Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Supply of Medical Services' Category

The Next Generation ACO

Medicare currently has two Accountable Care Organizations (ACOs)–the more popular Medicare Shared Savings Program (MSSP) and the Pioneer ACO program. However, these ACOs have generated only limited cost savings. Only 11 of 23 Pioneer ACOs and 58 of 220 MSSP participants generated cost savings. To address some provider concerns and due to the limited cost […]

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Regional Growth in Medicare Spending, 1992–2010

Below is an abstract from a paper I co-wrote with Camille Chicklis, Thomas MaCurdy, Jay Bhattacharya, and Dan Rodgers.  The title of the paper is Regional Growth in Medicare Spending, 1992–2010. Objective: To determine if regions with high Medicare expenditures in a given setting remain high cost over time. Data Sources/Study Setting: One hundred percent of national Medicare Parts […]

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What’s wrong with the SGR?

Why are doctor’s always complaining about the sustainable growth rate (SGR) issue? What is the SGR? The Brookings blog has a nice primer on the SGR. What is the SGR Put in place through the Balanced Budget Act of 1997, the SGR is a system designed to control the costs of Medicare payments for physicians. […]

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The end of urgent care?

A recent trend where urgent care centers are being converted to free-standing emergency rooms has hit the Midwest. The Milwaukee Journal Sentinel reports that “Froedtert Health proposing to convert its urgent care clinic in New Berlin to a free-standing emergency department.” Why would they do that?  Conventional wisdom holds that EDs are money losers. Although this is […]

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Psych Boarding in the ER

The president of the American College of Emergency Physicians, Michael Gerardi, was recently interviewed about his plans for the organization.  One of his key initiatives will be to stop the practice of housing psychiatric patients in the ER. According to Dr. Gerardi: It is inhumane that a lot of patients, especially adolescent patients, sometimes live in an […]

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Regulatory Tsunami?

Medicare is working hard to make sure that doctors are efficiently providing high-quality care. Programs such as the Physician Quality Reporting System (PRQS) and the Value-Based Payment Modifier all are aimed to improve quality and lower cost. The downside of such programs, however, is that the impose reporting burdens on physicians. For instance, Medicare can […]

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The cost of Informal Elder Care

Many adults spend significant time caring for sick, elderly parents.  What is the cost of providing this informal care?  Would it be better to have family members outsource the care to formal caregivers? A paper by Chari, Engberg, Ray and Mehrotra (2014) attempt to answer this question.  They use data from the  American Time Use Survey […]

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Residency Hour Restrictions and Patient Outcomes

Residency has been a right of passage for physicians. Long 36-hour shifts mix with the excitement of new learning. However, recent regulations have now capped residency weekly hours at 80. Although patient medical care in the short-run may improve (because physicians are less tired), in the long run, are physicians exposed to as wide a […]

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How important is having a good nurse?

Perhaps unfairly, doctors get all the credit. When patients have better health outcomes, physicians are rewarded; when they have worse health outcomes, the physician is blamed. However, the quality of nurses also likely affects the quality of care that patients receive. A recent paper by Yakusheva, Lindrooth and Weiss (2014) finds that nurse quality does […]

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What does an ACO look like?

ACOs are all the rage, but what does a typical ACO look like ? A study by Shortell et al. (2014) attempts to answer this question using data from the National Survey of ACOs. This survey includes ACOs participating in Medicare, Medicaid, or commercial payer programs.  The authors consider eight attributes for creating an ACO taxonomy […]

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