Unbiased Analysis of Today's Healthcare Issues
CMS is increasingly moving to alternative payment models whereby providers are paid based on their ability to improve/maintain quality and hold the line on cost. A key question then, is how does CMS evaluate quality of care? Today, the Healthcare Economist will answer this question for the case of Medicare’s Shared Savings Program (MSSP), which…
A few weeks ago, I reviewed a study that showed that maybe we don’t need Hospital Compare any more. The study found that there was significant overlap between crowdsourced ratings of hospital quality and those on Hospital Compare. However, will the quality of crowd-sourced reviews decline over time? This may be the case if reputation…
A recent report from the Health Care Payment Learning and Action Network (HCP LAN) examines how providers are getting paid in the U.S. today. Traditionally, health care providers (e.g., physicians, hospitals) were paid via fee-for-service (FFS). Fee-for-service means that every time a provider does a service, they get paid. This is truly largely regardless of…
This is basically the question that Perez and Freedman (2018) ask. They find the following: Among crowdsourcing sites’ best‐ranked hospitals, 50–60% were also the best ranked on [Hospital Compare’s] HC’s overall and patient experience ratings; 20% ranked as the worst. Best‐ranked hospitals had significantly better clinical quality scores than worst ranked hospitals, but were not…
Pharmaceuticals on the one hand can greatly improve patients health and quality of life. At the same time, some of these treatments are expensive and–despite clinical trial results–evidence from the real-world is lacking at the time of a drug launch. To address these issues, Oklahoma’s Medicaid program is taking the lead by adopting two different…
Medicare’s Merit-based Incentive Payment System (MIPS) aims to link physician quality of care to their reimbursement. At first glance, paying more to high quality physicians seems like a great idea. However, a paper by Liao et al. (2018) surveys physicians from a large national sample maintained by the American College of Physicians (ACP). They find…
How do physicians learn? A paper by Van Gestel, Muller, and Bosmans (2018) claims that the answer is through cumulative experience, economies of scale, or human capital depreciation. Learning from cumulative experience refers to the idea that treating an additional patient generally improves physician (or team) performance. When referring to economies of scale, we capture…
CMS has focused in recent years on payment reform–especially alternative payment models–in Medicare’s fee-for-service (FFS) reimbursement system, but much less has been paid to beneficiaries enrolled in Medicare’s managed care program (i.e., Medicare Advantage). Currently, however, more than 1 in 3 beneficiaries are enrolled in an Medicare Advantage plan, and by 2028 that number could…
Many of Medicare’s alternative payment models are based on the premise that there is a lot of waste in health care. If that is the case, we could reduce cost with little to no effect on quality. While that would be nice, is that really the case? Consider two articles from the most recent edition…
It appears that the answer is ‘yes’. Many studies by the Dartmouth Atlas team have shown that regions that spend more on medical care do not always get better outcomes. However, a recent paper by my Precision Health Economics colleagues James Baumgardner, Ahva Shahabi, Mark Linthicum, Seanna Vine, and Darius Lakdawalla as well as Chris Zacker…