Friday Links
HEOR and decentralized clinical trials. State to crack down on prior authorizations? Memory formation and DNA. AI eye exams. Lessons on learning: Jason Kelce on band.
Month: March 2024
Why don’t physicians accept Medicaid patients?
One reason is that reimbursement rates for Medicaid are lower than for Medicare or commercial insurance. Another (often overlooked) factor, however, is physician’s risk of payment denials and the administrative hassle they face trying to get reimbursed by Medicaid. A paper by Dunn et al. (2024)–cleverly named “A Denial a Day Keeps the Doctor Away“–shows…
RIP: Daniel Kahneman
Nobel prize winner Daniel Kahneman passed away today. His work incorporating psychology into economics through Prospect Theory has been a major advance. From the N.Y. Times obituary: Professor Kahneman delighted in pointing out and explaining what he called universal brain “kinks.” The most important of these, the behaviorists hold, is loss-aversion: Why, for example, does…
Cross-country comparison in health care price growth: 2000-2020
How did health care prices change over the past 2 decades. That is the question a paper by Papanicolas (2024) aims to answer, comparing US prices to those from Australia, Canada, France, and the Netherlands between 2000 and 2020. Before we get to the results, we first need to determine what types of price indices…
Imputing deductibles in claims data
Many researchers are interested in how cost sharing impacts health care utilization, cost and patient outcomes. This is especially true as high-deductible health plans (HDHP) have become more common in the US. In 2023, 29% of covered workers in the US had a HDHP. One helpful type of data for analyzing HDHPs is claims data.…
Links
FDA on AI. Rural hospital closures on maternal and infant health. Price caps for obesity drugs? One framework for fair drug pricing. Iterative approach to model-based decision making in health.
A Tutorial on Estimating Costs Associated with Disease Model States Using GLM
Modelling health care cost is often problematic because are distributed in a non-normal manner. Typically, there are a large number of $0 observations (i.e., individuals who do not use any health care) and cost distribution that is strongly right skewed among health care users due a disproportionate number of individuals with very high health care…
Does the UK use £15,000, £30,000 or a £70,000 per QALY cost effectiveness threshold?
A de facto number that is used by National Institute for Health and Care Excellence (NICE) is £30,000 per quality adjusted life year (QALY). Some recent literature (Martin et al. 2023) argues for a lower cost-effectiveness threshold (£15,000/QALY or less) based on their marginal cost per QALY (MCPQ) estimates. Alternatively, a paper by Sampson and…
Medicaid Coverage and Reimbursement of Antiobesity Medications across States
Medicaid policies vary from state-to-state. With the advent of new, GLP-1 medications (and others) to treat obesity and overweight, there are potentially significant health benefits to be gained. However, are State Medicaid Agencies actually covering these medications? This is the question asked by Liu et al. (2024). They use data from public state Medicaid formulary…