Inside the ‘Black Box’ of Health Care Spending Data

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WHEN ATUL GAWANDE famously dubbed McAllen, Texas one of the most expensive health-care markets in the country in the New Yorker, the critique was based on Medicare spending patterns. Data from private insurance plans wasn’t available. But groundbreaking new research based on a new private-payer database has changed that, and journalists can now see how much private-insurance plans are paying for common procedures and per person in communities across the U.S. One early surprise: Spending patterns for Medicare and private plans in a given locale are often totally different. So, while McAllen today is the fourth most expensive health-care market in the country when it comes to Medicare spending, it is in the middle of the pack when it comes to private plans. This webinar will help journalists and policy makers contextualize the private-payer data, discuss possible policy responses, and offer suggestions for how reporters can use this resource to bolster their reporting. 

Webinars are free and made possible by the National Institute for Health Care Management Foundation

The Health Matters Webinar series is supported by the National Institute for Health Care Management Foundation. The Center for Health Journalism is solely responsible for the selection of webinar topics and speakers.

Panelists


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Zack Cooper

Zack Cooper, Ph.D., is an assistant professor of health policy and of economics at Yale University. He is also a resident fellow at the school’s Institution for Social and Policy Studies, where he directs the ISPS Health Center. Cooper’s work is focused on using big data analysis and economic research to improve health care policy. Cooper received his undergraduate degree from the University of Chicago, and his doctorate from the London School of Economics, where remains a faculty associate at the school’s Centre for Economic Performance. His research on health care spending on the privately insured can be found at www.healthcarepricingproject.org.

 

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Martin S. Gaynor

Martin S. Gaynor, Ph.D., holds the E. J. Barone Professorship of Economics and Health Policy at Carnegie Mellon University. His research focuses on competition in health care markets and the role of incentives within health care. Gaynor also is the former director of the Bureau of Economics at the Federal Trade Commission, and has served as a consultant to the U.S. Department of Justice and the California Department of Corporations on antitrust issues. He’s a research associate of the National Bureau of Economic Research in Cambridge, Mass., and the Centre for Market and Public Organization at the University of Bristol in the U.K.

 

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Dan Gorenstein

Dan Gorenstein is the senior reporter for Marketplace’s Health Desk, covering the business of health care. Before joining Marketplace in 2012, he spent more than 11 years at New Hampshire Public Radio. He got his start in journalism at the Chicago Reporter, an investigative journal that examines race and class disparities in Chicago. He has won numerous national and local awards, including a Sigma Delta Chi investigative reporting award from the Society of Professional Journalists. In 2014, Gorenstein completed a National Health Journalism Fellowship at USC Annenberg. He earned a bachelor’s degree in human development and social relations from Earlham College.


 

 


Suggested reading & resources

The Experts Were Wrong About the Best Places for Better and Cheaper Health Care,” by Margot Sanger-Katz and Kevin Quealy, The New York Times

Where Health Care Is Better and Cheaper: Answers to 10 Questions,” by Margot Sanger-Katz and Kevin Quealy, The New York Times

Health Care’s Price Conundrum,” by Atul Gawande, The New Yorker

An unprecedented look at medical costs nationwide,” by Dan Gorenstein, Marketplace

Why Are Hospital Prices So Crazy? Hint: The Hospitals May Not Be At Fault,” by John C. Goodman, Forbes

Want Lower Health Care Costs? Encourage Competition.” By Kevin Drum, Mother Jones

Data suggest hospital consolidation drives higher prices for privately insured,” by Melanie Evans, Modern Healthcare 

Health Care Pricing Project, by Zack Cooper et al.

National Chartbook of Health Care Prices, 2015, Health Care Cost Institute

The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured,” Zack Cooper, Martin Gaynor, Stuart V. Craig, John Van Reenen

"The Limits of Using Medicare Data to Evaluate U.S. Health Care Spending," by Donald Moulds, The Commonwealth Fund blog