Unbiased Analysis of Today's Healthcare Issues

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ASSA 2016: Effect of Medigap on Medicare spending

Although most elderly are covered by Medicare, elderly patients face significant cost sharing. For instance, skilled nursing facilities stays are free for the first 20 days, cost $137.50 per day for days 21-100, and patients must pay out of pocket after 100 days. For Part B cost, patients must pay 20% of all costs. Further, […]

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Synthetic Control Method

A common method for measuring the effect of policy interventions is the difference in difference (DiD) approach.  In essence, one examines the change in outcomes among observations subject to the policy intervention and compare them agains observations that were not eligible for the policy intervention. A key assumption for this approach to be valid is […]

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What is the IHS?

What is the Indian Health Service (IHS)?  The video below gives a nice primer on the history of IHS. The IHS provides health care to American Indians and Alaska Natives at 33 hospitals, 59 health centers and 50 health centers.   You can find the current locations of IHS facilities HERE.  Whereas the IHS annual budget […]

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Quotation of the Day

A man who procrastinates in his choosing will inevitably have his choice made for him by circumstance. Hunter S. Thompson  

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How to measure quality

Medicare’s Shared Savings Program (MSSP) contracts with accountable care organizations (ACOs) and provides financial rewards to ACOs that provide high-quality, low-cost care.  One question is whether or not the MSSP program does a good job of defining quality. A paper by Valuck and co-authors examines what constitutes high-quality of care for 20 high-cost and highly prevalent […]

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ICD-10 Oddities

On October 1, Medicare switched from ICD-9 to ICD-10 diagnosis coding.  As a researcher, I appreciate that ICD-10 will give a much more granular representation of a disease.  However, the risk is that the level of granularity is so fine that the administrative costs on providers becomes high.  Some of the diagnose codes, in fact, seem […]

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Racial Disparities in Pain Management

A JAMA Pediatrics study of children being treated for appendicitis found that “Black children are less likely to receive any pain medication for moderate pain and less likely to receive opioids for severe pain, suggesting a different threshold for treatment.” Aaron Carroll from the Incidental Economist weighs in with his thoughts:    

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Quality measurement: Where are we?

Leaders from two of the nations top quality organization–Christine Kassel from NQF and Rick Kronick from AHRQ–weigh in on the topic.  In a recent JAMA article, they first note some concerns: These concerns were underscored by the recent Institute of Medicine report on core metrics for health and healthcare progress,which noted the need to align […]

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Selection on Moral Hazard

The terms adverse selection and moral hazard are well known within the field of health economics.  But what is “selection on moral hazard”?  Amy Finkelstein explains using the following analogy: In the context of an all-you-can eat restaurant, traditional selection is that people with big appetites are more likely to go to all-you-can-eat restaurants.  Selection […]

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Medicare spending surges again

The August update to the Congressional Budget Office’s 10-year economic outlook is fairly rosy.  The deficit will ‘only’ be $426 billion, which is $59 billion less than the deficit last year and would represent 2.4% of GDP, the smallest deficit as a share of GDP since 2007.  Nevertheless, CBO still products overall US debt to rise […]

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