Weekend Links
Moral hazard and HIV treatment. Physicians are a rate limiting factor. The biggest supreme court decisions of 2018. FDA=Federal Drug Administration Is marijuana addiction rising in Colorado?
Month: June 2018
We are spending too much on end of life care…or are we?
A number of studies have suggested that we are spending too much on end of life care. Consider this Kwok et al. (2011) study published in Lancet. Many elderly people in the USA undergo surgery in the year before their death. The rate at which they undergo surgery varies substantially with age and region and…
Should we move from patents to prizes?
An interesting article by Charles Silver and David A. Hyman argues that we should do away with patents for pharmaceuticals and move to a prize based system. They write in Vox: A well-designed prize regime would lower drug prices by eliminating drug monopolies, yet it would also create the necessary incentives for innovation, including incentives to…
When is physician failure a good thing?
How do physicians learn? A paper by Van Gestel, Muller, and Bosmans (2018) claims that the answer is through cumulative experience, economies of scale, or human capital depreciation. Learning from cumulative experience refers to the idea that treating an additional patient generally improves physician (or team) performance. When referring to economies of scale, we capture…
Do hospital purchases of physician practices increase or decrease prices?
The effect of health care industry consolidation on prices is a question argued about by many including researchers, economists, anti-trust, lawyers, regulators and more. There is evidence that health plan consolidation increases premiums, and hospital consolidation increases price. For instance, Dafny et al. 2015 writes: The harsh reality is that it’s difficult to find well-documented…
Friday Links
Does advertising work? (ACA edition) Is an individual mandate constitutional? Demand for health services researchers. NIH grant reviews: “The intraclass correlation — a statistic that refers to how much groups agree — was 0 for the scores assigned. This meant that there was no agreement at all on the quality of any application.” AMA: CVS-Aetna…
Open-Source Tools for Value Assessment
While many advancements have been made thus far in the progression toward value-based health care, there are persistent challenges in the measurement of value. In order to deliver value-based care, health care decision makers, eg, insurers and health system administrators, need value data at their fingertips—data that are relevant to their own context and reflect…
Is Medicare Advantage risk adjustment fair? And if not, what should we do about it?
While most patients in Medicare use the traditional fee-for-service route, a growing percentage of Medicare beneficiaries are relying on managed care plans through Medicare Advantage. Medicare Advantage provides beneficiaries with additional choice and also serves as a competitive alternative to traditional Medicare. In theory, Medicare should just allocate a beneficiary’s funding to a managed care…
What is Cronbach’s alpha and how do I calculate it?
Let’s say you have a test and it is composed of a bunch of different questions. Or you have a set of statistics–say statistics measuring how good a basketball player is–and you want to know how closely these statistics reliably measure the same thing. What you are looking for is a way to measure test…
Will Medicare Advantage be the future of Alternative Payment Models
CMS has focused in recent years on payment reform–especially alternative payment models–in Medicare’s fee-for-service (FFS) reimbursement system, but much less has been paid to beneficiaries enrolled in Medicare’s managed care program (i.e., Medicare Advantage). Currently, however, more than 1 in 3 beneficiaries are enrolled in an Medicare Advantage plan, and by 2028 that number could…