Unbiased Analysis of Today's Healthcare Issues
Today, I will review an excellent piece of investigative journalism on Medicare’s end-stage renal disease (ESRD) program. The program provides free access to medical care for patients with kidney disease. Some highlights of these ProPublica report include the following: Program Inception “…the new program would help about 11,000 Americans, just for starters. For a modest…
Most people know that in the U.S., all Americans (i.e., citizens or permanent residents) are eligible for Medicare once they turn 65. However, the benefits are not the same for all individuals. For instance, the following groups can receive Part A Medicare coverage without paying a premium: Individuals who already get retirement benefits from Social…
Why are hospitalization rates so high for Medicare beneficiaries living in long-term care facilities (i.e., skilled nursing facilities, nursing facilities, and assisted living facilities)? The first reason is obvious: they are sick. If they weren’t, they wouldn’t need to be living in these facilities in the first place. Hospitalizing sick patients is often necessary. Unnecessary…
Medicare spends a lot of money on beneficiaries living in nursing homes. How expensive are these beneficiaries: Six percent of Medicare beneficiaries spend some time in a long-term care facility, but these same beneficiaries make up 17% of total Medicare cost. Three percent of Medicare beneficiaries spent an entire year in a long-term care facilities.…
Under Medicare Part A, beneficiaries can receive coverage for care provided by skilled nursing facilities (SNFs), also known as nursing homes. Between 2000 and 2007, however, the rate of potentially avoidable re-hospitalizations for five key conditions (congestive heart failure, respiratory infection, urinary tract infection, sepsis, and electrolyte imbalance) increased from 13.7% to 18.5%. One potential explanation…
Bundled payment has been gaining popularity in the minds of policymakers. In essence, a bundled payment structure gives providers a single lump sum payment to cover all related services for an episode of care. In the private sector, the Texas Heart Institute and Geisinger Health System both charge a single lump sum for certain procedures.…
All patients with end stage renal disease (ESRD) are eligible for Medicare regardless of their age. In 1972, the Social Security Act extended all Medicare Part A and Part B benefits to individuals with ESRD (of any age) who are entitled to receive Social Security benefits. ESRD beneficiaries now account for 1% of Medicare enrollment.…
Should Medicare pay hospitals located in New York City more for the same care as hospitals in Montana? Prima facie, one might believe that New York hospitals should receive higher wages since the costs of operating a hospital are much higher in New York. Labor (i.e., nurses, doctors, etc.) may prefer to live in an…
The New York Times Magazine discusses two pressing issues: 1) what type of treatment to the elderly really wish to receive at the end of their life and 2) how does economic incentives affect how physicians advise these patients. Much of my own research has dealt with (2) [see here]. The following two excerpts are…