Unbiased Analysis of Today's Healthcare Issues
According to the CMS website, Quality Improvement Organizations (QIOs) are private, mostly not-for-profit organizations, which are staffed by professionals, mostly doctors and other health care professionals, who are trained to review medical care and help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum…
Medicare administrative data provides a rich source to conduct health services research. Researchers who wish to use this data, however, often have to restrict their sample population in order to have a similar types of patients and consistent data available. Today I review some popular methods to restrict Medicare samples for research use. Restrictions to…
One of my favorite magazines is Consumer Reports. I love getting a good deal and Consumer Reports unbiased research and decision to not accept any advertising dollars helps make sure I get my money’s worth on purchases big and small. In the latest issue of this magazine (December 2010), Consumer Reports provides useful advice to Americans…
Medicare pays physicians in New York City more for the same procedure than they do if that same physician was located in rural Wyoming. Why do they do this? The obvious reason is that the cost of operating a practice in New York City is much higher than in rural Wyoming. Medicare determines the amount…
The Medicare Economic Index (MEI) is a measure of practice cost inflation that was developed in 1975 as a way to estimate annual changes in physicians’ operating costs and earnings levels. Today, I review a timeline of how Medicare has paid physicians over time and also describe some adjustments CMS makes to the MEI to…
In 2009, 3.3 million Medicare beneficiaries used home health. In the past few years, the home health expenditure growth rate has outpaced Medicare spending in all other areas. This finding is likely correlated with the 9.7% increase in the number of home health agencies between 2008 and 2009. How should Medicare reform home health to…
More than 3 million frail and disabled individuals rely on nursing home services in any given year. About half of these individuals consider the nursing home to be their primary place of residence. Nursing home quality, however, has often been called into question. Some experts believe pay-for-performance schemes will improve nursing home quality. Today, I…
For the under-65 population insured by Blue Cross, total spending per-member-year in McAllen, Texas, was 7 percent lower than in El Paso, Texas. By contrast, Atul Gawande’s 2009 New Yorker article, which used data from theDartmouth Atlas of Health Care on variations in Medicare spending, showed that per capita spending in McAllen was 86 percent higher…
Do Medicare beneficiaries in fee-for-service plans access better physicians than those in Medicare Managed Care (MMC) plans? Huesch (2010) attempts to answer this question for beneficiary access to quality cardiologists. Using data on heart patients without AMI in Florida, the authors observes the following results: “No evidence was found that Medicare payor type significantly influenced…
From the Commonwealth Fund: “The analysis says people have many plans to choose from but that enrollment is concentrated in a handful. It notes, for example, that the average Medicare beneficiary in 2010 has 33 plans from which to choose. But in 14 states and the District of Columbia, a single company (not the same…