Unbiased Analysis of Today's Healthcare Issues
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…
This is the topic of a recent publication with co-authors Kata Bognar, Katie Everson, Michelle Brauer, Darius Lakdawalla and Felicia Forma. The full title is Does knowledge of patient non-compliance change prescribing behavior in the real world? A claims-based analysis of patients with serious mental illness. The abstract is below, but do read the whole thing…
The 340B program requires pharmaceutical firms to give large discounts to hospitals and clinics that serve high volumes of low-income patients. This sounds like a good idea at first: give money to people who can’t afford their medicines. However, when one reads the sentence above closely, it becomes clear that patients don’t receive these discounts:…
Yesterday, I discussed the idea of managed competition in California. One of the original tenets of managed competition was insurers having integrated, mutually exclusive provider networks. This would mean much more consolidation on the provider side. While this could improve quality, there is also a risk that prices could rise. In fact, this is what…
That is the finding from a recent study by Mahajan et al. (2018). The authors use data from the American Community Survey between 2011. They compare hours worked and the share of physicians who were self-employed over time. To determine whether any changes were correlated with increaed Accountable Care Organization market share, the authors examined…
Accountable Care Organizations aim to improve quality and reduce cost through an integrated care model. The theory is that by coordianting care better across different provider specialties and care settings, patients care improves. In order to coordinate care, however, you need data. In order for payers to provide higher reimbursement to high quality/low cost ACOs,…
Yesterday I noted that competition is key to driving down prices in health insurance markets. Competition is about expanding the number of suppliers available for a given product. Now let’s think about the demand side. Does reducing the number of purchasers increase or decrease price? One could think that price would fall because buyers would…
The National Cancer Institute defines personalized medicine as “uses information about a person’s genes, proteins, and environment to prevent, diagnose, and treat disease”. In practice, however, patient treatment is rarely personalized by individual since evidence to support complete personalization is rarely available. Personalization in practice more often means care that varies with some individual characteristics.…
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…
Conventional wisdom holds that in recent years the answer is ‘yes’, however what does the data show? A paper by Nipay, Richards and Penso (2018) uses an SK&A survey of physician office practices between 2007 and 2017 to find the answer. In short, conventional wisdom is largely true with the caveat that there is significant…