Health care providers fear rising costs in 2020 as Obamacare becomes a ‘death spiral’

Health care delivery systems across the country are grappling with rising costs.

Some, like Medigap, are already struggling with the prospect of even higher costs as Obamacare looms large over the rest of the country.

Some have already raised the prospect that they might close down, or have already been forced to shut down, by the costs.

Here’s a look at what that means for them and for the patients they serve. 

1.

Hospitals are getting more expensive: As Vox’s Adam Liptak noted last year, the ACA’s expansion of Medicaid coverage was the most expensive in the nation.

As a result, a number of hospitals in many states are closing down.

A recent report from the Commonwealth Fund says the number of Medicare patients receiving care in hospitals across the U.S. is now roughly 2.5 million. 

2.

Medigaps are getting less profitable: The Affordable Care Act has mandated that states run a single-payer health care system, which would result in a big reduction in the price of the medicine and the ability to pay for it.

The idea is to cut the costs of prescription drugs and other services for the people who are getting them, while also allowing insurance companies to sell cheaper plans. 

3.

Hospice care is becoming more expensive.

According to the Commonwealth Care Institute, the average Medicare patient in the U, which is the largest group of people receiving care, pays about $4,400 a year for hospice care.

The price of that care, on average, has gone up to about $12,700 a year, which translates into a $2,000 savings over a typical year.

That’s a big chunk of change, especially for those who are already under-insured. 

4.

Hospices are getting cheaper: Some doctors are already turning away patients because of their inability to pay.

In 2018, one of the largest health systems in the country, Mercy Medical Group, cut its patient rolls in half because of the law. 

5.

Hospi-care providers are getting pricier: Hospitals have become so expensive that they’ve become increasingly reliant on prescription drugs.

According the Commonwealth Healthcare Institute, only about 5 percent of doctors in the United States are currently taking Medicare prescription drugs, a drop from 20 percent a few years ago. 

6.

Hospicare costs are going up: Hospi clinics and medical homes are now becoming more costly.

In 2017, the Commonwealth Health Center at Johns Hopkins University found that Medicare patients are paying $1,934 for an average of 6.6 prescriptions for a drug.

That is a huge increase from the previous year, when Medicare was paying $717 for the same amount of prescription medication. 

7.

The ACA has been bad for doctors: The law has increased the cost of primary care and specialty care, which are primary care services that include procedures like surgery, endoscopies, and pediatric surgeries. 

8.

Medicare is now getting more costly: Medicare is becoming a bigger expense for Medicare beneficiaries, as the number that receive the program has dropped.

According a 2017 study by the Commonwealth Foundation, the cost for an individual Medicare beneficiary in 2018 was about $1.3 million, which translated into an additional $4.4 billion in cost to Medicare. 

9.

HospICare is getting more costlier: Hospice is also getting more affordable.

According The Commonwealth Care, the price for a Medicare patient to be treated at a hospice has gone from $1 for a single visit to $2 for the first 10 days. 

10.

Hospirex is getting cheaper.

The number of HospiX patients in the market is about 8,000, up from about 7,000 in 2017.

Hospira, the company that runs HospiceX, told CBS News that it is the first of its kind to offer hospice for the average American. 

11.

Health plans are shifting to single payer: Medicare Advantage plans are starting to drop out of the market, as are many employer-sponsored plans.

In the Commonwealth, Medigape plans are also declining. 

12.

Hospierans are starting more often: In 2018 and 2019, the number the average hospice patient received per year dropped from about 1,000 to about 600, according to the Center for Medicare and Medicaid Services.

That means that the number receiving hospice services increased by more than 1,600 per year, from 1,800 in 2018 to 1,900 in 2019. 

13.

Hospics are getting harder to access: Hospices aren’t just getting harder and harder to find.

As Vox previously reported, a new study from Harvard Medical School found that just 20 percent of U. S. residents had an appointment within three weeks of needing it, and only 4 percent of people had an in-person appointment within 12 months of needing one. 

14.

Health insurance plans are dropping out of Medicare: Medicare plans are going the way of the dodo bird: