OpenHealthDataHub

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Opioid Prescribing Collapsed — But One Drug Kept Climbing openhealthdatahub.com/blog/opioid-pr…

Vermont had 5.34 buprenorphine claims per 1,000 Medicare Part D claims in 2016. New Jersey had 0.86. Same country, same drug, nearly 6x difference in access.

Sepsis Billing Exploded After a Definition Change — Not an Outbreak openhealthdatahub.com/blog/sepsis-bi…

Sepsis billing grew by 250,000 Medicare discharges after the 2015 definition change — but the payment premium over all DRGs collapsed from 21.7% to 2.8%. More cases, lower average acuity.

Young Men's Blood Pressure Is the Epidemic No One Is Treating openhealthdatahub.com/blog/young-men…

90.6% of young men with Stage 2 hypertension are insured — yet 23.2% of men aged 18-39 have undiagnosed high blood pressure, more than double the rate for young women. Coverage isn't the problem.

Cost-Skipping at the Doctor Is Getting More Common, Not Less openhealthdatahub.com/blog/cost-skip…

Among insured adults who recently lost their jobs and didn't graduate high school, 25% still skipped a doctor visit due to cost. Having coverage and being able to use it aren't the same thing.

Office Visits Cost Medicare 40% More Than You Think They Do openhealthdatahub.com/blog/office-vi…

Medicare pays $82.03 for a standard office visit — but the same visit billed from a hospital outpatient department costs the system more overall, because the hospital adds a separate facility fee on top of the reduced physician payment.

Sepsis fell victim to Goodhart’s law Sepsis used to be a clinical diagnosis without rigid criteria … but you knew it when you saw it But then … it became a “quality measure” … but in order to measure it objectively, it had to be defined. Objectively Hospitals and insurers LOVE the new definition of sepsis 1. It pays more for the diagnosis. 2. It makes less sick patients appear more sick Why is this a plus? If you cure more septic people, your stats look better than average But of course … at some point it’s mandatory… why? Because if you refuse to play the game, the hospital across town will throw out better stats than you Why would insurers love it? Because Medicare gives bonuses to MA plans if they are responsible for sicker patients.

Medicaid's Mental Health Spending Boom Nobody Planned For openhealthdatahub.com/blog/medicaid-…

259 Medicaid providers captured 36.3% of behavioral health spending on key codes in 2024. Four years earlier, it took 220 providers to capture just 26.9%. The pool shrank and the concentration grew.

Which Medical Schools Produce the Most Underserved-State Doctors? openhealthdatahub.com/blog/which-med…

University of Vermont sends 23.12% of its graduates to low-clinician states — the highest rate of any medical school. The #2 school, University of Washington, is at 15.02%. Most schools aren't close to either.

One Drug Ate Medicare's Entire Drug Budget Growth for a Decade openhealthdatahub.com/blog/one-drug-…

One blood thinner, apixaban, consumed 13.18% of Medicare Part D's entire decade-long spending growth. It went from $24.7 million in 2013 to $17.4 billion in 2023. No other drug came close.

Sepsis Is Now Medicare's Single Biggest Expense openhealthdatahub.com/blog/sepsis-is…

Medicare's single most expensive DRG isn't hip replacements or heart failure. It's sepsis — one code alone generated $77.97 billion in payments from 2013–2023, roughly $33 billion more than the next closest DRG.

Poor Americans Have Older Blood: The Inflammation Gap openhealthdatahub.com/blog/poor-amer…

Obese current smokers below the poverty line have a mean hsCRP of 8.49 mg/L. Obese current smokers with higher incomes: 3.51 mg/L. Same risk factors, 2.4x the inflammation.