Unbiased Analysis of Today's Healthcare Issues
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…
Access to physician services and pharmaceuticals is vital–particularly among patients with serious mental illness–to insure patients receive the care they need. However, the likelihood patients receive this care depends on where they live. A paper by Manchester (2018) examines a cohort of patients eligible for both Medicare and U.S. Social Security Disability Insurance (SSDI) and…
Health Affairs December 2018 issue focuses on telehealth. The general assumption is that telehealth is an unambiguous good. Getting access to health care providers–particularly those who live in remote areas or have transportation challenges–is certainly a good thing. But could telehealth increase the price of health care? In this thought exercise, pretend for a moment that…
In the past few weeks, I discussed how well Hospital Compare does on measuring the quality of hospital care (see here and here). Now, I turn to how well Nursing Home Compare does on truly measuring quality of care. A study by Brauner et al. (2018) attempts to answer this question. They compare the quality…
Pharmacists are often seen as individuals who just dispense drugs. However, pharmacists are increasingly considered as providers that are part of the broader health care team. My own research has shown that pharmacists are a more cost-effective and safe approach to getting vaccinations compared to primary care providers (see Fontanesi et al. 2009). A Health Affairs Entry…
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…
There is a lot of hype about digital medicine. Though the definition of what digitla medicine mans varies, many digital devices are able to monitor patient physiology, medication adherence, or other behavior and communicate that with the patient as well as their provider team. One key barrier to having the provider team actually use these…