Unbiased Analysis of Today's Healthcare Issues
Why does Medicare spend $7,500 for patients in El Paso, Texas but spends $15,000 for patients in McAllen, Texas? It McAllen richer? Does McAllen receive better care? Are patients sicker in McAllen? “Come on” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here pure and simple.” Doctors, he said,…
Medicare Part D decreased the number of seniors without drug coverage. In 2006 only 7% of seniors lacked drug coverage compared to 24% in 2004.
Bond Markets seem to be concerned over the escalating level of U.S. Government debt. Yields rose during the latest $14 billion auction of U.S. 30-year Treasury Bonds. This graph shows an ominous budget deficit trend as well. There seems to be good reason for this. American’s stimulus plan and entitlement programs are putting an…
How much of my salary goes to pay for Medicare? What is the difference between Medicare Part A, B, C and D? What is a donut-hole? [hint: They don’t have them at Dunkin’ Donuts] The Incidental Economist has a concise, easy-to-understand three-part series of posts on Traditional Medicare, Medicare Advantage, and Medicare Prescription Drug…
How do hospitals estimate the cost of different inpatient stays? A paper by Clement et al. (2009) reviews 3 techniques: Microcosting. “With microcosting, a detailed list of each component of a patient’s care is created and costed separately for each facet of a patient’s hospitalization. Given the level of detail, microcosting is generally considered the…
All health services researches know that comparative-effectiveness research is a vital link towards improving quality and decreasing cost. Comparative effectiveness examines different medical treatments and evaluates which are the most cost effective. The UK’s NICE (National Institute for Health and Clinical Excellence) publishes clinical appraisals regarding which treatments the NHS should cover. Should the U.S. create a…
In 2004, 29% of Medicare enrollees had Medigap coverage. Are these policies priced efficiently? An NBER paper by Maestas, Schroeder and Goldman (2009) argues that the answer is no. Prior to July 1992, Medigap was minimally regulated. With the passage of the Omnibus Budget Reconciliation Act of 1990 (implemented in July 1992), Medigap plans…
Joe Paduda of Managed Care Matters has a two great posts on Medicare’s new payment structure. The first post reports how exactly Medicare is changing its reimbursement for medical services. “It looks like reimbursement for cognitive services – the 99xxx codes for readers expert in CPT-4s…office visits and similar services for others – will…
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,…
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…