Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Supply of Medical Services' Category

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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Are wellness programs legal?

A post at The Incidental Economist considers the issue: Workplace wellness programs discriminate. That’s what they do. Employees who adhere to a wellness program pay less for their coverage; those who don’t pay more. Wellness programs thus clash with federal rules that generally require employers to treat their employees even-handedly, regardless of health status. The […]

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Obamacare’s slow repeal?

While we are waiting for the King v. Burwell verdict, which could repeal large sections of Obamacare, the house of representatives has already approved rolling back some ACA provisions. Modern Healthcare reports: Lawmakers postponed final passage of the proposed Protecting Seniors’ Access to Medicare Act despite a majority voting in favor of the bill. The […]

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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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Does home health care reduce long-term care costs?

It has long been posited that increased used of home health care will decrease the use of long-term care.  Clearly, there are some patients who need assistance, but for whom long-term care is not needed.  If most of these people who would use home health care would otherwise be in long-term care, home health care […]

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What is MIPS?

Yesterday I posted about MIPS, the new Medicare physician reimbursement program set to begin in 2019.  The Health Affairs blog provides a nice summary of some of the changes. First and probably most importantly, the formulaic approach to setting base payment rates is gone, replaced with automatic increases for all doctors from 2015 through 2019. For […]

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‘Doc fix’ fixed?

This may be the case.  Fox News reports: The Senate overwhelmingly passed legislation permanently overhauling how Medicare pays physicians late Tuesday in a rare show of near-unanimity from Congress. The legislation headed off a 21 percent cut in doctors’ Medicare fees that would have taken effect Wednesday, when the government planned to begin processing physicians’ […]

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Robots vs. Physicians?

The Economist reports that adverse events occur relatively frequently when physicians insert catheters: placing needles inside veins deep in the body is notoriously difficult. Some 15-30% of attempts suffer complications, mainly punctured arteries that can lead to infection (around 250,000 cases in America annually), but also bleeding, collapsed lungs and even cardiac arrest. Failure rates in […]

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Does your doc want to be in an ACO?

The answer is likely “It depends.”  To see why this is the case, let us consider the case of some proposed health reforms in Switzerland to force physicians into managed care (MC) networks.  As described in Rischatsch (2015): In 2012, Switzerland held a referendum…aimed at encouraging the nationwide development of MC networks. Among other changes…the legal […]

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