Risk Scores and provider size

At a recent AcademyHealth presentation, Cheryl Damberg discussed her research to design a P4P program for implementation for Integrated Healthcare Association (IHA).  One thing I noticed about the presentation was that smaller provider groups had patients with lower risk scores (i.e., healthier patients).  Is it really the case that small providers treat much healthier patients?…

Certificate of Need Stringency

Many states have certificate of need (CON) laws which restrict providers supply for certain procedures.  A paper presented by Vivan Ho at AcademyHealth claimed that there were 37 states with a CON law for at least one procedure.  Following up earlier research which found that CON laws decreased quality, Dr. Ho found that dropping CON…

Negotiating Power

On Monday I attended a talk at AcademyHealth on the impact of market consolidation on the cost of health care.  Particularly interesting was Robert (Bob) Berenson’s analysis of the effect of provider consolidation on negotiating power and health care prices.  Particularly, provider have been gaining market power of late, according to recent CTS site visits.…

Federal Medicaid Spending: The Worst is Yet to Come

As the economy worsened, Medicaid enrollment has risen.  In the short-run, however, States have been able to avoid large increases in Medicaid spending because the Federal government has footed the tab.  According to the HHS: “Over the past three years, despite rising enrollment due to the economic recession, nationwide State spending on the Medicaid program…