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The ideas and innovators shaping health care | | | | |  | | By Ben Leonard and Erin Schumaker | | | | | 
Let me explain your bill. | Getty Images | Medical inflation has lagged behind economywide price increases since they started spiking in 2021, with one recent gauge putting the health care rate at 2.3 percent. But people who pay out of pocket for their medical expenses haven’t been so lucky, according to an analysis by digital health company Sesame. It examined costs in the cash-pay market, which includes the uninsured, people on high-deductible health plans and those who choose to pay instead of involve an insurer, and found the average cost for a visit grew 15 percent from $36.80 a year ago to $42.50 in May. The firm leaned on data from thousands of providers on what they charge for their services. Costs are rising for many types of care, according to the company’s metrics. Increases include: — 16 percent for urinary tract infection visits and Covid screenings — 15 percent for virtual care consultations — 11 percent for prescription refills — 5 percent for mental health visits Why’s it happening? Sesame says demand for cash-pay appointments is increasing as people use services like telehealth that may be accessed more quickly when they skip an insurance middleman. And it could get worse: The post-pandemic reassessment of Medicaid eligibility by all 50 states will leave more people without health coverage, further driving demand for cash-pay appointments. Meanwhile, the end of the public health emergency is also shifting Covid care costs to consumers.
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Mammoth Hot Springs, Yellowstone National Park | Sam Oates | This is where we explore the ideas and innovators shaping health care. Spotted: A bipartisan group of senators with an issue they can agree on. It’s a new bill that takes aim at the spotted lanternfly, the red-speckled insect threatening plants in the eastern U.S. Introduced by Pennsylvania Democrat John Fetterman, the Spotted Lanternfly Research and Development Act would make the invasive species a high-priority research initiative for the National Institute of Food and Agriculture. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Kelly Hooper talks with Robert King about his reporting on the Biden administration’s announcement that the makers of 43 drugs will have to pay rebates to Medicare because they raised prices faster than inflation —and how that will affect Medicare participants.
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Evidence is mounting that telehealth is more cost saver than cost expander. | Steve Ruark/AP Photo | A key question about telehealth’s growth is how it will impact health care costs. Advocates tout cost-saving potential, while skeptics fear that fraud and overuse could cause expenses to spiral. New research in the American Journal of Managed Care backs the cost-saving case. What did it find? That a 24/7, co-pay-free telehealth program for Penn Medicine employees cut costs by 23 percent. The average cost for a virtual care visit was $380 versus $493 for in-person visits between mid-2017 through 2019. The virtual visits tended to be for less significant issues like allergies and respiratory and sinus infections. The study adjusted for disease severity between virtual care and in-person users, said lead author Krisda Chaiyachati, an adjunct assistant professor of medicine at Penn Medicine. The study period didn’t cover the pandemic, which could have altered the results. The employees had a mean age in the mid-30s. Why it matters: Congress wants to rein in health care costs and has also shown bipartisan interest in boosting telehealth access. Recent surveys have found that Americans like using telemedicine for minor illnesses and prescription refills, while preferring in-person care for mental health appointments and emergencies. So far, evidence of widespread telehealth fraud is scant. HHS’ inspector general found last year that 0.2 percent of Medicare telehealth claims during the pandemic were a high risk for waste, fraud or abuse. However, the Drug Enforcement Administration has investigated telehealth firms for allegedly overprescribing ADHD drugs.
| | | | GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGISTER HERE. | | | | | | | | |  Amazon is taking steps to curb the emissions from its data centers. | AP | As health care increasingly goes digital, there’s an under-the-radar environmental impact. Estimates range, but data centers overall make up around 1 percent of carbon emissions, a figure that’s expected to rise as technology proliferates. And if health care as an industry were a country, it’d be the fifth-largest polluter in the world. It's worse in the U.S. than across the globe — 8.5 percent of U.S. emissions come from health care, about double the global figure. Hospitals are the largest source of emissions, even though some are trying to reduce their carbon footprints. As of now, it’s mostly a voluntary effort. In Congress: The issue has caught the eye of Democratic leadership on the Ways and Means Committee, which surveyed hospitals and other health care organizations about what they’re doing and reported the results last year. In industry: Firms like Amazon Web Services are trying to reduce the carbon impact from their data centers. Amazon is using more efficient processors that use about 60 percent less energy than other models. “When we're talking about massive machine learning and computing, which is going to take up vast amounts of energy in the future, having custom silicon that is energy efficient is going to be absolutely critical,” said Rowland Illing, chief medical officer at Amazon Web Services. Cloud firms like Google Cloud, AWS and Microsoft are competing to cut their carbon emissions by reporting publicly how they’re doing.
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