Unbiased Analysis of Today's Healthcare Issues
ASPE has a report out on the potential impact of the Inflation Reduction Act on Medicare Part D beneficiary out-of-pocket spending. This is a particularly relevant topic as the share of patients who have fallen into the catastrophic coverage has increased over time. Some of the medical conditions with the top out-of-pocket payments for Medicare…
An interesting recent paper by Moler-Zapata, Grieve, Basu, and O’Neill (2023) compares local instrumental variables (LIV) with two-stage least squares (2SLS) to IV. Local instrumental variable (LIV) approaches use continuous/multi-valued instrumental variables (IV) to generate consistent estimates of average treatment effects (ATEs) and Conditional Average Treatment Effects (CATEs). There is little evidence on how LIV…
Which HVBP components matter for patients choosing a hospital? Conflict of interest for RVU determination. How are payers de-risking cell and gene therapy cost (hint: stop-loss insurance) Over-the-counter birth control pill approved. ICER to advise CMS on MFP calculation?
That is the title of an important paper by Jonathan Gruber, Mengyun Lin & Junjian Yi. The abstract is below: The New Cooperative Medical Scheme (NCMS) rolled out in China from 2003-2008 provided insurance to 800 million rural Chinese. We combine aggregate mortality data with individual survey data, and identify the impact of the NCMS…
One piece of good news for consumers is that generic prices are falling. However, generic prices may be falling so much that drug shortages are occurring (which is not a good thing). Data from a working paper by Sardella (2023) finds a dramatic drop in generic prices in recent years. The authors claim that shortages…
Adverse selection is a classic problem in health insurance. If you offer insurance to individuals, you may want to set the premiums based on the average price of the population you plan to cover. At this price, however, the sickest patients are the ones most likely to take up insurance and the health insurer’s expenses…
That is the title of a study published today with co-authors Sabiha Quddus, Moises Marin, and Dennis Scanlon PhD. The abstract is below. ObjectiveTo estimate the incremental health benefits of pharmaceutical innovations approved between 2011-2021 and the share that would surpass the National Institute for Health and Care Excellence (NICE) ‘size of benefit’ decision weight…
CMS released a guidance on June 30, 2023 providing additional detail on on how the maximum fair price (MFP) will be calculated. The document also has nearly 100 pages of public input comments. A summary of some key points are below. Of most interest is that CMS is taking a ‘reference price’ based approach to…