Unbiased Analysis of Today's Healthcare Issues
Perhaps according to Austin Frakt. He writes in JAMA Forum: In every year since 2011, more hospitals have closed than opened…For example, 15 of the 21 hospitals that closed in 2016 were in rural communities, and since 2010, nearly 90 rural hospitals have done so. Hundreds more are at risk of closure.One source of financial challenges to…
While I leave the answer to the first question for another day, the answer to the second question is ‘yes’. Done, Herring and Wu (2019) explain’s Maryland’s approach to global capitation payments for hospitals covering both inpatient and outpatient hospital services. Maryland is the only state that still operates an all‐payer rate‐setting system for hospitals,…
As the U.S. ages, more and more individuals have chronic conditions or functional limitations which may at some point require senior housing, such as independent or assisted living facilities and nursing homes. The question is, will individuals be able to afford this type of housing? According to a paper by Pearson et al. (2019), the…
A paper by McDermott et al. (2019) examines how primary care services are commissioned in the United Kingdom under the National Health Service (NHS). Interestingly, the study provides a nice overview of the history of GP contracting in the UK as well. An excerpt is below. The current primary care system in England, whereby GPs…
Is caregiving by family members superior to paid home health caregiving? According to a paper by Coe et al. (2019), the answer is ‘yes’. We find that some family involvement in home‐based care significantly decreases health‐care utilization: lower likelihood of emergency room use, Medicaid‐financed inpatient days, any Medicaid hospital expenditures, and fewer months with Medicaid‐paid…
The National Institute for Health Care Management (NIHCM) has some nice slides describing trends in hospital consolidation. First, we see a trend of increased hospitalizations over time. Further, these mergers are not small. In 49% of cases, the acquired (i.e., smaller) hospital has revenue of >$100m and in 19% of cases the acquired hospitals has…
According to research by Leech et al. (2018), the answer may depend on whether or not you are black or white. Compared to the control group, “Black” auditors were less likely to be told an office was accepting new patients and were more likely to experience both withholding behaviors and misattributions about public insurance. The…
In single payer systems, the problem of adverse selection in health insurance is solved because the single payer must cover all people. Because the single payer cannot avoid covering any individual, there is no strategic gaming on coverage decisions. There may, however, be strategic decisions made on the treatment of patients. Consider the case of…
A number of studies (e.g., Wasfy et al. 2017, Desai et al. 2016) have found that the Centers for Medicare and Medicaid Services (CMS) Hospital Readmissions Reduction Program (HRRP) reduce hospital readmissions. However, are these findings valid? A recent paper by Ody et al. (2019) argues maybe not. Because readmission rates are risk-adjusted, changing coding…
The answer is ‘perhaps’ according to a new paper by Wadhera et al. (2018). They use data from 2005 to 2015, and apply an inverse probability–weighted 30-day and 45-day post-discharge mortality measure stratified by whether there was an associated readmission. They examine admissions for acute myocardial infarction, heart failure, and pneumonia. Among Medicare beneficiaries, the HRRP…