On The Health Care Blog (THCB), Dr. Vineet Arora argues that being a doctor is not as attractive as it once was. She writes: After all, why go into this much debt and spend so much time in training if your prospects are not much better? More recently, the New York Times article points out [...]
Read the rest of this entry »Archive for the 'Supply of Medical Services' Category
Baskets of Care
What are the best practices for providing care for a specific condition? This question is not easy to answer. Further, the best practices for treating the average patient may differ from the best practice for treating certain other types of patients; particularly when a patient suffers from multiple conditions simultaneously. Despite these challenges, this information [...]
Read the rest of this entry »Do hospitals cost shift?
Many health policy experts claim that hospitals engage in cost shifting. Cost shifting assumes that hospitals have some target profitability level and can demand is fairly inelastic. Thus, if public programs (i.e., Medicare or Medicaid) cut prices, hospitals ‘cost shift’ by raising prices to the privately insured in order to reach their target profitability level. [...]
Read the rest of this entry »Long Term Care in the 13th Century
There have been a number of recent efforts to finance long-term care for the elderly. The health reform law, as amended by the Health Care and Education Reconciliation Act of 2010, created a national, voluntary insurance program for purchasing community living services and supports known as the Community Living Assistance Services and Supports program (CLASS [...]
Read the rest of this entry »End the Gag Rule
As Time Magazine reports, health care prices are fucked up. Castlight is one company that is trying to shed some light on health care prices to improve transparency. Their CEO, Giovanni Colella, write the following in Forbes: To start, health insurance companies should refuse to agree to “gag clauses” with hospitals who do not want their [...]
Read the rest of this entry »Medicare pays $5.1 billion for Poor Quality Skilled Nursing Facility Care
The Office of the Inspector General found substandard care at a number of skilled nursing facilities. Their investigation found the following: For 37 percent of stays, SNFs did not develop care plans that met requirements or did not provide services in accordance with care plans. For 31 percent of stays, SNFs did not meet discharge [...]
Read the rest of this entry »The Effect of Medicaid P4P on Nursing Home Quality
Over 10 million Americans need long-term services and supports to assist them in life’s daily activities. Of these, 1.6 million reside in a nursing home. Nursing home care, however, is expensive ($74,800 per year) and and quality is highly variable. To improve the quality of care, many states have begun adopting pay-for-performance (P4P) programs for nursing homes. Between [...]
Read the rest of this entry »Free-Market Healthcare? Nursing Home Payment and Financing
Although many people believe that the U.S. healthcare system is a free-market, that is far from the case. Consider nursing homes. Two-thirds of patient spending on nursing home care comes from public sources. Not only do public funds pay for the variable cost of running nursing homes, but the federal government also provides low-interest [...]
Read the rest of this entry »Effect of Nursing Home Ownership on Quality
Do non-profit nursing home provide better quality than for-profit nursing homes? Generally, for-profit nursing homes appear to have better quality measures, but this could be due to the fact that non-profit nursing homes act as a safety net, whereas non-profit nursing homes treat sicker patients. Today, I look at Grabowski et al. (2012)‘s attempt to [...]
Read the rest of this entry »P4P and Diabetes Care
In April 2006, Ontario instituted the Diabetes Management Incentive (DMI) that increased payments to physicians that provided high-quality diabetes care. Did the incentive improve payments quality? According to a paper by Kantarevic and Kralj (2012), it turns out that the answer is yes, but the magnitude of the change depends on the type of physician. [...]
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