Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Reform' Category

Do does episode bundling improve quality and reduce cost?

This is the question put forth in a paper by Chen et al. (2017).  The authors examine Medicare’s Acute Care Episode (ACE) Demonstration Program, which was a small, voluntary episode-based bundled payment program. According to the CMS website, There were 28 cardiac and 9 orthopedic inpatient surgical services and procedures included in the bundled payment demonstration. These […]

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Can California afford a single payer system?

There have been a number of moves to try to move California towards a single payer system.  A single-payer bill, Senate Bill 562, was offered up last year.  Some Silicon Valley tech workers are trying to move voters towards a single payer system as well. The question is, can we afford it? This is the […]

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Obamacare premiums rose 32% in 2018

Between 2017 and 2018, premiums Obamacare health insurance plans plans rose by 32%.  To be more specific, the Urban Institute reports that: The national average increase was 32.0 percent for the lowest-priced silver plans and 19.1 percent for gold plans, but the increases varied by states…State changes in average lowest-priced silver premiums ranged from a 22.5 […]

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The costs of quality reporting

Provider pay-for-performance initiatives aim to increase reimbursement to physicians and others who provide high-quality, low-cost care to patients. Medicare has two main programs for physicians to ahcieve these goals: (i) the Merit-Based Incentive Payment System (MIPS) and (ii) the Alternative Payment Models (APM).  MIPS measures cost and quality for smaller physicians groups whereas APM requires […]

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Does episode-based payment reduce cost?

That is the question that Carroll and co-authors try to answer in their latest NBER working paper (WP #23926).  They examine the Arkansas Health Care Payment Improvement Initiative (APII), which is a state-wide, multi-payer episode-based program.  Unlike most episode-based payment (EBP) models, provider participation  in the program was mandatory (as of 2013).  NBER summarizes the program […]

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Need data on health plan benefit design in the ACA exchanges?

The Robert Wood Johnson Foundation has a publicly available data source you can use to find this information.  Known as HIX Compare, the data contain descriptions of plans in the individual and small group markets across all 50 states. HIX Compare is the only dataset with information on nearly every individual and small group marketplace plan […]

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How did the Affordable Care Act affect the U.S. labor supply?

The Affordable Care Act (ACA) aimed to increase health insurance coverage largely through two pathways: (i) raising the income limits for individuals to qualify for Medicaid, (ii) creating new health insurance exchanges and health insurance subsidies to encourage the purchase of private health insurance among individuals that were not eligible for Medicaid.  Other provisions, such […]

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Progress on Obamacare Sign-ups

According to the N.Y. Times: Despite the Trump administration’s efforts to scale back the health law, about 300,000 more people have signed up for health insurance in the Affordable Care Act marketplaces in the first weeks of this enrollment period than last year. This is about a 25% increase from last year at this time.  However, […]

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Why shopping for health insurance is hard

The premise is simple.  Create markets, let consumers choose the products that fit them best, and the competition will lead to higher quality and lower prices.  That is the premise behind the Affordable Care Act’s health insurance exchanges.  A necessary condition for this to work, however, is that patients have visibility into the quality and […]

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Trump tax bill keeps the individual mandate

The Trump tax bill–potentially known as the “the Tax Cuts and Jobs Act“– includes provisions such as increasing the standard deduction and reducing the number of tax brackets from 7 to 4.  Additionally, a number of deductions are removed–such as capping local and state property tax deductions at $10,000 and only allowing mortgage interest deductions for […]

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