Unbiased Analysis of Today's Healthcare Issues
Are narrow networks a good thing? On the one hand, they may be able to reduce health insurance premiums if insurers can negotiate lower prices. On the other hand, narrow networks means less choice of providers for patients. An less well-understood question is how narrow networks affect health care costs and utilization. Empirically, broader networks…
As the N.Y. Times reports, more transparency is coming to provider prices. The White House released an executive order Monday afternoon intended to require insurance companies, doctors and hospitals to give patients more information about precisely what their care will cost before they get it. More transparency is generally good and surprise billing for out-of-network costs has been a major…
Why have a physician do a job when a nurse could do it? Why have a nurse do it if a home health aide could do it? Clearly, the latter group in each sentence is lower cost; however, the former group may provide higher quality care. The balance of who can do what in terms…
A paper by McDermott et al. (2019) examines how primary care services are commissioned in the United Kingdom under the National Health Service (NHS). Interestingly, the study provides a nice overview of the history of GP contracting in the UK as well. An excerpt is below. The current primary care system in England, whereby GPs…
According to research by Leech et al. (2018), the answer may depend on whether or not you are black or white. Compared to the control group, “Black” auditors were less likely to be told an office was accepting new patients and were more likely to experience both withholding behaviors and misattributions about public insurance. The…
In single payer systems, the problem of adverse selection in health insurance is solved because the single payer must cover all people. Because the single payer cannot avoid covering any individual, there is no strategic gaming on coverage decisions. There may, however, be strategic decisions made on the treatment of patients. Consider the case of…
There is a lot of hype about digital medicine. Though the definition of what digitla medicine mans varies, many digital devices are able to monitor patient physiology, medication adherence, or other behavior and communicate that with the patient as well as their provider team. One key barrier to having the provider team actually use these…
This is the topic of a recent publication with co-authors Kata Bognar, Katie Everson, Michelle Brauer, Darius Lakdawalla and Felicia Forma. The full title is Does knowledge of patient non-compliance change prescribing behavior in the real world? A claims-based analysis of patients with serious mental illness. The abstract is below, but do read the whole thing…
Yesterday, I discussed the idea of managed competition in California. One of the original tenets of managed competition was insurers having integrated, mutually exclusive provider networks. This would mean much more consolidation on the provider side. While this could improve quality, there is also a risk that prices could rise. In fact, this is what…
That is the finding from a recent study by Mahajan et al. (2018). The authors use data from the American Community Survey between 2011. They compare hours worked and the share of physicians who were self-employed over time. To determine whether any changes were correlated with increaed Accountable Care Organization market share, the authors examined…