How good is your mental health care? Depends where you live

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…

Would telehealth increase the price of health care?

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…

How good is Nursing Home Compare?

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 as health care providers

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…

90% of health plans think the use of alternative payment models will increase in the coming years

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…

AMA and the adoption of digital medicine

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…

Do we need Hospital Compare if we have Yelp?

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…

Does physician knowledge of patient non-compliance change prescribing behavior in the real world?

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…

340B Facts and Figures

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:…

Market consolidation in California

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…