Unbiased Analysis of Today's Healthcare Issues

Archive for November, 2009

Medicare Doc Paycut Reversed

In 1998, Medicare enacted the sustainable growth rate (SGR) which would slowly bring down Medicare physician compensation.  However, each year, it gets reversed by Congress. Now, instead of a gradual decline, the implementation of SGR would  result in a 21.2% pay cut for Medicare docs. Before the Thanksgiving holiday, however, Congress once again reversed the […]

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How has episode-based P4P worked in California?

Episodes of care are defined as the bundle of medical treatments used to treat an illness over  a specified time period.  Because all treatments are bundled together, these episodes have been thought to provide a superior unit of analysis in pay-for-performance (P4P) systems.  In fact, Oxford Health Plan pioneered episode payment in the 1990s.  [Later, […]

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The Ecological Fallacy

Are foreign-born individuals more likely to be literate (in English) than native born Americans?  One would think not, but consider the following information: Robinson (1950) computed the following two pieces of information: the percent of the population who are foreign-born, and the percent who are literate.  Robinson observes that states with a high percentage of foreign-born […]

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Happy Thanksgiving

Two important stories for you to read.  Two things to be thankful for: How giving thanks improves your health. Packers beat Lions: 34-12.

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The Four-Party System

Who does health care reform affect?  Charles Kroncke and Ronald White organize individuals into the following four major stakeholder groups: First-party patients.  The patients who seek care. Second-party providers.  These include hospitals,  physicians, nurses, physical therapists, dentists, and pharmaceutical companies. Third-party payers.  The payers are generally either private insurance companies or government programs such as […]

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Turkey Links

Some links to tide your over to Turkey Day. House vs. Senate Reform Bills: A graphic comparison. Physician’s cost to interaction with health plan: over $23 billion. Early Detection Does Not Equal Prevention. Daily Lesson Plan: Health Care Reform. Cost/life saved for mammogram under 50: $20 million. Tyler Cowen’s Health Reform Rx. Bucks Diary, a […]

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Why it is difficult to evaluate physicians quality: No medical home

One laudable goal is to improve medical quality while reducing cost. One way members of Congress have proposed to accomplish this is to use episode groupers in order to provide feedback to doctors regarding their resource use. None other than Max Baucus has advocated this (see p. 45 of this white paper). However, matching patient […]

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House Reform Bill’s Impact on the Number of Uninsured

The CMS’ Office of the Actuary estimates the impact of the House health care reform bill on insurance coverage 10 years in the future: One can see that the number of uninsured drops dramatically, but there will still be over 20 million Americans without insurance. The most interesting and difficult part of the analysis is […]

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Links: California Edition

California’s PPO report card. A tax increase by any other name: California taxpayer’s compulsory interest-free loan to the state. Confusion: Los Angeles marijuana dispensaries face a federal ban, California medical marijuana laws, and now possible city ordinances. 32% fee increase for the University of California system. California hospital prices increased 10.6% per year for private […]

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Quotation of the Day: The curious task of economics

“The curious task of economics is to demonstrate to men how little they know about what they imagine they can design.” F. A. Hayek, The Fatal Conceit.

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