Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Physician Compensation' Category

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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Can physicians affect medication adherence?

According to a recent study by Koulayev, Simeonova, and Skipper (2016) using data from Denmark, the answer is ‘yes’. Non-compliance with medication therapy remains an unsolved and expensive problem for healthcare systems around the world, yet we know little about the factors that affect a patient’s decision to follow treatment recommendations. In particular, there is […]

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How does market structure affect technology adoption?

The answer: more competition leads to more technology adoption.  This is the finding from a study by Karaca-Mandic et al. (2016).  They use data from 100% Medicare claim in 2003 and 2004 as well as linked information on hospitals [American Hospital Association (AHA) Annual Survey] and physicians [American Medical Association (AMA) Masterfile]. Competition is measured two […]

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Is balance billing a good thing?

Are health care prices set on an open market? Almost certainly not. In many cases, physician fees are set by insurers. Currently, for instance, Medicare sets fees for physicians administratively. At Medicare’s inception, however, Medicare did allow physicians to charge whatever fees they wanted; Medicare would pay a base rate and patients would be responsible […]

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The problem with bundled payments

Bundled payments sound like a great idea for improving efficiency and in the short-run they are. Bundled payments involve paying a fixed fee for the treatment of a specific patient over a specific time period.  For instance, CMS have considered using a singled bundled payment to reimburse providers for both acute and post-acute care providers.  This approach gives providers […]

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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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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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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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