Unbiased Analysis of Today's Healthcare Issues

Hospital Quality Reporting in Italy

In the U.S. patients can use Hospital Compare to evaluate the quality of care individuals receive at each hospital in the U.S.  In Italy, there is P.Re.Val.E.  A paper by Renzi et al. explains: A Regional Outcome Evaluation Program (P.Re.Val.E.) was launched in the Lazio region of central Italy starting in 2005 (Fusco et al. […]

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Shrinkage Estimators and Composite Quality Scores

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 […]

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Does Public Reporting Affect Patient Behavior?

A number of studies have already examined this question. Baker et al. (2003) examined the effectiveness of a public reporting effort in hospitals in Ohio, finding little relationship between a hospital’s report card ranking and changes in its market share. Cutler et al. (2004) examined the effects of reporting quality information about cardiac surgery on […]

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Medicare Spending per Beneficiary

Medicare’s Hospital Compare website evaluates hospital quality.  One of the most recent measures to be added to Hospital Compare is a measure of efficiency.  The measure calculates a price-standardized, case-mix adjusted measure of spending during period before, during and after a hospital admission. The Healthcare Economist (Jason Shafrin) and a team at Acumen (including Tom […]

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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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Patient Centered Medical Home: Is your doctor ready?

The answer is probably not.  The NCQA defines 149 factors which would make a practice a successful medical home.  These include physician access during and after office hours, electronic access to patients information, availability of clinical data and use of that data for population management, identification of high risk patients, ability to refer patients to […]

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California Health Care Almanac

The California Health Care Foundation (CHCF)’s Health Care Almanac provides some unique insights on trends in health care quality in California and for the United States as a whole.  Many of the national figures for the Almanac come from the CDC (BRFSS and Vital Stats) and AHRQ’s National Healthcare Quality Report.  California quality figures come […]

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Inpatient Rehabilitation Facility’s Quality Reporting Program

Medicare’s push to evaluate all types of providers is being extended to Inpatient Rehabilitation Hospitals (IRFs).  According to Health Reform bill (specifically, Section 3004 of the Affordable Care Act), CMS is required to start publishing quality measures for IRFs by October 1, 2012. This newly created IRF Quality Reporting Program (QRP) currently has proposed two […]

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Medicare to Hospitals: The Patient is Always Right

Starting in fiscal year 2014, Medicare will start rewarding hospitals with high quality care and penalizing hospitals with low quality care.  The rewards and penalties will be financial in nature. High-quality hospitals will receive a bonus and low-quality hospitals will receive a financial penalty.  There is a lot of existing documentation on this hospital value-based […]

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Does getting cancer incentivize individuals to switch from Medicare managed care to FFS?

Medicare beneficiaries have a choice: pick the standard Medicare fee-for-service (FFS) benefit or rely on managed care plans to supply their healthcare through the Medicare Advantage (MA) program.  Many Medicare beneficiaries prefer MA because it offers them lower out-of-pocket costs and provide benefits not available in the traditional FFS Medicare program. Other beneficiaries prefer the […]

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