Unbiased Analysis of Today's Healthcare Issues
In the past Medicare has reimbursed physicians that administer Part B drugs–typically injectable medications administered in a physician’s office–at 6% of the drug’s cost. The 6% aims to cover the cost of purchasing and storing the drug as well as administering it. Because physician reimbursement is proportional to the cost of the drug, physicians have…
Medicare’s move towards bundling payment for acute and post-acute care means that hospitals have an incentive to carefully monitor care received after discharge. But what are the key drivers of post-acute care cost: hospital readmissions? use of any post-acute care? type of post-acute care used? A paper by Huckfeldt et al. (2016) examines Medicare claims data…
The Congressional Budget Office (CBO) released its 2016 10-year budget projections last month and the numbers do not look good. CBO estimates that the 2016 federal budget deficit will be more than half a trillion dollars ($544 billion), which will cause the total level of federal government debt to increase to 76% of GDP. How…
In 2006, the Medicare program was expanded to include prescription drug coverage through the Part D program. Previous studies have found that Medicare Part D improved prescription drug coverage rates among seniors (Levy and Weir,2010), increased medication utilization (Duggan and Morton, 2010), decreased out-of-pocket spending (Engelhardt and Gruber, 2011; Ketcham and Simon, 2008), and reduced medication…
Medicare’s ACO program–the Medicare Shared Savings Plan (MSSP)–has recently been revised. AJMC reports that Patrick Conway, MD, MSc, deputy administrator for innovation and quality and chief medical officer at CMS, describes the proposed changes to the Medicare Shared Savings Program and how they will assist accountable care organizations transitioning to tracks with more risks.
You can find one of my recent papers measuring how well survival measures from clinical trials (i.e., overall survival, progression free survival, time to progression) translate into real-world survival outcomes in Current Medical Research and Opinion here. The abstract is below. Objective It is unclear how well different outcome measures in randomized controlled trials (RCTs) perform in…
In the U.S., the answer is largely the government. An NBER paper by Mariacristina De Nardi, Eric French, John Bailey Jones, and Jeremy McCauley provide some helpful statistics using data from 1996 to 2010 waves of the Medicare Current Beneficiary Survey (MCBS). The government pays for two-thirds of health care spending by the elderly, with Medicare…
Why do Medicare patients choose to stay in their current Part D prescription drug plan or switch to another? Are they rational actors maximizing their their financial benefit or do other factors play a role. A paper by Kate Ho and co-authors (NBER WP version) presented at the 2016 ASSA meetings find the switch rates…
With the ACA and now MARCA, Congress is moving full steam ahead with payment reform. An article by Paul Ginsburg and Gail Wilensky (2015) consider some of the implications of these reform efforts. This belief – that a set of metrics can be developed or delivery systems specified that could lead to the delivery of…
In 2013, Medicare launched the Bundled Payments for Care Improvement (BPCI) initiative. There were 4 models included in the program: Model 1 (least comprehensive): includes Part A services for the index hospitalization alone, and thus most closely resembles current fee-for-service payment. Model 2 (most comprehensive): encompasses Part A and Part B services for the index hospitalization, readmissions, and all other post…