Quality Measurement of German Hospitals

Public reporting of hospital quality of care could improve the care patients receive through at least two pathways. First, patients (or their physicians) could send patients to higher quality hospitals (i.e., the selection pathway). Alternatively, hospitals themselves could have behavioral responses to the metrics and may improve quality of care in response to public reporting…

Is it time to end 340B?

A Health Affiairs Forefront article by DiGiorgio (2023) argues the 340B has outlived its purposes. He writes:  By mandating that drug companies give a large discount to covered entities, the majority of which are hospitals with disproportionate share or critical access designations, the 340B program was intended to provide a financial buffer for institutions such as the…

Enhancing Oncology Model: Payment Methodology

Back in July, I provided an overview of the Enhancing Oncology Model (EOM). Today I build upon that post focusing largely on CMS’s EOM’s Payment Methodology. I use a Q&A format as well. What is the goal of EOM? According to CMS “EOM is a CMMI alternative payment model designed to advance health equity, promote…

Hospital finances in 2022: Outlook is grim

Based on some recent reports, hospital finances in 2022 look poor. Government cash infusions from COVID-19 were helpful during the pandemic but have largely disappeared. At the same time, costs for labor and supplies have risen. Adding on to these financial pressures is the recent rise in the number of RSV cases. According to a…

Where is the US experimenting with Global Capitation?

Many people believe that the US is a fee-for-service system and many European countries are more likely to use global capitation reimbursement for providers. Those who dislike fee-for-service claim it incentivize over-treatment and disincentives prevention and use terms like “waste” and “too expensive”. Those who dislike global capitation claim that approach leads to reduced access…

Challenges faced by rural hospitals

That is the topic of a commentary by Carroll et al. (2022) in Health Services Research. The first issue they discuss is access to care. A core challenge in rural communities is declining access to hospital care. Eight percent of rural hospitals have closed over the last decade, and closure rates have increased in recent…

VA vs. private hospitals

How do efficiently is care provided for patients at Veteran Affairs’ hospitals as compared to private hospitals? This is not an easy question to answer as the composition of patients differs between these hospitals. Even among dually-eligible individuals–those with both VA and commercial insurance–individuals treated at VA hospitals are generally more severely ill. To better…