Unbiased Analysis of Today's Healthcare Issues

Archive for December, 2012

Cause of Rising Hospital Costs (Hint: It’s not MRIs and CT Scans)

A recent study use measures of hospital costs to charges to examine changes in inpatient cost between 2001 and 2006.  What did they find? Methods The data come from the Healthcare Cost and Utilization Project State (HCUP) State Inpatient Databases (SID) and Medicare Cost Reports for all community, nonrehabilitation hospitals in nine states.  The nine […]

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Appropriate IME and DSH payments

Although Medicare has a set rate schedule, not all hospitals receive the same payment for providing the same service. Among the number of adjustments Medicare makes to its inpatient prospective payments rates are the indirect medical education (IME) and disproportionate share hospital (DSH). The goal of IME is to compensate hospitals for patient care costs […]

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Accountable Care Organizations in Medicare

I have written numerous posts about the pros and cons of Accountable Care Organizations.  In 2012, Medicare begame allowing providers to form ACOs.  An article by Pope and Kautter provides an overview of the initiative. The Medicare program, which covers the elderly and disabled, is the largest medical insurance system in the USA. One major […]

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Measuring Hospital Quality

How does one measure hospital quality? Quality occurs along multiple dimensions. Thus, to summarize overall quality, one must create a weighting scheme to compete the distinct quality measures in a single measure. In most cases, quality measures should also account for differences in patient case mix. Hospitals should not be punished with lower quality scores […]

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Friday Reading

  Sick now or later? On-line medical consultation. 12-12-12. NFL & concussions. Health Exchange Deadline today. More Predictions of Rate Shock. Zeigarnik Effect

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How do commercial insurers evaluate physician quality?

Often, this is done with claims-based measures and beneficiary surveys. Today, I take a more detailed look at the UnitedHealth Premium physician designation program. The program evalutates physicians based on established quality measures and–for those who meet the minimum quality requirement–a measure of efficiency (i.e., low cost). A more detailed description is available here. Without […]

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CoR #172

The latest edition of the Cavalcade of Risk is up at Amaxx Workers Comp Resource Center.  Thanks to Michael Stack and Rebecca Shafer for making  their CavRisk hosting debut.

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Capitalism and Russia’s Alcohol Problem

It turns out that capitalism was not the cause of Russia’s current (largely alcohol-related) mortality crisis.  From an NBER working paper by Bhattacharya, Gathmann, and Miller (2012): Political and economic transition is often blamed for Russia’s 40% surge in deaths between 1990 and 1994. Highlighting that increases in mortality occurred primarily among alcohol-related causes and […]

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How to reduce compliants

Simple, increase the amount of occupied time.  For a more detailed explanation, check out this article from NPR to find the answer.  With respect towards complaints waiting for baggage at airports. A few years ago, The New York Times reported that airline passengers in Houston were complaining bitterly about how long they had to wait […]

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Five Reasons That Many Comparative Effectiveness Studies Fail To Change Patient Care And Clinical Practice

The Patient-Centered Outcomes Research Institute (PCORI) is poised to develop and oversee a vast portfolio of new comparative effectiveness research. For this endeavor to transform patient care, new evidence must be disseminated to clinicians and patients, understood and considered relevant, and used in the decisions that inform clinical care.  According to a Health Affairs paper […]

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