The problem with bundled payments

Bundled payments sound like a great idea for improving efficiency and in the short-run they are. Bundled payments involve paying a fixed fee for the treatment of a specific patient over a specific time period.  For instance, CMS have considered using a singled bundled payment to reimburse providers for both acute and post-acute care providers.  This approach gives providers…

VBID in practice

In a typical insurance plan, patients have a fixed copayment, insurance and deductible regardless of whether the treatment they receive is considered high or low value.  However, an alternative insurance structure–known as value-based insurance design (VBID)–uses a different approach.  Under VBID, patient cost sharing is higher for low-value treatments and lower or eliminated for high-value…

Health Care in Malaysia

Malaysia is a middle income country (GDP per capita $26,600, about half of U.S. income levels) of 30.5 million people (about the population of New York and Ohio combined).  Life expectancy is 74.75 years, just 5 years below the U.S.  Health spending in Mayalsia is only 4% of GDP (compared to 17% of GDP in…

Improving DCE Response Rates

Non-response bias is a key problem when conducting any type of survey, including surveys that use a discrete choice experiment (DCE) methodology.  Non-response bias occurs when sampled individuals who respond to the survey differ from those who do not respond in ways that would affect the survey response.  For instance, assume that in the real-world, half of…