Unbiased Analysis of Today's Healthcare Issues
There is mixed evidence about whether hospital mergers improve quality. On the one hand, economies of scale could lead to more investment in information technology, or allow for further specialization of services. A recent paper by Wang et al. (2022) investigates the impact of a recent hospital merger on quality in New York. The merging…
Recent news articles have spilled much ink about the current nurse shortage. According to Pew, due to nursing shortages “Hospitals nationwide are canceling nonemergency surgeries, struggling to quickly find beds for patients and failing to meet the minimum nurse-patient ratios experts recommend.” Nursing wages are rising as well. The Baltimore Sun reports that the University…
Medicare pays higher reimbursement to teaching hospitals through indirect medical education (IME) payments to hospitals that train a high share of residents. IME inflate standard reimbursements in an attempt to compensate hospitals for these additional costs. Medicare also pay hospitals directly for some cost of training residents through the graduate medical education (GME). A key…
An interesting paper from Kevin Chiu in the Journal of Health Economics looks at the relationship between certificate of need laws and health outcomes: Certificate of need (CON) regulations requires that health care providers obtain state approval before offering a new service or expanding existing facilities. The purported goal of CON regulations is to reduce…
I recently finished reading the book titled The Hospital: Life, Death and Dollars in a Small American Town by Brian Alexander. The premise of the book is very interesting. It takes a detailed look at a hospital in rural America, Bryan, Ohio to be specific. The book touches on the challenges a small-town hospital from…
New regulation is making hospital prices available to patients. The Kaiser Family Foundation (KFF) reports: As of January 1 of this year, hospitals are required to post prices of common health services on their websites via consumer-friendly tools for patient use. Prior to implementation of this rule, hospitals were only required to publish their gross,…
Is your hospital high quality? Well, this depends on what quality means. Does it have low readmission rates? Low rates of mortality? Do they follow clinical guidelines? Are patients satisfied? Are they good at cardiology care? What about cancer treatment? Combining all these different dimensions of quality is a complex task. The Centers for Medicare…
Quality of care is difficult to measure. Even if you had a perfect measure of quality in terms of health outcomes, risk adjustment is imperfect. For instance, academic medical centers are often assumed to have high quality, but actual outcomes observed in the data may not be that good if they also receive the sickest,…
How much are hospital CEOs getting paid? A paper by Mulligan et al. (2020) provides the answer: Between 2010 and 2015, mean hospital CEO compensation (in 2015 US$…) increased 7.8%, from approximately $639,000 to $689,000 (p = .05), and median compensation increased from $431,000 to $464,000. Not surprisingly, CEOs of larger hospitals systems get paid…
Last week I reviewed an article on some of the potential positives and negatives of large, integrated health systems. A recent 60 Minutes episode talks about some of the perils by examining how Sutter health system has become a near monopoly provider in Northern California. Consider the following interaction between Leslie Stahl of 60 minutes…