Unbiased Analysis of Today's Healthcare Issues
An interesting article by Mor (2023) examines the history of the requirement for a 3-day hospital stay for Medicare to cover a skilled nursing facility (SNF) transfer. The 3-day requirement: …was introduced very early in the history of the Medicare SNF benefit at a time when most nursing homes (NHs) offered primarily custodial care and…
There are a few sub-questions we need to break down to answer before answering this one larger question. These sub-questions include: Is nursing staff turnover at nursing homes a big problem? Is nursing staff turnover correlated with quality of care? Does using nursing staff turnover as a quality metric provide the right incentives? A paper…
An interesting article on the Marketplace Morning Report last week dives into the topic. Hundreds of nursing homes around the country have shut down leaving states to deal with what to do with people who need long term care…In Massachusetts, lawmakers have extended a $50 million lifeline to keep some nursing homes open. One nursing…
In the past few weeks, I discussed how well Hospital Compare does on measuring the quality of hospital care (see here and here). Now, I turn to how well Nursing Home Compare does on truly measuring quality of care. A study by Brauner et al. (2018) attempts to answer this question. They compare the quality…
There have been a number of studies that have examined how publicly reporting quality ratings (for health plans, physicians, hospitals or other health care providers) affects market share. Less attention has been paid to the effect of measured quality on health care prices. A paper by Huang and Hirth (2016) aim to answer just this…
Many people have feared that robots, computers, and other forms of technology will take people’s jobs. Conventional wisdom holds that healthcare workers have been largely immune from these technological changes to date. However, a new paper from Lu, Rui and Seidmann examines whether technological advances–specifically computerized provider order entry (CPOE)–affects employment at nursing homes. Using…
There have been numerous efforts to measure quality of health care, especially among the elderly. For instance, Nursing Home Compare measures of quality of care for nursing homes. However, these quality measures focus on health and safety. They do not measure quality of life. Atul Gawande’s book Being Mortal describes why nursing homes focus more on…
From a working paper by Karen A. Kopecky and Tatyana Koreshkova. …even though they are only a third of OOP [out-of-pocket] health expenses, the presence of nursing home expenses accounts for more than half of savings for all health expenses…We find that 27 percent of savings for old-age OOP health expenses, 3.7 percent of private wealth, is…
Although many people believe that the U.S. healthcare system is a free-market, that is far from the case. Consider nursing homes. Two-thirds of patient spending on nursing home care comes from public sources. Not only do public funds pay for the variable cost of running nursing homes, but the federal government also provides low-interest…
Shrinkage estimators (such as the James-Stein estimator) are well-known in the economics literature and have a number of applications. A recent paper by Shwartz et al. 2012 demonstrates how one could apply shrinkage estimators to measure nursing home quality. “A challenge when examining individual QIs across a range of facilities is that sample sizes are…