Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Reform' Category

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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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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How does payment reform affect providers in competitive vs. non-competitive markets?

How does payment reform affect access to care?  And what does payment reform mean? Payment reform can mean manythings but in this context we will mean substituting fee-for-service or cost-plus reimbursement schemes for fixed reimbursement for a fixed episodes of care or fixed bundles of services during a specific time frame. One example of how payment reform worked, […]

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Small business in limbo and other health care stories

The ACA is here…for now.  The AHCA is dead…for now.  Where will the health insurance market be 1 year from now, let alone in 5 or 10 years?  These questions have not yet been answered and the uncertainty is especially taxing for small businesses, especially as their premiums have risen. Marketplace has an interesting story […]

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Supply side health reform

Alex Tabarrok of Marginal Revolution notes that designing a health care system that focuses on benefits to consumers and is important, but one should not ignore how any health care system design affects the supply of health care, in particular incentives to create innovative goods and services. By greater spending on medical research, I mean not […]

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How the AHCA will affect the Federal Budget

On the positive side, the American Health Care Act (AHCA) will decrease the federal budget deficit due largely to reductions in Medicaid spending and subsidies for the Health Insurance Exchanges enacted by the Affordable Care Act (ACA).  On the other hand, the AHCA will greatly increase the number of people without health insurance. Federal Spending […]

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Lessons from Obamacare: Comments on Vox’s article

Sarah Kliff and Ezra Klein and Ezra Klein of Vox have an interesting article on “The Lessons of Obamacare“.   I list the lessons below from the article and discuss whether I agree or disagree with the statement and why. Lesson 1: Everything in health care is a painful trade-off. Own it. Agree.  The authors provide a […]

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Why don’t people like the American Health Care Act?

There has been a lot of criticism of the Republican’s “repeal and replace” bill known as the American Health Care Act. The critiques are coming from both the left and the right. Let’s look at just one provision–the premium age bands–to better understand why both people on the left and right do not like the […]

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Trump Addresses Congress: The Healthcare Economist’s Take

Tonight, President Donald Trump delivered his first address to a joint session of Congress.  Although the speech touched on a number of topics, I give my line-by-line commentary on the portions of the speech related to health care. “Tonight, I am also calling on this Congress to repeal and replace Obamacare with reforms that expand choice, […]

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