Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Supply of Medical Services' Category

Managing post-acute care cost

Medicare’s move towards bundling payment for acute and post-acute care means that hospitals have an incentive to carefully monitor care received after discharge.  But what are the key drivers of post-acute care cost: hospital readmissions? use of any post-acute care? type of post-acute care used? A paper by Huckfeldt et al. (2016) examines Medicare claims data […]

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FFS vs. Capitation Reimbursement: Responses by Physicians and Medical Students

How do people respond to financial incentives?  In the medical world, physicians often are paid fee-for-service (FFS) or capitation.  Physicians receiving FFS reimbursement receive additional compensation for each additional service they do.  For instance, physicians under FFS receive twice as much compensation for 2 office visits as they would for 1 office visit.  On the other hand, […]

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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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Are “Focused Factories” a good idea?

In recent years, there has a been a trend towards patient-centered care focusing on caring for a patient holistically.  For instance, a NEJM perspective piece by Porter states: Accountability for value should be shared among the providers involved. Thus, rather than “focused factories” concentrating on narrow groups of interventions, we need integrated practice units that are […]

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HWR and Kaiser

Kaiser Permanente is opening a medical school in 2019.  How will the school be different from current medical schools?  The L.A. Times reports: …its approach will differ markedly from that of many established medical schools. It will hew closer to the company’s commitment of rapidly adopting new technology and adhering to the latest medical evidence […]

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International perceptions of ability to manage complex patients

In an international study using data from the Commonwealth Fund, Robin Osborn and co-authors survey primary care doctors in the United States and nine other industrialized countries on how well they are able to treat patients with complex needs. They found that the percentage of doctors that feel that their practice is well-prepared to manage […]

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How do patients choose their physician?

What matters to patients when choosing a physician?  Expertise?  Bedside manner?  Previous relationship with the physician? To answer this question, a paper by Groenewoud et al. (2015) conducts a discrete choice experiment (DCE) survey of Dutch patients with knee arthrosis, chronic depression, or Alzheimer’s disease.  They found that patient preferences for their physician depended on the disease. The […]

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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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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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