Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Quality' Category

Geographic Variation in the Quality and Cost of Care for Patients with Rheumatoid Arthritis

This is the title of my latest article in JMCP co-authored with Arijit Ganguli,  Yuri Sanchez Gonzalez, Jin Joo Shim, and Seth A. Seabury.  The paper’s abstract is below. BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best […]

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The AMA on value-based drug pricing

The American Medical Association released a statement yesterday in support of value-based pricing of pharmaceuticals.  However, AMA claims that value-based pricing should follow the following core principles. Value-based prices of pharmaceuticals should be determined by objective, independent entities. They also should be evidence-based and the result of valid and reliable inputs and data that incorporate […]

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Are quality bonus payments based on hospital readmissions reliable?

Maybe not.  That is the answer from a study by Thompson et al. (2016).  Using data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for six states (AR, FL, IA, MA, NY,WA)  from 2011 to 2013, the authors measure hospital performance reliability for the Hospital Readmission Reduction Program (HRRP).  The define reliability as follows: […]

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Will technology replace nurses?

Many people have feared that robots, computers, and other forms of technology will take people’s jobs. Conventional wisdom holds that healthcare workers have been largely immune from these technological changes to date. However, a new paper from Lu, Rui and Seidmann examines whether technological advances–specifically computerized provider order entry (CPOE)–affects employment at nursing homes. Using […]

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How are payers tackling value-based drug pricing?

A growing number of value-based drug pricing arrangements are tying the price of treatments to outcomes. While these payment models are far from prominent now, is it likely that drug makers will have a greater share of the risks and rewards associated with value-based care moving forward? This is what is written in a feature […]

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Another VBP fail?

Value-based purchasing is supposed to tie reimbursement to quality of care and costs.  Providers that are high quality and low cost are supposed to get higher reimbursement, those that are low quality and high cost the reverse.  The key question is: does this reimbursement approach work in practice? According to a recent study by Grabowski […]

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VBID comes to Medicare Advantage

CMS announced last week that they are extending their value-based insurance design (VBID) program to more states and more patients.  I describe VBID and the proposed changes below. What is VBID? Value-Based Insurance Design (VBID) generally refers to health insurers’ efforts to structure enrollee cost sharing and other health plan design elements to encourage enrollees […]

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ACOs and VBP

Accountable Care Organizations aim to link providers through the supply chain (i.e., hospitals, physicians, post-acute care facilities) to incentivize providers to improve quality and reduce costs.  In addition to its ACO program (the Medicare Shared Savings Program), the Centers for Medicare and Medicaid Services (CMS) have implemented a number of value-based payment programs, including the […]

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Will value-based pricing be coming to the U.S.?

The answer may be yes.  One of the big inpediments to value-based pricing of pharmaceuticals was that any discount given to any single organization based on outcomes needed to be reflected in the Medicaid price.  Since outcomes are subject to random noise, there will inevitably be health plans that end up getting a low price due to worse than expected […]

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Children and Cost-Benefit Analysis

Alan Balch, PhD, discusses the Institute for Clinical and Economic Review’s (ICER’s) Value Assessment Framework tool that aims to provide stakeholders in healthcare with evidence to make more informed decisions regarding new cancer therapies. Dr Balch also considers limitations to the tool’s effectiveness. Plus, he even discusses why if we lived life using a strict […]

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