Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Supply of Medical Services' Category

Did Hospital VBP work?

How can Medicare improve quality and reduce cost? One idea is to introduce value-based purchasing (VBP). For instance, Medicare’s hospital value-based purchasing (HVBP) system increases payment rates for hospitals that demonstrate high quality. A paper by Ryan et al. (2014) explains the program in more detail. Under HVBP, acute care hospitals—those paid under Medicare’s Inpatient […]

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Do EHRs increase “upcoding”?

Upcoding occurs when physician or hospitals artificially increase the patient’s severity of illness. For instance, a hospital may record additional comorbidities. In Medicare’s inpatient prospective payment systems (IPPS), Medicare reimburses hospitals more for caring for patients who are sicker. Some health policy experts worry that electronic health records (EHRs) will decrease the cost of documenting […]

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Are nursing home expenses driving savings?

From a working paper by Karen A. Kopecky and Tatyana Koreshkova. …even though they are only a third of OOP [out-of-pocket] health expenses, the presence of nursing home expenses accounts for more than half of savings for all health expenses…We find that 27 percent of savings for old-age OOP health expenses, 3.7 percent of private wealth, is […]

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Regional Variation in Medical Spending: A Texas Case Study

A large body of research (including my own) indicates that there exists significant regional variation in medical spending. What is the source of these differences: differences in the prices paid per service or differenes in the amount of healthcare services used? The conventional wisdom is that Medicare does a better job of controlling prices, and […]

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Long-Term Care Hospitals

What are Long-Term Care Hospitals (LTCH)?  These facilities are different from nursing homes.  The New York Times explains the type of care they provide: These are no ordinary hospitals: Critically ill patients, sometimes unresponsive or in comas, may live here for months, even years, sustained by respirators and feeding tubes. Some, especially those recovering from accidents, […]

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Medicare Pricing Distortions and Patient Satisfaction

The cost of operating a physician practices differs across states.  For instance, rent is much higher in New York City than Nebraska.  Labor costs are much higher in Los Angeles than in La Crosse, Wisconsin.  To account for differences in the cost of operating a practice, Medicare adjusts reimbursement rates in their standard physician fee […]

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Is Health Care Exceptional?

Many health care wonks claim that health care is a market unlike any other. Unique features make it unsuited to be governed by a market economy. However, research research by Amitabh Chandra, et al. (2013) claims that healthcare providers act like firms in most any other industry. The conventional wisdom in health economics is that large […]

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Hospitals moving to the ‘burbs

The ACA offers States the option to expand Medicaid eligibility to millions of Americans.  The goal of the expansion was to increase poor and middle class Americans’s access to affordable health care.  However, access to acute care may be getting more difficult for poor individuals. A recent article looking at Milwaukee’s hospital market describes how hospitals are […]

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Will a VA scandal happen in England?

The VA scandal of long wait times is now well-known. Part of the reason why patients were left off official wait lists–ironically–was because VA senior staffers wanted to reduce wait times. Senior VA staff monitored wait times closely to check for any upticks. Some of the VA management at the Phoenix hospital believed the only […]

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Memorial Day and the VA

Memorial Day is a day to remember those who have served the country.  However, it is also important to remember the veterans who currently living and address their needs.  The issue receiving the most press is the long VA wait times.  I discuss the issue below. According to Vox.com, the VA rules aim to “ensure patients […]

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