Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Physician Compensation' Category

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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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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