Unbiased Analysis of Today's Healthcare Issues
While CMS has a target of getting 100% of Medicare beneficiaries into value-based payment (VBP) programs–such as accountable care organizations–by the end of the decade, implementing VBP in practice will be challenging. An editorial by Navathe et al. (2024) in Health Affairs provides some key considerations. Providers forego certain revenue for uncertain ‘bonus’ payments. “One…
A paper by Kogut (2024) has a nice overview of the organizations that develop pharmacy plan quality metrics. Pharmacy plan quality is vital since approximately 85% of the US population has prescription drug coverage through public (e.g., Medicare , Medicaid) or commercial (e.g., employer-provided) pharmacy plans. A helpful summary table is below. Quality measures are…
That is the question asked by a recent NBER working paper by Chandra et al. (2023). This question is important for a variety of reasons. First, quality measure data collection is expensive. Saraswathula et al. 2023 found that Johns Hopkins Hospital had to report 162 unique quality metrics, and the cost for collecting these data…
According to a paper by Smith et al. 2023, the answer is ‘no’. The authors use data from AHRQ’s Healthcare Cost and Utilization Project (HCUP) State Inpatient Data, Hospital Cost Reporting Information System Data, Office of Pharmacy Affairs Information System Data, and American Hospital Association Annual Survey for 15 states between 2008 to 2014. The…
That is the finding from a paper by Geruso, Layton and Wallace (2023). They exploit the random assignment of approximately 70,000 Medicaid beneficiaries to Medicaid managed care (MMC) plans from 2008 to 2012 in New York City. In short, beneficiaries in New York who did not actively choose a plan within a designated choice period…
Public reporting of hospital quality of care could improve the care patients receive through at least two pathways. First, patients (or their physicians) could send patients to higher quality hospitals (i.e., the selection pathway). Alternatively, hospitals themselves could have behavioral responses to the metrics and may improve quality of care in response to public reporting…
Out recently is an interesting AEA paper by Okeke 2023, who examines a policy experiment by the Nigerian government that aimed determine whether expand access to physicians improved health outcomes. In this experiment, some communities were randomly selected to receive a new doctor. These doctors were posted to the local public health center. Prior to…
As a health economist who likes to think about the world in a quantitative manner, I do whatever I can to measure quality in a numeric manner. Thus, if I was visiting a primary care physician (PCP) and needed some specialist care, I would want the PCP to refer me to the specialist with the…
In the past, I have written about the Enhancing Oncology Model (EOM), including an overview of the EOM program as well as a more detailed review of EOM’s payment methodology. A new paper in JAMA Health Forum by Kocher and Adashi (2023) describes their perspective on the EOM program. First, they provide a nice overview…
Back in July, I provided an overview of the Enhancing Oncology Model (EOM). Today I build upon that post focusing largely on CMS’s EOM’s Payment Methodology. I use a Q&A format as well. What is the goal of EOM? According to CMS “EOM is a CMMI alternative payment model designed to advance health equity, promote…