Unbiased Analysis of Today's Healthcare Issues
A nice overview is provided by Johnson, Kishore and Berwick (2020). They review the HR13841 and S 1129.8 in detail [Note: HR 1384 and S 1129 were also proposed in the last Congressional session and they have an overview of that as well] HR 1384 and S 1129 both establish a single payer federal insurance…
Every year, the Congressional Budget Office projects how the federal budget will look over the coming decade. For the coming decade, the numbers look grim. Federal deficits in CBO’s baseline average $1.2 trillion per year and total $11.6 trillion over the 2020– 2029 period…Those deficits would average 4.4 percent of gross domestic product (GDP). Other…
To answer this question, one can examine how individuals choose health plans based on premiums, expected out of pocket cost, plan quality, and other factors. A paper by Abaluck and Gruber (2011) use data from 2006 and find that up to 70% of seniors appear to choose plans that are not optimal. Do these conclusions…
Today at the Academy of Managed Care Pharmacy (AMCP) 2019 Annual Conference, I attended a session titled “Medicare Formulary Updates Impact. How will proposed recent rulemaking affect formulary design? Some answers are below. CMS 2020 draft call letter Improved access to opioid reversal agents. The CMS 2020 draft call letter would place opioid reversal agents…
The answer is ‘perhaps’ according to a new paper by Wadhera et al. (2018). They use data from 2005 to 2015, and apply an inverse probability–weighted 30-day and 45-day post-discharge mortality measure stratified by whether there was an associated readmission. They examine admissions for acute myocardial infarction, heart failure, and pneumonia. Among Medicare beneficiaries, the HRRP…
Conventional wisdom holds that Medicare Advantage provides better service and lower cost sharing than traditional Medicare fee-for-service, and thus is attractive for many people. However, Medicare Advantage may restrict access to providers and may be less attractive to patients with more severe illnesses. Healthcare economists, however, do not rely on rumors and stories to make…
CMS is increasingly moving to alternative payment models whereby providers are paid based on their ability to improve/maintain quality and hold the line on cost. A key question then, is how does CMS evaluate quality of care? Today, the Healthcare Economist will answer this question for the case of Medicare’s Shared Savings Program (MSSP), which…
A recent report from Assistant Secretary for Planning and Evaluation (ASPE) found that for about 30 physician administered drugs, prices are 8 times as high as those charged in other developed countries. To address the high prices, President Trump unveiled a three-part plan to reduce drug prices. Under the “international pricing index” proposal, U.S. drug…
According to one study by Martin Anderson presented at the NBER’s Program on Health Economics meeting May 4, the answer is yes. Dr. Anderson examines the changes in insurance coverage, health care utilization, and mortality after the expansion of Medicare coverage to all patients with end stage renal disease (ESRD). The study finds that: …the expansions…
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…