Did the ACA cause industry consolidation?

The Affordable Care Act (ACA)–among other things–mandated a number of reforms to the Medicare reimbursement system.  For instance, the ACA created Accountable Care Organizations (ACOs) and bundled payment initiatives were initiatives.  If Medicare started paying providers more based on quality and total cost of care across all provider settings, one would hypothesize that industry consolidation would accelerate.…

Need health care data?

The International Society For Pharmacoeconomics and Outcomes Research (ISPOR) has put together a database of databases from around the world. The ISPOR International Digest of Databases has goal is to organize global health care databases into searchable models.  Their working group on this topic is chaired by Carl Asche and Elisabeth Oehrlein.  If you have…

The Changing US Health Insurance Market

An interesting paper by Graves and Nikpay (2017) look at the evoluation of the health insurance market before and after Obamacare.  The authors find We found that the ACA’s unprecedented coverage changes increased transitions to Medicaid and nongroup coverage among the uninsured, while strengthening the existing employer-sponsored insurance system and improving retention of public coverage.…

Medicare Advantage and Upcoding

Medicare’s cost are growing due to an aging population, technological advances, and other factors.  One of those factors may be upcoding that is occurring among Medicare Advantage plans.  Rick Kronick writes in Health Affairs that: Over the past decade, the average risk score for Medicare Advantage (MA) enrollees has risen steadily relative to that for fee-for-service…