Unbiased Analysis of Today's Healthcare Issues
A hospital in New York City faces higher labor costs than a hospital in Billings, Montana. To take into account these cost differences, Medicare adjusts hospital payments to reflect these cost differences using a hospital wage index. As currently constructed, however, many hospitals petition to be included in labor markets where they would receive a…
Many health policy experts believe that when Medicare or Medicaid decrease prices, hospitals will increase the prices they charge to the privately insured. Does this make sense? Ginsburg (2003) summarizes the debate: Most executives in hospitals, physician organizations, health plans, and businesses have long been convinced that reductions in rates paid to Medicare and Medicaid…
In January, the CBO released a report titled The Budget and Economic Outlook: Fiscal Years 2010 to 2020. A summary of the findings is available on the CBO Director’s blog. Today, however, I focus on CBO’s evaluation of how changes in health care spending affect the federal budget. “Medicaid spending (excluding stimulus funding) increased by…
Regional differences in the cost of health care are due to differences in both the price and volume of medical care. Since, Medicare sets prices, there should be little variation in prices…right? Actually, Medicare payments have geographic adjustments based on a number of factors. For instances, the hospital wage index gives pay hospitals more in…
“The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires the Department of Health and Human Services (DHHS) to develop a plan that will transition Medicare payments into a VBP [value based purchasing] program for physician and other professional services that is based on efficiency and the quality of services provided. The Act…
Accountable Care Organizations (ACOs) are the latest rage in the health policy world. The question is, what are ACOs. The Urban Institute’s Kelly Devers and Robert Berenson try to answer the following question: “Can Accountable Care Organizations Improve the Value of Health Care by Solving the Cost and Quality Quandaries?” The goal of ACOs is…
The California HealthCare Foundation has an almanac entry on Children’s Health Coverage Facts and Figures. Eligibility requirements for these programs is described in this table. Other key findings include: The proportion of children without health insurance continued to decline through 2007, though the pace of improvement has slowed. Nearly 80 percent of California’s uninsured children…
How does one evaluate a physician’s efficiency level? This process has five main dimensions. Which resource use measurement methodology to use. There are two main profiling methodologies: per capita and episode-based. How to account for differences in patient health status. This is done through risk adjustment. However, choosing the proper risk adjustment method is crucial…
One problem with any government-run health insurance program is that politicians have an incentive to make decisions that are attractive to small, wealthy, cohesive constituencies, rather than for the greater good. For instance, although CMS administrator tried to stem the tide of rising physician costs, Congress has repeatedly reinstated the physician raises. The following three…
California’s Medicaid program, known as Medi-Cal, is the largest in the nation. The California Health Care Foundation offers some interesting facts about the program in this report. For instance: In just two years, Medi-Cal’s share of the state’s General Fund spending increased from 17% to 19%. If not for provisions in the federal stimulus bill that…