Unbiased Analysis of Today's Healthcare Issues

Archive for October, 2016

The Quest to Improve Health Care Quality

By 2018, CMS aims to tie 90% of reimbursements to value-based care. Value-based reimbursement is the latest rage. According to a paper by Levine and co-authors in JAMA Internal Medicine, however, progress on quality of care has been modest at best. Despite more than a decade of efforts to improve the quality of health care […]

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The problem with managed care is…

Managed care, as the names suggests, aims to manage health care.  The goal is to identify high quality, low cost treatments in order to insure that patients get the best care while keeping premiums low.  While good in theory, managed care critics often contend that some of the stricter managed care policies reduce patient access […]

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The problem with p-values

Interesting article in Aeon on why p-values may not be the best way to determine the probability we are observing a real effect in a study. Tests of statistical significance proceed by calculating the probability of making our observations (or the more extreme ones) if there were no real effect. This isn’t an assertion that […]

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High quality comparative effectiveness research

What are the best practices for conducting comparative effectiveness research in the real-world?  One proposed best practice guildelines are the Good Research for Comparative Effectiveness (GRACE) guidelines.  However, most studies do not follow these guidelines.  A paper by Dreyer, Bryant and Velentgas (2016) assembled 28 observational comparative effectiveness articles published from 2001 to 2010 that compared treatment effectiveness and/or […]

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Friday Links

Health state utilities: Best practices and critique. Health, big data and privacy. Tying drug prices to patient outcomes. Dr. Watson. Absolute vs. relative risk.

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Does defensive medicine work?

Dr. Anupam B. Jena, a Harvard professor and colleague of mine at PHE, has an interesting interview at the Cunningham Group.  Dr. Jena discusses his study published in BMJ, which finds that higher resource use by physicians is associated with fewer malpractice claims.  In other words, defensive medicine “works” for physicians even if it may […]

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2016 Nobel Prize in Medicine goes to…

Yoshinori Ohsumi. He won the award for his discoveries of mechanisms for autophagy. What is autophagy? The Nobel Prize website explains: The word autophagy originates from the Greek words auto-, meaning “self”, and phagein, meaning “to eat”. Thus,autophagy denotes “self eating”. This concept emerged during the 1960’s, when researchers first observed that the cell could […]

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2016 Nobel Prize in Economics goes to…

…Oliver Hart and Bengt Holmström for their research on contract theory. One of my favorite papers in all of economics is Holmstrom and Milgrom’s 1991 paper titled “Multitask Principal-Agent Analyses: Incentive Contracts, Asset Ownership, and Job Design.”  In a world where health care is increasingly moving to value-based payment, payers (i.e., insurance companies, employers, and the government) are increasingly […]

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Do narrow networks reduce cost?

Many health plans in the Obamacare health insurance exchanges aim to keep premiums down by limiting patients to a select group of providers (e.g., hospitals, physicians). The thought is, by limiting patients to a “narrow network” of providers, patients are in essence restricted to see the most efficient providers.  Some may claim that “efficient” means high quality […]

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HWR is up

Joe Paduda has posted “Pre-election pundit ponderings!” edition of the Health  Wonk Review up at Managed Care Matters.    

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