Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Physician Compensation' Category

Does the value-modifier improve quality and reduce health disparities?

In short, no.  That is the answer Roberts, Zaslavsky and McWilliams reach in their 2017 paper in Annals. Some background on the value modifier program.  In 2013, practices with 100 or more eligible clinicians were rewarded just from reporting quality measures. By 2014, however: Practices with 100 or more clinicians were subject to upward, downward, […]

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Health insurance expansion and physician supply

When new bills pass in Congress or state legislatures that expand health insurance coverage, most researcher look at the demand side effect.  How does the insurance expansion affect the number uninsured?  How does it affect access to care?  How does it affect out of pocket cost? What is less frequently studied is the supply side […]

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Why do physician practices join value-based payment initiatives?

Are physicians ready for value-based payment? That is the question a recent paper by Markovitz et al. (2017) attempts to answer. This question is not hypothetical as the Medicare Access and Children’s Health Insurance Program Reauthorization Act (MACRA) requires physicians to choose between the current fee-for-service structure under the Merit-Based Incentive Payment System (MIPS) or […]

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Health care market concentration

One question is whether more physician concentration is a good thing.  On the one hand, larger practices could lead to more efficient care. On the other hand, larger practices could give providers more market power and could drive up prices. A separate question is whether federal authorities could do anything about increased physician market concentration. […]

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Will MACRA kill small physician practices?

Depending on the source, 34% to 59% percent of physicians are employed in practices of less than 10 physicians.  On the other hand, 39% of physicians are employed by hospitals.  How will these proportions change over time? An interesting paper by Casalino (2017) examines the impact of the  Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on […]

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The kindly physician or the profit maximizer?

In the U.S. physician fees are largely set through regulation or negotiation with insurers. For physicians accepting Medicare or Medicaid patients, fees are set by government entities (i.e., the Centers for Medicare and Medicaid Services for Medicare reimbursement for the former and state Medicaid agencies for the latter). Rates for physicians accepting patients with private […]

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Supply side health reform

Alex Tabarrok of Marginal Revolution notes that designing a health care system that focuses on benefits to consumers and is important, but one should not ignore how any health care system design affects the supply of health care, in particular incentives to create innovative goods and services. By greater spending on medical research, I mean not […]

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Immigrant Physicians

Interesting facts from Alex Tabarrok of Marginal Revolution: One percent of all the physicians in the United States come from the six countries targeted in Donald Trump’s new Executive Order. I found that a surprisingly high number. According to the Immigrant Doctors Project, those 7000 physicians provide 14 million doctors’ appointments each year and many of them […]

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Machine learning and physician employement

An article by Ajay Agrawal and Avi Goldfarb (“The Simple Economics of Machine Intelligence“) provide an interesting perspective on how machine learning will affect employment with a nice example from the health care sector. All human activities can be described by five high-level components: data, prediction, judgment, action, and outcomes. For example, a visit to the […]

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Physicians moving to larger groups

This is the finding of Muhlestein and Smith (2016): The proportion of physicians in groups of nine or fewer dropped from 40.1 percent in 2013 to 35.3 percent in 2015, while the proportion of those in groups of one hundred or more increased from 29.6 percent to 35.1 percent during the same time period. Initiatives requiring […]

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