Unbiased Analysis of Today's Healthcare Issues

EMR Adoption: Not what you might expect

Are urban or rural physician practices more likely to adopt electronic medical records (EMR)?  The answer is suprrising.  A paper by Whitacre (2016) finds the following: Overall practice-level EMR adoption rates generally increase with the degree of rurality and range from 47 percent in the most urban counties to over 60 percent in the most […]

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Avoiding unnecessary care: Does insurance coverage matter?

Consumer Reports‘ “Choosing Wisely” initiative aims to identify high-cost, low-value treatments that can often be avoided.  One question remains is why do providers still offer these services?  Do payer coverage policies or reimbursement rules affect these choices? A paper by Colla et al. (2017) attempts to answer that question.  The authors used commercial payer claims data […]

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Geographic Variation in the Quality and Cost of Care for Patients with Rheumatoid Arthritis

This is the title of my latest article in JMCP co-authored with Arijit Ganguli,  Yuri Sanchez Gonzalez, Jin Joo Shim, and Seth A. Seabury.  The paper’s abstract is below. BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best […]

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ASSA 2016: Regional variation in hospital spending among U.S. privately insured patients

How do health care costs vary across the country. Although the team at the Dartmouth Atlas has done this exercise with patients in Medicare, there has been less study of region variation in health care spending among the privately insured with the notable exception of a 2013 Institute of Medicine report. In a study by […]

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How useful are health rankings?

According to an HSR editorial by Stephan Arndt, the answer is not very.  Generally, county level health rankings are too variable to be of much use.  Further, while some metropolitan regions may have large sample sizes, the sample sizes in less densely populated rural counties will be far lower leading to less precise estimates of any […]

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What can Geographic Variation in Health Care Spending Tell Us About Efficiency?

In a project with the Institute of Medicine (IOM), I examined the sources of regional variation in Medicare and Medicaid spending and spending growth. The IOM wisely concluded that policymakers should target decision-makerss rather than geography when attempting to improve the efficiency of the healthcare system. I recent paper by the Louise Sheniner of the […]

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Geographic variation in Medicare and Medicaid spending

In some research I conducted with the Institute of Medicine, we found that there is little relationship between the geographic variation in Medicare and Medicaid spending.  Research by Todd Gilmer and Rick Kronick of UC-San Diego conduct their own research using Medicaid data from 2001-2005.  Like my own research, they find that a state’s per […]

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Regional Variation: Interpretation

The quality and efficiency of the care patients receive is often determined by the accident of where they live and seek care. – Dartmouth Atlas Brief Within-[region] variation in spending and utilization is significantly larger than the across [region] variation for both Medicare and Medicaid.” – Report for the Institute of Medicine. Which statement is […]

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Variation in Healthcare Spending: Medicare vs. Private Insurance

Is regional variation in health care spending larger for Medicare beneficiaries or those enrolled in private health plans? Before answering that question, one should better understand the sources of this variation.  Regional variation in spending can be due to variation in the utilization, variation in prices, or both.  A paper by Philipson et al. (2010) […]

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Determining Population Size

How do ecologists determine the size of a population?    One method is the mark and recapture (a.k.a. capture/recapture method).  This method relies on having two separate trials to capture (either physically or in data) members of certain population and determines the population size based on the proportion of specimens who are captured in both […]

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