Unbiased Analysis of Today's Healthcare Issues
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.…
Asymptotic theory has played a large role in the development of many recent econometric methods. For instance, the central limit theorem states that distribution of the mean drawn from any large samples is approximately normally distributed. Asymptotic theory, however, generally assumes that sampling occurs infinitely and with replacement. In the real world, populations are not…
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.…
The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a standardized survey instrument and data collection methodology for measuring patients’ perceptions of their hospital experience. HCAPHS is the first national standard for collecting and reporting hospitals quality data. The survey asks discharged patients 27 questions about their recent hospital stay. The survey is…
Do more intensive medical services improve patient satisfaction? Not according to Mittler et al. (2010): Overall, higher intensity use was associated (p<.05) with worse (seven measures) or no better care experiences (two measures). In higher-intensity markets, Medicare FFS and MA beneficiaries reported more problems getting care quickly and less helpful office staff. However, Medicare FFS…
Comparative Effectiveness Research (CER), as it name suggests, compares how well different medicines treat a given disease. Politicians claim that using CER findings can help improve quality and decrease cost. If one treatment produces better health outcomes on average than another and also costs less, we should always make people use that treatment, right? Not…
From a paper by Weinstein and Skinner (NEJM 2010): “Moreover, there is considerable variation in health care expenditures and a weak or even negative association between spending and outcomes, such as mortality at the regional level and quality measures at the state level. This evidence has been interpreted to mean that cutting back on these…
Comparative Effectiveness has been a hot topic in health services research. According to a recent article in the New England Journal of Medicine, “the American Recovery and Reinvestment Act of 2009 authorizes the expenditure of $1.1 billion to conduct research comparing ‘clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used to…
A paper by Sutton, Elder Guthrie and Watt (2010) describes the UK’s National Health Service’s (NHS) adoption of the Quality and Outcomes Framework (QOF) in April 2004. In general, P4P programs can have positive or negative spillovers. An example of a positive spillover would be the adoption of EMR to comply with certain P4P initiatives,…
The US News and World Report has popular rankings for colleges, graduate schools and now hospitals. Do patients actually decide to seek care at different hospitals based on these ratings? Devin Pope attempts to answer this question in a recent Journal of Health Economics article (free draft). To determine whether or not this is the…