How Health Reform will affect Hospital’s Business Strategy

For many years, fee for service payment was the status quo. FFS model encourages hospitals to adopt the following strategies to maximize market share and profits: Centered on short-term acute care Focused on specialist alignment Driven by a volume-based service-line strategy Using expensive medical equipment purchases to encourage physician referrals Attracting patients with new construction…

Patient Centered Medical Home: Is your doctor ready?

The answer is probably not.  The NCQA defines 149 factors which would make a practice a successful medical home.  These include physician access during and after office hours, electronic access to patients information, availability of clinical data and use of that data for population management, identification of high risk patients, ability to refer patients to…

Medicare reducing reimbursement for low-quality docs

In 2015, Medicare will begin implementing a value-based purchasing (VPB) program for physicians.  Initially the program will target only certain physicians and groups of physicians, but by 2017 all physicians is participate in this program. The VBP program will evaluate physicians along two broad dimensions: quality and cost.  In the final rule: Section 1848(p) of…

Malpractice Insurance Caps

Many people support malpractice insurance caps.  They believe that malpractice insurance award caps will reduce medical costs in two ways: i) by decreasing malpractice premiums and ii) by decreasing the amount of defensive medicine physicians practice to avoid lawsuits.  An article by Shirley Svorny, however, argues that malpractice awards are bad medicine.  Physicians who are…

The Number of Uninsured Growing in California

Although Health Reform has passed, many of its mandates–such as Health Insurance Exchanges–have not yet been implemented.  As the cost of health care has been growing over time, the number of uninsured has also been growing. The California Health Care Foundation examines the uninsured in California in more detail.  Although Texas has the highest share…

Will Nurses Steal Market Share from Physicians?

Currently, physicians are the dominant force in determining how health care is provided in the United States today.  Nurses, however, also play a vital role in the provision of health care services.  Although there are about 660,000 physicians in the U.S., there are 2.6 million registered nurses and another 750,000 LPNs. Leveraging the skills of…

At the AEA

I am currently attending the American Economic Association (AEA) Annual Meeting in Chicago.  The Presidential Address was given by Bengt Holmstrom (Massachusetts Institute of Technology) on “The Nature of Liquidity Provision: When Ignorance is Bliss.” Although there are numerous presentations on health care, such as the Health Insurance and Health Care Practice seminar lead by…