Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Hospitals' Category

Impact of Medicare Advantage on Hospital Admissions

Do patients who enroll in Medicare Advantage go to the hospital less frequently? The answer is yes. However, this fact may not be causal. Patients who enroll in Medicare Advantage are generally younger and healthier than patients who enroll in Medicare’s fee-for-service (FFS) program. A paper by Duggan, Gruber and Vabson (2016) uses a novel […]

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Are home births as safe as hospital births?

The popularity of home births has been rising in recent years. One question is whether they are as safe as in-hospital births. A new study in NEJM found that most home births are safe, but hospital births are safer. As the N.Y. Times reports: The study analyzed nearly 80,000 pregnancies in Oregon, and found that […]

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2016 ASSA: How does competitions among insurers affect premiums

Typically, most economists believe that increased competition decreases prices.  However, is that the case for competition among health insurers? On the one hand, competition among health insurers could decrease prices if consumers choose plans based on premiums.  Competition may increase insurer’s incentive to negotiate with providers and may force insurers to make lower margins or lower […]

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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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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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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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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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