Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Supply of Medical Services' Category

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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Do physicians care about patients’ cost?

A paper by Li and Laxminarayan (Health Econ forthcoming) examines an interesting question: Are physicians sensitive to drug prices faced by their patients? In an ideal world, physicians act as perfect agents for their patients, taking into consideration their medical needs and financial constraints. In reality, the choice of drug and whether a generic or brand-name […]

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Productivity Spillovers: The Case of AMI

The Healthcare Economist has written a lot about the fact that there exists significant regional variation in health care spending.  Is this due to a provider cultural norms?  Or are other factors at play? A paper by Chandra and Staiger (2007) claim that productivity spillovers may explain this results.  I summarize their proposition in more […]

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California Hospitals Charge Fair Prices to the Uninsured

Why is that?  Because in 2006 California passed the Hospital Fair Pricing Act.  Melnick and Fonkych (2013) describe the bill as follows. The Hospital Fair Pricing Act…mandated that hospitals develop formal, written financial assistance policies and limit the  prices they charge uninsured patients with low to moderate incomes…Under the law, hospitals must limit the amounts they collect from […]

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Long-Term Care in 5 European Countries

Trends in long-term care spending and use has been rising over time.  The graphs below, from Nadash et al. (2012) demonstrate this trend between 2000 and 2008. Annual Expenditures Long-Term Care Expenditures   Annual Enrollment in Long-Term Care Programs Today, I review the long-term care systems in five European countries: Austria, England, France, Germany, and […]

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Is Quality of Care within a Hosptial Homogeneous?

According to a paper by Zhang, Hauck and Zhao (2013), the answer is ‘no‘.   Using a Bayesian approach (i.e., three-level random intercept probit mode) the authors find that different specialties within the same hospital can provide very different quality of care to the patients.  The authors summarize their findings as follows: Of the variation in […]

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Dartmouth Response to “Target Decision-makers, Not Geography” Report

The title of the Institute of Medicine’s recent report “Target Decision-makers, Not Geography” at first glance appears to be an indictment of the work of the Dartmouth Atlas, which largely claims that policymakers can reduce healthcare spending by targeting the highest spending geographic areas. A more detailed review shows that the empirical findings from IOM […]

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International Strategies for Skilled Nursing Facility Reimbursement

In the past, I have written about how Medicare pays for Skilled Nursing Facilities (SNF).  Medicare uses a case-mix adjusted per diem rate.  This approach, however, isn’t the only manner payers can use to reimburse nursing facilities.  Consider how Australia pays for nursing care under their Australian National Sub-Acute and Non-Acute Patient Classification System (AN-SNAP): […]

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Does Increased Hospital Spending Reduce Mortality?

According to Romley, Jena and Goldman (2011), the answer is yes. For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality. During 1999 to 2003, for example, patients admitted with acute myocardial infarction to […]

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Device Pricing Policies in the U.S. and Europe

How do public payers set device reimbursement in the U.S. and Europe?  A Health Affairs article by Sorenson, Drummond and Burns answers this question. Compared to the United States, Europe more formally and consistently considers value to determine which technologies to cover and at what price, especially for complex, costly devices. Both the United States and Europe have […]

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