Unbiased Analysis of Today's Healthcare Issues

Will MACRA kill small physician practices?

Depending on the source, 34% to 59% percent of physicians are employed in practices of less than 10 physicians.  On the other hand, 39% of physicians are employed by hospitals.  How will these proportions change over time? An interesting paper by Casalino (2017) examines the impact of the  Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on […]

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Physician Prescribing Recommendations for Themselves and for Patients

In one of my recent publications, I show that patient and physician risk preferences differ.  Patients are willing to take take treatments with more both upside and downside risk, whereas physician prescribe treatments large based on which one provides the most efficacy to the average patient. One question that remains is how do patients and physician preferences over treatments […]

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Does your doc want to be in an ACO?

The answer is likely “It depends.”  To see why this is the case, let us consider the case of some proposed health reforms in Switzerland to force physicians into managed care (MC) networks.  As described in Rischatsch (2015): In 2012, Switzerland held a referendum…aimed at encouraging the nationwide development of MC networks. Among other changes…the legal […]

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Physician Payments in the 1990s

One of my favorite health economists and bloggers is Austin Frakt of the Incidental Economist.  In a recent paper, he examines whether new Health Reform provisions have learned from the mistakes in the 1990s from shifting provider reimbursement to a capitation based-system.  To find the answer, you’ll need to read his commentary (with Rick Mayes) […]

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Why are there no doctor reviews on the web?

The N.Y. Times has an interesting article citing a number of reasons why there are no good websites with doctors reviews on the web.  There are some ratings websites (HealthGrades, RateMDs, Angie’s List, Yelp), but the listings are often sparse, with few contributors and little of substance.) For one, physicians don’t like them. “Several years ago, […]

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Medicare reducing reimbursement for low-quality docs

In 2015, Medicare will begin implementing a value-based purchasing (VPB) program for physicians.  Initially the program will target only certain physicians and groups of physicians, but by 2017 all physicians is participate in this program. The VBP program will evaluate physicians along two broad dimensions: quality and cost.  In the final rule: Section 1848(p) of […]

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Doc Fix Fixed…for Two Months

Kaiser Health News reports: The House GOP leadership’s agreement to a Senate proposal averts a 27 percent paycut to doctors scheduled to take effect in January. The deal delays the cut until March 1, and lawmakers hope to hammer out an agreement on a longer-term fix to the payment formula before then. As I previously noted, […]

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