Unbiased Analysis of Today's Healthcare Issues
Many people might know that generally the answer is commercial health plans have the most generous reimbursement compared to government plans. However, a key question is how much more do they pay? Commercial vs. Medicare rates A January 2022 report by the Congressional Budget Office finds that commercial payers reimburse hospitals at 223% of Medicare…
Since its inception in 2006, Medicare Part D beneficiaries had to contend with the dreaded “doughnut hole”. The “doughnut hole” is a coverage gap during which patients were required to pay 100% of treatment cost. To help defray some of these costs, the Patient Protection and Affordable Care Act (ACA) implemented provisions to reduce the…
That is the topic of a new paper by Drummond et al. (2022). When medical devices receive regulatory approval, payers can make one of three coverage decisions: (1) approve, (2) reject or (3) coverage with evidence development (CED). Note that all countries approve medical devices based on safety and efficacy but only England, the Netherlands,…
This is the goal of a paper by Yang et al. (2022) out in Health Economics. They first provide a nice review of the literature and divide the methodologies around risk taking into type types. I briefly summarize that literature below. Direct methods. These methods may ask individuals about their attitude toward risk or likelihood…
That is the question Kouri et al. (2022) aim to answer. They conduct a systematic literature review and meta-analysis and find: …overall [computerized clinical decision support systems] CDSS uptake was 34.2% (95% CI 23.2 to 47.1%). Uptake was only reported in 12.4% of studies that otherwise met inclusion criteria. Multivariable meta-regression revealed the following factors…
That is the title of a paper published today with my co-authors Felicia Forma, Kevin Chiu, Jason Shafrin, Dusica Hadzi Boskovic, and S Phani Veeranki. The subtitle is: Caregiver preferences for health technology tools to monitor medication adherence among patients with serious mental illness. The paper abstract is below: Background Adherence to antipsychotic medication is…
Fair prices→ Fair access? Harmonize HTA? What has California done on drug prices? Do work hours explain the gender pay gap? Does HDHP lead to lower hospital-negotiated prices for childbirth services? Is regret minimization or utility maximization a better decision rule? Does steps per day impact mortality?
That is the question asked by Horwitz and Nichols (2022) in their paper out this week in Health Affairs. I summarize their paper below. Data The authors use data from 2014-2019 American Hospital Association (AHA) annual member surveys among all acute care hospitals (both general medical and surgical) located within urban metropolitan statistical areas (MSAs)…
According to a paper by Rodriguez et al. (2022), the answer is ‘yes’. They use data from the 2017–18 National Survey of Healthcare Organizations and Systems (NSHOS), to determine if a physician practice has a “robust set of care management capabilities.” The specific capabilities that were used to determine whether the health system was robust…
What disease components are most burdensome to patients? How do researchers find this information out? To answer this question, the Food and Drug Administration (FDA) recently put out its second guidance document on Patient-Focused Drug Development: Methods to Identify What Is Important to Patients. A few qualitative approaches they recommend to collect this information include:…