Are hospital quality metrics causal?

That is the question asked by a recent NBER working paper by Chandra et al. (2023). This question is important for a variety of reasons. First, quality measure data collection is expensive. Saraswathula et al. 2023 found that Johns Hopkins Hospital had to report 162 unique quality metrics, and the cost for collecting these data…

Does the 340B program improve quality of care?

According to a paper by Smith et al. 2023, the answer is ‘no’. The authors use data from AHRQ’s Healthcare Cost and Utilization Project (HCUP) State Inpatient Data, Hospital Cost Reporting Information System Data, Office of Pharmacy Affairs Information System Data, and American Hospital Association Annual Survey for 15 states between 2008 to 2014. The…

Quality Measurement of German Hospitals

Public reporting of hospital quality of care could improve the care patients receive through at least two pathways. First, patients (or their physicians) could send patients to higher quality hospitals (i.e., the selection pathway). Alternatively, hospitals themselves could have behavioral responses to the metrics and may improve quality of care in response to public reporting…

Health impact of increasing access to physicians

Out recently is an interesting AEA paper by Okeke 2023, who examines a policy experiment by the Nigerian government that aimed determine whether expand access to physicians improved health outcomes. In this experiment, some communities were randomly selected to receive a new doctor. These doctors were posted to the local public health center. Prior to…

Enhancing Oncology Model: Payment Methodology

Back in July, I provided an overview of the Enhancing Oncology Model (EOM). Today I build upon that post focusing largely on CMS’s EOM’s Payment Methodology. I use a Q&A format as well. What is the goal of EOM? According to CMS “EOM is a CMMI alternative payment model designed to advance health equity, promote…

Real-World Patient-Centered Research: Is It Possible Across Countries

That was the title of the second plenary at ISPOR Europe this year. One interesting slide from Nancy Devlin who outlined how different countries used different patient-reported outcome measures (PROMs). English NHS PROMs programme. Variation in provider performance linked to reimbursement UK Private Healthcare Information Network (PHIN). Part of an initiative to improve patient choice…

Medicare Advantage and Lake Wobegon

That is the connection made between Medicare Advantage (MA) Star Ratings under the Quality Bonus Program (QBP) and Garrison Keillor well-known segment on the Prairie Home Companion in a recent paper by Teno and Ankuda (2022). To better understand this linkage, first recall the famous quote from Mr. Keillor: That’s the news from Lake Wobegon,…