Unbiased Analysis of Today's Healthcare Issues

Archive for May, 2017

Are bundled payments the solution? Five key barriers to implementation

Alternative payment models, bundled payment and episode-based payments are the latest trend in reducing unnecessary care and making sure care is delivered efficiently.  However, what is a “bundle”?  Based on a recent report from the Health Care Payment Learning and Action Network (HCP LAN), bundled payment can be designed at three levels: At the setting […]

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Will MACRA kill small physician practices?

Depending on the source, 34% to 59% percent of physicians are employed in practices of less than 10 physicians.  On the other hand, 39% of physicians are employed by hospitals.  How will these proportions change over time? An interesting paper by Casalino (2017) examines the impact of the  Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on […]

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End of the Week Links

Safety regulation: Unintended consequences in the NFL? Measles is back. Physicians, coding, and reimbursement. Is healthcare funding a game of hot potato? 70% of employers offer HDHP.

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Interpreting evidence on value

Value is the latest jargon to hit the health care sector.  One potential way value could manifest itself is through value-based insurance design (VBID).  Under VBID, patients would pay lower copayments for treatments that are highly effective and/or low cost would pay higher payments for treatments that have low effectiveness or high cost to the […]

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Do Incentives for Healthy Behaviors Work? A Case Study of Medicaid in Iowa

One of the primary changes in the healthcare system directed by the Affordable Care Act was providing funding for states to expand Medicaid.  Many states did so; many others did not.  Some states expanded Medicaid but put additional hurdles in front of beneficiaries to receive this coverage at no cost.  Consider the case of the State of Iowa. […]

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The Case For Patient-Centered Assessment Of Value

Value assessments are all the rage these days. From ASCO to ESMO, from MSKCC to AHA/ACC, from AMCP to ICER, there are a variety of value frameworks (and acronyms) out there. In the Health Affairs blog today, Alan Balch and Darius Lakdawalla make the case that treatment value should be measured from a patient-centered approach. […]

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Effect of Medicare Part D on Mortality

Huh and Reif (2017) have an interesting study of the effect of Medicare Part D on mortality.  The abstract is below. We investigate the implementation of Medicare Part D and estimate that this prescription drug benefit program reduced elderly mortality by 2.2% annually. This was driven primarily by a reduction in cardiovascular mortality, the leading cause of […]

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Mid-week Links

Does increasing MD reimbursement increase patient access to care? Cure for diabetes? A huge waste of money? The benefits of early treatment. A money-back guarantee.  

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Trump’s First 100 Days: A Healthcare Review

The Order to begin the ACA Repeal. Appointing Neil Gorsuch to the Supreme Court. Appointing Tom Price to run HHS. Proposing the American Health Care Act (AHCA) to replace Obamacare. Confirming Seema Verma to run CMS. Delayed implementation of bundeled payments. Trump decides to continue Obamacare insurance subsidies. All this and more happened in Donald […]

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Does the hedonic treadmill work in reverse?

The hedonic treadmill is a concept that people acclimate to changes in their life and improvements in quality of life. For instance, people who buy a new car have a brief short-term burst of happiness, but after people acclimate to having the car, their quality of life returns to the previous level. This concept can be […]

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