Unbiased Analysis of Today's Healthcare Issues

30-day readmission rates

AHRQ has put together a nice infographic, which I show below.

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Does Increased Hospital Spending Reduce Mortality?

According to Romley, Jena and Goldman (2011), the answer is yes. For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality. During 1999 to 2003, for example, patients admitted with acute myocardial infarction to […]

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How Medicare Measures Hospital Quality

There are many ways that Medicare evaluates hospital quality. Medicare conducts patient surveys (i.e,. HCAHPS). Medicare has hospitals report a variety of process of care measures through the Inpatient Quality Report (IQR) Program. Medicare uses data that Centers for Disease Control and Prevention (CDC) collects via the National Healthcare Safety Network (NHSN) tool to measure […]

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Will Medicare Reduce Your Hospial’s Reimbursement Rates?

Do you work at New York-Presbyterian in Manhattan? Massachusetts General Hospital in Boston? Both these hospitals, with large market shares in their cities, will see their Medicare payments reduced through the Hospital Value-Based Purchasing (HVBP) program. If you work at Cleveland Clinic or Intermountain Medical Center in Utah, on the other hand, Medicare will be […]

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Appropriate IME and DSH payments

Although Medicare has a set rate schedule, not all hospitals receive the same payment for providing the same service. Among the number of adjustments Medicare makes to its inpatient prospective payments rates are the indirect medical education (IME) and disproportionate share hospital (DSH). The goal of IME is to compensate hospitals for patient care costs […]

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How much does a hospital stay cost?

A paper by Geue et al. (2012) attempts to answer this question by examining five different methods of estimating the cost of a continuous hospital stay (CIS). Each method is discussed below in more detail. Costing Methods

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The Effect of Hospital Consolidation on Prices and Quality

An interesting report from the Robert Wood Johnson Foundation summarizes the literature describing the effect of hospital concentration in a market on prices and quality.  The general consensus from the literature is the following: Increases in hospital market concentration lead to increases in the price of hospital care Hospital mergers in concentrated markets generally lead […]

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Hospitals as Hotels

More evidence: “One patient who gave the hospital low satisfaction scores, particularly on room cleanliness, was contacted to explain why, [Jim] McManus [vice president of finance at St. Joseph’s Health system in Southern California] said. It wasn’t that the room was dirty, the patient replied. He wanted the cleaning schedule to mirror a hotel experience—cleaned […]

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Measuring Hospital Efficiency

Medicare recently released the Medicare Spending per Beneficiary (MSPB) measure on Hospital Compare. This measure includes all payments to doctors, hospitals or other facilities for services provided to a patient during the three days before the hospital stay, during the stay, and during the 30 days after discharge from the hospital. Kaiser Health news provides […]

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Medicare Spending per Beneficiary

Medicare’s Hospital Compare website evaluates hospital quality.  One of the most recent measures to be added to Hospital Compare is a measure of efficiency.  The measure calculates a price-standardized, case-mix adjusted measure of spending during period before, during and after a hospital admission. The Healthcare Economist (Jason Shafrin) and a team at Acumen (including Tom […]

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