Integrated Healthcare Association and P4P

The largest P4P program is run by California’s Integrated Healthcare Associates (IHA). A 2006 report (“Advancing quality through collaboration“) chronicles IHA’s progress in working with the California Association of Physician Groups as well as Dr. Stephen Shortell to establish a P4P measures. The report has two very interesting summary tables: one describes how the IHA…

Focused Factories

The popularity of specialty medical facilities (SMF) has increased over the years. The number of Medicare-certified ambulatory surgery centers (ASCs) has doubled to 3,371 during the past decade. A question remains: are these “Focused Factories” good for society? In an article by Casalino, Devers and Brewster, (“Focused Factories…“) the authors try to answer this question.…

Grand Unification Theory of Healthcare

Dr. Richard N. Fogoros has a very interesting website named, the Grand Unification Theory of Healthcare, which relates his views about health care.   His analysis is systematic.  One is able to understand the health care system from the point of view of physicians, patients, health plans, the government, and employers. His “Pathway # 2 to…

AMA takes on Retail Clinics

As my colleague Mike Ewens wrote to me: “Monopolists hate competitors and have to use the government to keep them away.” An example that takes center stage can be found in a recent Chicago Tribune article (“AMA takes on Retail Clinics“) . Some doctors have asked the AMA to ban on in-store clinics currently being…

List Size and Primary Care Production

In Norway, each primary physician assumes medical responsibility for a well-defined population of patients. Norwegian physicians receive approximately NOK 300 (~$50 USD) per patient on their list so their income is largely determined by list size. This capitated payment is supposed to make up 30% of primary physician income with the remainder coming from FFS…

Today’s Recipe: How to cook the books

Giving corporate executives bonuses based on the performance metrics of the company they manage is one way to incentivize managers to increase profits, sales, company stock price or any other financial measure. But is this the best way to run a company? In 1985, Paul Healy wrote prescient paper of how corporate executives can alter…

Pay Enough or Don’t Pay At All

Monetary incentives improve performance. This statement is almost gospel in the economics field. For instance, if I pay all my blog readers $1 for each time they visit this website, it is likely that the traffic on Healthcare Economist will increase dramatically. Sales staff compensated on a 100% commission basis often sell more items than…