Unbiased Analysis of Today's Healthcare Issues

Are quality bonus payments based on hospital readmissions reliable?

Maybe not.  That is the answer from a study by Thompson et al. (2016).  Using data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for six states (AR, FL, IA, MA, NY,WA)  from 2011 to 2013, the authors measure hospital performance reliability for the Hospital Readmission Reduction Program (HRRP).  The define reliability as follows: […]

Read the rest of this entry »

Providers move into digital health

Marketplace reports: On a recent visit to the hospital, Riley, who is five years old, swallowed a tiny white pill with an embedded sensor – roughly the size of a grain of sand. When it reached her stomach, it sent a signal to a patch she’s wearing on her skin and alerted her parents and […]

Read the rest of this entry »

Is value-based purchasing working for hospitals?

The Incidental Economist is one of my favorite blogs to read.  This week’s post on a recent BMJ article on the failure of P4P did not disappoint.  The article (Figueroa et al. 2016) looks at 4267 acute care hospitals in the United States that participated in Medicare’s Hospital Value Based Purchasing (HVBP) system.  During my time […]

Read the rest of this entry »

2016 ASSA: How does competitions among insurers affect premiums

Typically, most economists believe that increased competition decreases prices.  However, is that the case for competition among health insurers? On the one hand, competition among health insurers could decrease prices if consumers choose plans based on premiums.  Competition may increase insurer’s incentive to negotiate with providers and may force insurers to make lower margins or lower […]

Read the rest of this entry »

Hospitals moving to the ‘burbs

The ACA offers States the option to expand Medicaid eligibility to millions of Americans.  The goal of the expansion was to increase poor and middle class Americans’s access to affordable health care.  However, access to acute care may be getting more difficult for poor individuals. A recent article looking at Milwaukee’s hospital market describes how hospitals are […]

Read the rest of this entry »

Will a VA scandal happen in England?

The VA scandal of long wait times is now well-known. Part of the reason why patients were left off official wait lists–ironically–was because VA senior staffers wanted to reduce wait times. Senior VA staff monitored wait times closely to check for any upticks. Some of the VA management at the Phoenix hospital believed the only […]

Read the rest of this entry »

The uselessness of volume-based hospital analysis

Do hospitals with higher volumes have better outcomes? If hospitals specialize or providers learn-by-doing, hospitals with more admissions or more procedures may have higher quality. A paper by Hentschker and Mennicke (2014) examine just this question and find: We define hypothetical minimum volume standards in both conditions and assess consequences for access to hospital services […]

Read the rest of this entry »

Do you live in an area with hospital competition?

Likely not.  At least according to some research by William Vogt.  In an NIHCM Issue Brief, Dr. Vogt states: The inpatient hospital market in the United States was transformed by a wave of hospital consolidation during the 1990s, which witnessed more than 900 mergers and acquisitions. Many cities came to be dominated by two or three large hospital systems, and […]

Read the rest of this entry »

The End of Hospital Cost Shifting?

Medicare is cutting reimbursement to hospitals.  Austin Frakt (HSR 2013) gives some highlights findings from a CMS report: [The ACA] will permanently reduce the Medicare payments hospitals would otherwise receive. Its ‘productivity adjustment’ will scale payments downward by the average rate at which private nonfarm businesses’ productivity increases. That rate has been estimated to be […]

Read the rest of this entry »

California Hospitals Charge Fair Prices to the Uninsured

Why is that?  Because in 2006 California passed the Hospital Fair Pricing Act.  Melnick and Fonkych (2013) describe the bill as follows. The Hospital Fair Pricing Act…mandated that hospitals develop formal, written financial assistance policies and limit the  prices they charge uninsured patients with low to moderate incomes…Under the law, hospitals must limit the amounts they collect from […]

Read the rest of this entry »