Medicare spending surges again

The August update to the Congressional Budget Office’s 10-year economic outlook is fairly rosy.  The deficit will ‘only’ be $426 billion, which is $59 billion less than the deficit last year and would represent 2.4% of GDP, the smallest deficit as a share of GDP since 2007.  Nevertheless, CBO still products overall US debt to rise…

What is Comprehensive Care for Joint Replacement?

Bundled Payments for Care Improvement (BPCI)A helpful post from Steven A. Farmer, Meaghan George and Mark B. McClellan explains.  Comprehensive Care for Joint Replacement (CCJR) is a bundled payment structure for hip and knee replacements.  CMS notes that: 2013, there were more than 400,000 inpatient primary procedures in Medicare, costing more than $7 billion for hospitalization alone.…

A universal flu vaccine

Wired reports: Today, independent teams reported inScience and Nature Medicine how they’ve tinkered with a piece of viral protein so it can teach immune systems—in this case, in mice, ferrets, and monkeys—to fight whole groups of viruses rather than just a single strain. “It’s a great first step in the road for generating a universal…

Narrow Networks in your state

The Affordable Care Act aimed to increase patient access to care.  Although it has certainly improved the share of patients who are insured, it is not clear whether it has actually improved “access.”  Many health insurance exchange plans are able to offer low premiums by limiting the number or type of doctors you are able to…

ACO Characteristics

In recent years, payers have moved towards shifting more financial risk to providers.  One of the most significant ways financial risk is passed to providers is through the creation of Accountable Care Organizations (ACOs).  The biggest ACO program is Medicare’s Shared Savings Program (MSSP).  Are ACO’s improving quality and reducing cost?  A paper by Schulz,…

How useful are health rankings?

According to an HSR editorial by Stephan Arndt, the answer is not very.  Generally, county level health rankings are too variable to be of much use.  Further, while some metropolitan regions may have large sample sizes, the sample sizes in less densely populated rural counties will be far lower leading to less precise estimates of any…