300 for family coverage. That compares with 2016 limits of $6,850 for single coverage and $13,700 for family coverage.
According to Business Insurance, the proposed boost in the out-of-pocket limit is based on a methodology laid down by the Affordable Care Act (ACA) and is tied to increases in group health care plan premiums.
While we're on the subject of benefit planning, we'll take this opportunity to remind you of two notable ACA fees for the rest of 2016:
2016 PCORI (Patient-Centered Outcomes Research Institute) Fee
2016 Transitional Reinsurance Fee
MedBen clients who have questions regarding their plan's out-of-pocket maximums or ACA fees are welcome to call their Group Service Representative or Caroline Fraker, Vice President of Compliance & Chief Privacy Officer, at firstname.lastname@example.org.
MedBen University (MBU) launched its 2016 series of benefits management seminars with a well-attended session that offered an extensive look at the current state of the Affordable Care Act.
Entitled "Navigating the Health Care Reform Storm" and presented by MedBen Vice President of Compliance Caroline Fraker, the session covered a variety of topics, from 2016 plan design considerations to potential employer penalties and fees. Fraker also touched briefly on 1094 and 1095 reporting, a topic with she dealt with in depth at an MBU event last October.
One of the items discussed in some detail was ACA guidance offered to health care plans though the latest in a series of FAQs released by the U.S. Department of Labor. "These are sort of informal, 'this-is-what-we-really-meant-when-we-wrote-the-law' clarifications," Fraker said.
The 29th FAQ is something of a "pot luck" of health care reform issues. One noteworthy clarification pertains to preventive services: Any ancillary services to the preventive care, such as a follow-up to a mammography, must also be covered at 100%. "And they went even further to say that you can't impose a general exclusion in your plan that would impact a recommended preventive service," Fraker added.
The FAQ also requires that non-grandfathered plans must not only cover screenings for obesity in adults at 100%, but weight management services as well. However, Fraker noted, the guidance does allow for "reasonable medical management techniques," such as prior authorization and ensuring that a proposed treatment matches the diagnosis.
A new series of studies show that employer health plans can save thousands of dollars by encouraging the use of outpatient facilities for certain medical treatments, Forbes reports.
The studies examined four common medical procedures – hysterectomy, lumbar/spine surgery, angioplasty and gallbladder removal – that cost health plan members and their employers $11 billion in 2014. Once performed strictly in hospitals and necessitating inpatient stays, advancements in medical technology now enable physicians to offer these procedures on an outpatient basis, saving plan and patient alike from the added costs associated with hospital stays.
As the table above demonstrates, the total per-procedure costs in 2014 for outpatient care was substantially lower compared to inpatient treatment, ranging from $4,505 for hysterectomies to $17,530 for angioplasties. Moreover, patients who chose the outpatient option also realized significant out-of-pocket savings.
While not all medical treatments are available on an outpatient basis, the number of procedures has grown in recent years, likely contributing to the slower rise in health care spending during the past decade. The ongoing shift away from fee-from-service care to a value-based system has also encouraged the health care industry to find more efficient methods of delivering medical services.
The U.S. Justice Department has made its final round of settlements with hospitals suspected of excessive use of implantable cardiac devices (ICDs) following a five-year study. Meanwhile, MedBen has been protecting clients from this expensive practice for nearly a decade.
According to Modern Healthcare, 51 more hospitals – several leading hospital systems among them – will pay the government $23 million to end their probe into suspected overuse of ICDs. This follows a similar settlement in 2015 by 457 hospitals for more than $250 million.
ICDs are implanted near the heart to detect and treat arrhythmia – fast, life-threatening heart rhythms – by delivering a shock to the heart. Medicare allowed their for primary prevention of arrhythmia beginning in 2005, with the caveat that it wouldn't pay for devices implanted within 40 days of a heart attack or 90 days of bypass surgery or angioplasty. Even so, upwards of 40% are implanted contrary to clinical practice guidelines, when a less expensive pacemaker, or even medication, may have been sufficient to treat the condition.
MedBen follows research-based clinical criteria for appropriate placement of ICDs. Since 2007, we have employed cardiologists to perform clinical reviews on these devices on behalf of our clients, as a standard part of our clinical review process – and have saved clients $2.5 million in the process.
ICDs are among the most expensive devices to treat abnormal heart rate, costing $40,000 or more per unit, and need to be replaced every 5 years. Therefore, MedBen believes it essential to rely on expert physician reviewers to review charges like these that aren't caught by coding software and standard claim payment reviews.
MedBen's surveillance system flags claims for possible clinical issues like ICDs, in addition to a variety of other reasons, such as large loss potential for the employer or inappropriate provider billing. We focus on ensuring that our clients pay only for appropriate care, saving money for employer and patient alike.
Clients with questions regarding MedBen’s clinical review procedures are welcome to contact President and COO Kurt Harden at 888-633-2364.
A hospital in Los Angeles made national headlines recently when, following a cyberattack that disabled the facility's computer devices for over a week, it paid a $17,000 ransom to regain system access. However unusual the circumstances may seem, the threat of this type of attack is genuine, and it's the reason that MedBen employs multiple safety protocols to guard against it.
MedBen maintains constant vigilance against cyberattacks, using a series of external, internal and physical safeguards. Among the keys to our cybersecurity strategy are multiple layered hardware devices which prevent access to our internal networks. Additionally, all incoming and outgoing emails are scanned by a hardware device to detect and quarantine malware, and all devices accessing the Internet must pass through a hardware device that scans the traffic in either direction.
As a further measure of security, MedBen is subjected to an annual penetration test from an outside auditing firm. The timing of these tests and the manner in which they are executed is unknown to anyone at MedBen. The most recent breach attempt in 2015 proved unsuccessful – the same result as all previous tests.
The security and privacy of client information is of paramount importance to MedBen, as is ensuring uninterrupted systems operation. We make it our mission to earn your continuing trust in every way possible.
MedBen clients with questions regarding our cybersecurity measures are welcome to contact Vice President of Information Systems and Chief Privacy Office Rose McEntire at email@example.com.
The introduction of state and federal insurance marketplaces through the Affordable Care Act has not deterred most U.S. employers from offering group health care coverage, Healthcare Dive reports.
According to a recent Kaiser Family Foundation survey, employers today still provide health care coverage to 147 million people, over half of the working-age population – virtually unchanged from 2015. A handful of smaller employers (4%) have switched some full-time employees to part-time status, but even more (10%) have done the opposite.
“Employers are very hesitant to drop health benefits,” said Paul Fronstin, director of the health research and education program at the Employee Benefits Research Institute. “They don’t want to be the employer that did so in a tight labor market.”
Large employers – those with 50 or more employees – must, under ACA rules, offer health insurance to 70% of full-time employees or pay a penalty. But that fact notwithstanding, employers cite other reasons for continuing to provide coverage, including the slow growth in health care costs during the past few years and concerns about provider availability through the public marketplaces.
Offering a customized health care plan also allows employers to promote wellness and ensure that employees have access to necessary benefits, said Fronstin: “They want them to come to work healthy and to be productive, and they may have their doubts about the public exchanges’ ability to give the kind of care that they think their employees need to get.”
A new Columbus Business First survey reveals that MedBen is Central Ohio's leading third-party administrator, as ranked by local TPA employees. With 147 TPA employees residing in Licking, Franklin and surrounding counties, MedBen employs over 100 more local workers than the closest competition.
"As our home office has been based in Licking County for nearly eight decades, we've seen first-hand what a tremendous talent pool there is in Central Ohio," said Kurt Harden, MedBen President & COO. "And we're doubly fortunate that so many of them have chosen to work here and stay with MedBen for many years."
MedBen introduced third party administration in 1989, at a time when it specialized in traditional group health insurance. As the company evolved, it expanded its focus to cost-saving solutions for self-funded employers. The employee count grew accordingly, from about 25 employees in the late 1980's to its current number.
Harden says that employee growth is not merely a matter of needing more people to serve an ever-growing number of clients. "Over the years, MedBen has implemented a variety of ways to help clients save money, such as physician-directed claims surveillance and a groundbreaking pass-through prescription drug program. As such, we now have dedicated employees to ensure that our clients see the greatest financial return possible from these services."
Being that heart disease and stroke are the nation’s numbers one and five causes of death, MedBen WellLiving encourages individuals to seek proper care for their hearts. This includes at least one yearly visit to your family physician for a wellness exam, to monitor any changes with your heart or other areas of health.
According to the American Heart Association, 150 minutes of moderate (75 minutes of vigorous) physical activity per week reduces your risk of heart disease and stroke. Don’t be alarmed if you’re thinking, “I don’t have time for that” – physical activity is considered to be anything that gets your body moving and burns calories.
Going further than regular exercise, maintaining a hearty diet is also a necessity for a healthy heart. Eating foods such as fruits and vegetables, whole grains, or low-fat dairy products will help you to maintain an overall healthy diet. WebMD confirms that foods such as salmon, black beans, oranges, low-fat yogurt, and walnuts are proven to help save your heart.
Having a healthy diet and exercising regularly also help to improve or maintain one other major factor of your heart’s health: weight. There are many ways to check your BMI (Body Mass Index), which calculates an ideal weight range based on your height, but WellLiving suggests speaking with your physician about what a healthy weight means specifically for you.
The U.S. Department of Health and Human Services (HHS) is taking bold measures to move Medicare payments from the traditional model to alternatives based on the value of the services given. MedBen Analytics is currently working with providers nationwide to help them make this transition in a performance-efficient and cost-effective manner.
At the World Economic Forum Annual Meeting in Switzerland last month, Secretary Sylvia M. Burwell said HHS will meet their goal of moving 30% of fee-for-service Medicare payments to bundled payments and other value-based arrangements by year end. The agency has also set the goal of tying 50% of Medicare payments to alternative payment models by the end of 2018, Healthcare Dive reports.
HHS states that the use of alternative payment models has:
As bundled payments and other value-based payment models become more commonplace, and an ever-greater number of older Americans become eligible for Medicare, providers need to have the tools required to make informed decisions about the delivery of care. Toward this goal, MedBen Analytics turns claims data into actionable insights necessary to improve performance.
MedBen Analytics' proprietary analytics software takes the numerous and disparate Medicare files available to bundled payment initiative hospitals, health systems and physician practice participants and creates straightforward, interactive reports to benefit the provider of care as well as the recipient.
Organizations interested in discussing MedBen Analytics' services can call President and COO Kurt Harden at 888-633-2364 or email him at firstname.lastname@example.org.
Prostate-specific antigen (PSA) testing has declined as a standard wellness screening in recent years... but the likelihood of a recommendation depends largely on whether your doctor is a primary or specialty care provider.
In 2011, the U.S. Preventive Services Task Force advised against routine screenings for all men over 50, instead suggesting that men discuss options with their family doctor and make an educated decision about testing based on family history, lifestyle and symptoms. The American Cancer Society (ACS) and MedBen WellLiving also support this recommendation.
HealthDays News reports that, according to new research, PSA testing by primary care physicians decreased from 36% to 16% between 2010 and 2012, but testing by urologists fell only from 39% to 34% during the same period. The study authors suggest this discrepancy may be due to different perceptions of the benefits of the test among doctors, conflicting prostate cancer screening guidelines, and differences in patients' demographics or expectations.
"Moving forward, this finding emphasizes the need to continue interdisciplinary dialogue to achieve a broader consensus on prostate cancer screening," the researchers from Brigham and Women's Hospital in Boston concluded.
To reduce the risk of prostate cancer, the ACS recommends eating a diet rich in vegetables and fruits (at least 2½ cups each day), staying physically active, and maintaining a healthy weight.
In hopes of salvaging the Affordable Care Act's unpopular "Cadillac" tax, President Obama has proposed revising it as part of the 2017 federal budget, using individual health insurance marketplace plans as a new threshold yardstick.
According to Business Insurance, administration officials revealed that the proposal would change the threshold for the 40% employer excise tax from an across-the-board amount to one that would vary based on regional individual health care costs. In any state where the average marketplace premium for "gold" coverage exceeds the current threshold, the tax trigger would be set at the level of that average gold premium.
“This policy prevents the tax from creating unintended burdens for firms located in areas where health care is particularly expensive, while ensuring that the policy remains targeted at overly generous plans over the long term if health costs rise faster than the tax thresholds,” Jason Furman, chairman of the administration's Council of Economic Advisers, and Matt Fiedler, the council's chief economist, wrote in a New England Journal of Medicine article.
The threshold value is currently set at $10,200 for individuals or $27,500 for families, based on the tax's original 2018 start date. With implementation now pushed back two years, these amounts will likely increase before the tax takes effect.
Employer groups say that the change is appreciated but insufficient. “Its impact in high-cost areas is just one of its many problems,” James Klein, president of the nonprofit American Benefits Council, said in a statement. “It also unfairly hits health plans that cover large numbers of women, older workers and families suffering catastrophic health events. In short, the Cadillac tax cannot be fixed. It must be repealed.”
Bloomberg View columnist Megan McArdle adds that applying a different criteria to the tax will ultimately prove self-defeating: "If you want to control costs, the areas you want to target are the ones with higher average costs. Instead, the administration is perversely giving those areas a special exemption from the tax."
The White House released the federal budget on February 9.
(Post updated February 10 to reflect proposal's inclusion in budget.)
High-cost brand-name drugs are a frequent topic of discussion, but recently a different wrinkle on pharmacy pricing has joined the conversation: huge price increases in typically lower-cost drugs. And it's another reason that MedBen makes controlling drug spending a priority.
Turing Pharmaceuticals made headlines last year when it raised the price of its anti-parasitic drug Daraprim more than 5000%, from $13.50 a pill to $750. But while that's an extreme example of spiking drug costs, it's hardly the only one. According to Bloomberg Business, a new survey of about 3,000 brand-name prescription drugs found that prices more than doubled for 60 and at least quadrupled for 20 since December 2014. Overall, the cost of many drugs has continued to rise at annual rates of more than 10%.
As the U.S. winds its way to choosing a new president, the question of how to best control drug prices will undoubtedly pop up in many a debate and campaign ad in 2016. But rather than hold out for a government solution, MedBen is doing its part right now to help clients keep prescription drug costs in check.
Because MedBen believes a high dispense rate for generic drugs is key to controlling spending, our average discount on generics regularly exceeds 77%. Generics are available in nearly every drug class, and each increase in the generic dispense rate results in a 2% decrease in cost.
MedBen finds intelligent ways to reduce drug spending while ensuring that patients have access to the medications they need. Learn more about our Rx advantage by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
The percentage of U.S. babies that get flu shots has risen dramatically in the past decade... but the numbers still come in well short of expectations, according to a new study.
HealthDay reports that about 45% of babies aged 6 months to 23 months got vaccinated against the flu during the 2011-12 flu season. While that's a vast improvement over the 2002-03 rate of just 5%, that U.S. Centers for Disease Control and Prevention recommends that most children 6 months and older get a flu shot every year. (MedBen WellLiving guidelines advise clients to consult their pediatrician or family physician regarding childhood influenza immunizations.)
"While flu vaccination for children has gone up, there is still a long way to go to protect every child," said study lead researcher Tammy Santibanez, an epidemiologist with CDC's National Immunization Program. She added that special emphasis should be placed on encouraging black and Hispanic parents to get their children a flu shot, as their vaccination numbers are typically lower than those of white children.
On average, 20,000 children under 5 years of age are annually hospitalized because of complications from the flu. During last year's flu season, more than 140 children died from flu, the CDC said.
"Both parents and doctors can work together to do a better job at ensuring that children are fully vaccinated and protected against the flu," Santibanez said.
The 2016 season of MedBen University will soon be in session! For the 15th straight year, MedBen will be offering a variety of events that provide attendees with information they can use to be smarter consumers of health care.
If you’ve never had the opportunity to attend a MBU, we encourage you to join us at an upcoming session. Not only will you receive practical guidance about health care planning and timely updates about regulatory developments, you’ll have the opportunity to pose questions to a team of benefit management professionals and discuss coverage concepts with other self-funded employers. And you're welcome to attend even if you're not a current MedBen client!
The following sessions will be held at the C. Arthur Morrow Conference Center, 1821 W. Main St., Newark, Ohio (located next to the MedBen home office):
Navigating the Health Care Reform Storm
Thursday, February 25
The delay of the "Cadillac" tax and other recent changes to the Affordable Care Act have further complicated an already confusing law. We'll bring you up to date on the current state of health care reform and explore what's to come in 2016 as another presidential election nears. In addition, we'll share important cautionary information regarding the growing use of ACA scare tactics on self-funded employers.
Thursday, March 24
Thursday, April 7
These industry-specific events offer employers a unique opportunity to learn how health care spending trends affect their bottom line, and get strategies they can use to keep medical and pharmacy costs in check. Plus, attendees can see first-hand how their plans compare with those of other businesses.
And we're just getting started! Once again, we'll take MBU on the road to conduct sessions throughout the Midwest. We’re currently planning additional events in multiple states for the first half of 2016. If you're a MedBen client and we’re coming to your area, we’ll be sure to see that you get an invitation to attend.
To register for one or more of the MBUs listed above, or to receive additional information about upcoming events (whether you're a MedBen client or not), please contact MedBen Sales Analyst Sally Wood at (800) 423-3151, Ext. 502 or firstname.lastname@example.org. We look forward to seeing you at a future MBU!
"Data transparency will help drive success in the new world of value-based and bundled payments." That's the message MedBen President and COO Kurt Harden shared with hospital, health system, and provider group representatives at the 2nd Annual Bundled Payment Implementation Forum on January 25.
“The old world of health payments has been about delayed, withheld, filtered, and segmented information,” Harden told conference attendees. "The new world will need more on-demand, widely dispersed, useful, and comprehensive data use."
Harden was among the featured speakers at the conference, which offered professional perspectives on bundled payments, an increasingly common form of provider compensation.
As the Centers for Medicare and Medicaid Services (CMS) move away from a fee-for-service reimbursement model, a variety of alternative reimbursement models are being implemented. CMS Director, Sylvia Burwell says that 90% of the CMS payments will be in the form of alternate payments by 2018 – among them, bundled payments.
In a bundled payments model, hospitals, health systems, and providers are incentivized to meet payment targets for entire episodes of care. For example, the payment for a hip or knee replacement would cover all elements of the procedure, including the hospital stay, replacement joint, physician charges, anesthesia, most medications, and care for up to 90 days following discharge from the hospital.
Early indications from a variety of nationwide tests on this approach have shown success in controlling costs and improving outcomes for patients. As a result of those successes, CMS announced a mandatory lower joint replacement bundle to be implemented in 67 markets across the U.S. This mandatory bundle, known as the Comprehensive Care for Joint Replacement model, or CJR, will affect over 800 hospitals nationwide who perform lower joint replacements on Medicare recipients.
The U.S. Centers for Disease Control (CDC), in association with the American Diabetes Association and the American Medical Association, has launched a campaign to raise awareness about prediabetes, a serious health condition that affects more than one in three American adults.
HealthDay News reports that most people who have the condition, which is characterized by higher-than-normal blood sugar (but lower than full-blown diabetes), aren't aware of it. Gone untreated, prediabetes can lead to Type 2 diabetes within five years, as well as heart attack and stroke.
To determine your risk of prediabetes, the CDC has created a quick and easy online test at DoIHavePrediabetes.org.
"One of the problems with prediabetes and diabetes is that people sometimes don't feel sick until it's too late" said Dr. Mary Vouyiouklis Kellis, an endocrinologist at Cleveland Clinic. "If they are at higher risk, this [test] will hopefully prompt them to seek medical attention sooner."
If you are determined to be at risk for diabetes, simple changes in activity and diet can make a big difference.
"Losing 5 to 7% of body weight can significantly reduce your risk as well as making lifestyle changes, which include portion control, reducing foods with refined sugars and exercising regularly," Kellis added. "Exercising just 30 minutes a day, five days a week, can also help reduce this risk."
It also benefits to have a family doctor who serves as a lifestyle mentor. The MedBen WellLiving Primary Prevention program encourages regular checkups and recommended care, thereby improving the chances of catching diabetes and other chronic conditions in their earliest stages. Moreover, seeing a physician regularly provides an added incentive to maintain healthy habits.
Got more information about Primary Prevention through MedBen WellLiving by contacting Vice President of Sales & Marketing Brian Fargus at email@example.com.
The January 23 edition of the Newark Advocate features a "Q&A" interview with MedBen Chairman & CEO Doug Freeman and President & COO Kurt Harden. Speaking to reporter Kent Mallett, Freeman and Harden discuss changes to the health benefits management company over the past three decades and the challenges moving forward.
Asked about what they're most proud of about MedBen, Freeman answered, "We’re still here, and we’re growing and have great people that have stayed. Most of the senior staff has been here 20 years.” The biggest challenge, Freeman said, is "being relevant in a market that changes practically daily."
Other interview excerpts:
Q. What would you like people to know about this company they may not know?
Doug: “We’re not a household name, except for people that sell us or companies that hire us. But for general public, we’d like to be known for what we do in the community.”
Kurt: “Last year, employees raised $9,500 for Operation Feed, and MedBen added $15,000 to that. Our employees are people we’re very proud of and are very involved in the community.”
Q. How have things changed since the Affordable Care Act became law?
Doug: “It has completely changed the way we do business in so many ways, it’s hard to even fathom it. We discovered along the way, in complying with all the requirements, that we have a very good IT department. The MedBen I inherited when I came here in 1983 doesn’t exist anymore. What we were doing then, we’re not doing any of it now.”
The article also highlights the two men's activities outside MedBen, such as Freeman's work with the Community Health Clinic of Newark and Licking County, and Harden serving on the Newark School Board and City Council. Additionally, Freeman and Harden are asked several "lighter side" questions, such as their favorite TV shows and books, and which person they most admire in their lives (both wisely replied, "My wife").
For the third consecutive year, MedBen was pleased to serve as a premier sponsor for the Granville Turkey Trot (GTT). The 5K fun run/walk, held on November 26, 2015, raised $110,000 for the Food Pantry Network of Licking County – $10,000 more than the previous year.
Over 2,500 participants got up early on Thanksgiving morning to support the Food Pantry’s mission of ensuring that area families have nutritious food available to them during the holidays and in other times of need. Thanks to their efforts as well as those who donated online as “virtual runners,” the Food Pantry can continue to supply more than 3,600 meals each day in Licking County.
In addition to MedBen's role as a premier sponsor, company Chairman & CEO Doug Freeman serves on the GTT committee.
St. Luke’s Church in Granville has spearheaded GTT since its 2006 inception. Overall, the event has raised $422,500 for the Food Pantry Network. The 5K is truly a community event, as the participants' efforts are supported by hundreds of supportive spectators and helpful volunteers, all who give generously of their time.
MedBen would once again like to thank everyone who made the Turkey Trot such a success – in particular, the MedBen employees who contributed a portion of their Thanksgiving to help those less fortunate by volunteering or participating in the event. We look forward to seeing you all again this coming November!
A new study of end-of-life practices in the United States and other industrialized nations suggests that while American doctors are more aggressive in their treatment of terminally ill cancer patients, most patients do spend their final days in places other than hospitals.
According the online site Stat, an analysis of health records from 2010 to 2012 of more than 389,000 cancer patients in the United States, Canada, Belgium, the Netherlands, England, Germany, and Norway over the last six months of their lives found that American cancer patients were more than twice as likely than those in other countries to end up in the intensive care unit, and American patients were more likely to receive chemotherapy.
“We’re still overusing the high-tech aspects of medical care,” said Dr. Ezekiel J. Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania and the study’s senior author. “The ICU, the chemotherapy, it seems like we can’t fully control ourselves when it comes to those high-tech elements.”
The United States spent at least $18,500 per patient in their final months, roughly the same amount spent by Canada and Norway, but about twice as much as England.
The finding that American cancer patients are the least likely to pass away in a hospital (only 22% compared to Canada's 52%) comes as something of a surprise, going against long-held conceits. But as more terminally ill patients express a wish to die at home, the U.S. health system is becoming more responsive to such requests.
The study does comes with several large caveats, however. While all individuals in the study were cancer patients, some ultimately died from other diseases. Also, unlike the other countries analyzed, the U.S. doesn't include physician costs in its hospital cost data -- a discrepancy that could add another 11.5% to total expenditures, potentially bringing U.S. costs to at or near the highest in the study. As such, Emanuel said he considers the study “hypothesis-generating and not definitive.”