Trends in Medi-Cal Reimbursement

Medicaid provides a safety net for the poorest Americans.  Although eligibility criteria vary from state to state, the health service Medicaid provides are often life saving.  One of the main problems Medicaid beneficiaries experience, however, is access to care.  Many physicians do not accept Medicaid because the reimbursement rates are much lower than those paid…

Medicare Advantage Premiums

In 2010, one quarter of Medicare beneficiaries chose capitated plans through the Medicare Advantage (MA) program. According to MedPAC, “[MA] coverage must include all Medicare Part A and Part B benefits except hospice.  All plans, except PFFS [private fee-for-service] plans, must also offer an option that includes the Part D drug benefit.” How do private health plans set premiums…

Pay College Players

It’s time to start paying college sports players. Watching the ‘Fab Five’ documentary and lots of college basketball this weekend has only confirmed my belief.  People may think that the professional sports leagues like the NFL, NBA, and the MLB make a killing.  It’s true. They do.  Buy many college sports programs also bring in…

Friday Links

Let them depend on charity. Does P4P work? Quiz: Test your knowledge of Health Reform. Are mortgages in the U.S. cheaper? Did the drop in cocaine production in Colombia reduce overall cocaine production? College athletic department subsidies. The Orphan Drug Act in action. California: History of health insurance, (1929-2010) California: Health plan consolidation, (1985-2011)

Selecting Medicare Cohorts

Medicare administrative data provides a rich source to conduct health services research.  Researchers who wish to use this data, however, often have to restrict their sample population in order to  have a similar types of patients and consistent data available.  Today I review some popular methods to restrict Medicare samples for research use. Restrictions to…

Alternative Quality Contract

“In January 2009 Blue Cross Blue Shield of Massachusetts launched a new provider payment system called the Alternative Quality Contract that exemplifies the type of experimentation with novel payment models that the Affordable Care Act encourages. The Alternative Quality Contract is a modified global payment model in which annual payments to medical groups are linked to a per member per month budget.” Today I…

Did the Stimulus Hurt the Economy?

Although the stimulus money may have helped the economy in the short run (1-2 years), in the near-term it seems to have exacerbated problems by bloating state government spending and postponing necessary cuts. “As part of the 2009 stimulus package, Washington gave the states $150 billion. The states became dependent on a higher level of…