Quotation of the Day
We do not watch artists to see what they do, but watch what persons do to see the artistry in it. James P. Carse, Finite and Infinite Games
Month: March 2018
The costs of quality reporting
Provider pay-for-performance initiatives aim to increase reimbursement to physicians and others who provide high-quality, low-cost care to patients. Medicare has two main programs for physicians to ahcieve these goals: (i) the Merit-Based Incentive Payment System (MIPS) and (ii) the Alternative Payment Models (APM). MIPS measures cost and quality for smaller physicians groups whereas APM requires…
Weekend Links
Benefits of smoking bans. Service-level selection. Workplace wellness selection. The end of cervical cancer? The drawbacks of mental health reform.
Cigna-Express Scripts merger
Today, Cigna purchased Express Scripts for $52 billion. This follows another mega-deal where CVS bought Aetna. The integration of pharmacy benefit managers (PBMs) and insurers is nothing new. Previously, many insurers managed their own pharmacy benefit. However, as PBMs grew in size and were able to get larger discounts and rebates, in-house PBMs became less…
Pharmacy Spending Trends in Workers Comp
According the Centers for Medicare and Medicaid Services’ Office of the Actuary (OACT), in 2016 the U.S. spent $328.6 billion on prescription drugs, or 10% of all health care spending. We also see that prescription drug spending increased 1.3% to $328.6 billion in 2016, slower than the 8.9% growth in 2015. These trends towards more…
The downside of medical homes
Integrated delivery networks (IDNs) and medical homes are all the rage among health wonks. The ability for patients to receive holistic are from multispecialty practice teams seems like it would be beneficial. While quality of care may (or may not) improve with more integrated care, provider consolidation may have one downside: higher prices. An NBER…
Does episode-based payment reduce cost?
That is the question that Carroll and co-authors try to answer in their latest NBER working paper (WP #23926). They examine the Arkansas Health Care Payment Improvement Initiative (APII), which is a state-wide, multi-payer episode-based program. Unlike most episode-based payment (EBP) models, provider participation in the program was mandatory (as of 2013). NBER summarizes the program…
Alien Hand Syndrome
An interesting profile on the Alien Hand Syndrome from Invisibilia of NPR.
Links
ROI on VBP. Green jelly beans cause acne? The benefits of competition. Apple to jump into health care? Reverse nudge theory.
What is more for cancer patients: increased screening or treatment innovation?
Let’s get this out of the way: both are clearly important. Within appropriate screening, patients don’t get the treatment they need. Further, delayed screening can make treatments less effective if the cancer has progressed or metastasized. On the other hand, without effective treatment, screening won’t have a major impact on patient outcomes. The question is,…