Transportation Brokerage Services Lower Health Care Costs

Transportation issues can create significant barriers to accessing quality health care.  If you do not have a car, physically cannot drive, or do not have public transportation where you live, getting to the doctor’s office can be difficult.  Although the federal government mandates that state Medicaid programs provide nonemergency medical transportation services to vulnerable populations,…

California Health Care Market

In her California Healthcare Foundation report, Katherine Wilson does a nice job describing the health insurance market in California.  A little over health of individuals received health care from their employer or themselves (56%), a quarter of individuals receive health insurance through public programs, and 19% of Californians are uninsured (see chart).  The private health…

Value-Based Cost Sharing

Many policy experts have been proponents of value-based cost sharing.  Under value-based cost sharing, medical care that is seen to provide a higher marginal benefit to the patient will have lower coinsurance rates than medical care with lower marginal benefits.  If value-based cost sharing would be implemented, preventive care should have low coinsurance rates because…

Learning and Drug Diffusion

How do doctors know which drugs to give to which patients?  Of course there are clinical trials giving the relative efficacy of each drug.  With less than perfect adherence, however, clinical trials may not accurately predict a drug’s efficacy or the potential side effects. A paper by  Chintadunta, Jiang and Jin (2008) look at two…

Uwe Reinhardt on Hospital Prices

Health Economist Uwe Reinhardt supports expanding the DRG system to all payers.   “Under Medicare’s approach, hospitals are paid one price for an entire inpatient episode, rather than piece-rate (fee-for-service) for every single supply and service delivered in that episode…To eliminate the rampant price-discrimination inherent in current hospital pricing, all hospitals under this system would…

Does competition improve health care quality?

If economists decided to re-write the Ten Commandments, “Thou shalt love Competition” may make the list.  However, does competition always improve quality?  Even in the case of health care? A paper by Scanlon et al. (2008) “…found no evidence of a strong and consistent relationship between HMO competition (measured either by the HHI or the…

Reference Pricing

What percentage of your prescription drug costs should your insurance company cover?  You may say “100%, of course!”  However, if health insurance cover all pharmaceutical costs this will drive up premiums.   One solution to this problem is reference pricing.  If generics are available for $10 and name brand drugs are available for $100, the…

Shortage! Shortage!…Shortage???

In the news, you often hear that there are shortages of nurses and physicians.  We need more nurses and physicians, right?  According to an editorial by Laurence Baker in Health Services Review, we should be a little skeptical of calls for more and more healthcare providers.  If supplier-induced demand is a problem, more providers will…