340B Court Cases

The Public Health Service Act (PHSA) in 1992, created a program to allow hospitals providing care for underserved communities to be able to access discounted drugs. The program–known as the 340B Drug Pricing Program, has been described as follows: …[The] law requires pharmaceutical manufacturers participating in the Medicaid program to enter into a second agreement…

Few Americans research hospital prices

New regulation is making hospital prices available to patients. The Kaiser Family Foundation (KFF) reports: As of January 1 of this year, hospitals are required to post prices of common health services on their websites via consumer-friendly tools for patient use. Prior to implementation of this rule, hospitals were only required to publish their gross,…

Transparency and hospital prices

Health care costs are high in the U.S., making up 17.9% of the U.S. economy. The Economist reports on recent key drivers of US health care cost…and the answer isn’t drugs. Mr Trump has correctly identified a big villain behind health-care cost inflation, and it is not Big Pharma. Hospitals account for over 30% of…

Are HRRP’s readmission reductions an illusion?

A number of studies (e.g., Wasfy et al. 2017, Desai et al. 2016) have found that the Centers for Medicare and Medicaid Services (CMS) Hospital Readmissions Reduction Program (HRRP) reduce hospital readmissions. However, are these findings valid? A recent paper by Ody et al. (2019) argues maybe not. Because readmission rates are risk-adjusted, changing coding…

Do we need Hospital Compare if we have Yelp?

This is basically the question that Perez and Freedman (2018) ask.  They find the following: Among crowdsourcing sites’ best‐ranked hospitals, 50–60% were also the best ranked on [Hospital Compare’s] HC’s overall and patient experience ratings; 20% ranked as the worst. Best‐ranked hospitals had significantly better clinical quality scores than worst ranked hospitals, but were not…

340B Facts and Figures

The 340B program requires pharmaceutical firms to give large discounts to hospitals and clinics that serve high volumes of low-income patients.  This sounds like a good idea at first: give money to people who can’t afford their medicines.  However, when one reads the sentence above closely, it becomes clear that patients don’t receive these discounts:…

Measuring hospital quality requires understanding what a hospital is

Many programs–such as Medicare’s Hospital Value-Based Purchasing (HVBP) program–aim to reward hospitals with high quality through higher reimbursement and penalize hospitals with low quality through lower reimbursement.  Will this approach be successful? A commentary by McMahon and Howell (2017) says that hospitals are not really unified entities but rather a collection of workshops. Thus, the…

Health care market concentration

One question is whether more physician concentration is a good thing.  On the one hand, larger practices could lead to more efficient care. On the other hand, larger practices could give providers more market power and could drive up prices. A separate question is whether federal authorities could do anything about increased physician market concentration.…