Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Nonphysician Clinicians' Category

The pros and cons of retail clinics

Aaron Caroll does a nice job summarizing these viewpoints in his article in the N.Y. Times’ Upshot: Researchers for a study published in the American Journal of Medical Quality talked to patients who sought out care at retail clinics. Patients who had a primary care physician, but still went to a retail clinic, did so […]

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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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The use of NPs and PAs in Nursing Homes is growing

Using data from the Online Survey Certification and Reporting system and Medicare Part B claims on the use of nurse practitioners (NPs) and physician assistants (PAs) between 2000 and 2010, a paper by Intrator et al. (2015) finds: [Nursing homes] NHs using any NPs/PAs increased from 20.4 to 35.0 percent during 2000–2010. Average NP/PA [visit per bed year] […]

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Funding Physician Medical Education

Each year, more than $15 billion of taxpayers’ money is spent to support physicians in residency training. About one-third of this amount comes from Medicaid, the Department of Veterans Affairs, and the Health Resources and Services Administration. The remaining nearly $10 billion flows through the Medicare program, primarily to academic medical centers via a complex […]

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Are doctors and nurses to blame for high health care costs?

A study by Glied, Ma and Pearlstein (2015) says the answer is no. High worker wages are a reasonable place to start for explaining why US healthcare costs are so much higher than other countries as about half of healthcare spending is spent worker compensation. The study by Glied, Ma and Pearlstein does find that: […]

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Transitioning to Alternative Payment Models

CMS has stated that they want 30% of all fee-for-service payments to be transitioned to alternative payment models–such as pay for performance–in the upcoming years.  A future where all providers are paid capitation or based on some measure of value is not here yet.  And in the interim, providers are dealing with a complex system […]

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Dr. Wal-Mart

CVS’s Minute Clinic isn’t the only game in town for quick primary care visits anymore.  Wal-Mart is getting into the primary care game with $40 office visits with nurse practitioners.  MSN Money reports: Wal-Mart is making its long-awaited move into delivering primary care: The retailer has quietly opened half a dozen primary care clinics across South Carolina and Texas […]

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Scope of Practice for NPs and PAs

This blog has been a proponent of increased use of nurse practitioners and physician assistants to reduce the cost of health care.  However, do they really reduce the cost of care?  On the one hand, NPs and PAs cost less than physicians.  On the other hand, if patients must visit an NP/PA and then a […]

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The Growth of Nonphysician Clinicians

If you are an avid reader of this blog, you’ve heard about nurse practitioners (NPs) and physician assistants (PAs).  What you might not know is how they popularity has grown over the past decade.  A paper by Strange (2013) cites the following statistics: With more than 85,000 PAs and 150,000 NPs eligible to practice, their […]

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Nurse Practitioner Popularity Grows

Patients generally prefer physicians to nurse practitioners (NP) or physicians assistants (PA) assuming a visit to either costs the same.  However, what happens when one takes into account waiting times? A paper by Dill et al. (2013) reveals the following: Respondents were given a choice between seeing a physician assistant or nurse practitioner today or a physician […]

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