Month: April 2012

Healthcare Spending in Indonesia

Jason Shafrin2 Comments

A recent J Health Econ paper describes the changes to the system of public health financing in Indonesia.  Today, I review this article. Public Health Expenditures in Indonesia In the Suharto Regime, district health offices implemented centrally determined policies, and “a large network of public health clinics (puskesmas) was set up to deliver primary outpatient…

All-or-Nothing P4P

Jason ShafrinLeave a comment

Many of Medicare’s value-based purchasing (VBP) initiatives offer a continuum of rewards based on provider performance.  Whereas all-or-nothing VBP initiatives only grant bonuses to providers who exceed a single threshold, the Medicare VBP programs–such as its hospital VBP program–reward hospitals based a value-based modifier that is proportional to its quality score. One of the reasons…

Are nurse practitioners cost effective?

Jason Shafrin5 Comments

Nurse practitioners (NPs) are non-physician clinicians that can often either assist or directly provide primary care. Some studies have found that NPs can independently manage 80 percent of patients’ primary care needs. Other studies show that NPs provide high-quality care. A recent article, however, suggests that NPs may not be cost effective.  This is a curious…