Unbiased Analysis of Today's Healthcare Issues
On the one hand, home infusions can reduce cost; on the other hand, there may be some safety issues. A Modern Healthcare article provides an overview: Around 900 providers and 1,500 pharmacies offer home and specialty infusion therapy to 3.2 million patients annually, according to estimates from the National Home Infusion Association. Clinicians travel to…
For years, Medicare and other payers have used quality measures to evaluate the quality of care patients receive at various types of providers settings (e.g., hospital, home health agencies, skilled nursing homes). For some payers, higher quality scores/higher star ratings lead to direct increases in reimbursement through a value-based purchasing arrangement. Typically, value-based payment systems…
No, this is not coming nation-wide, but it may be on its way in California. Kaiser Health News reports: A provision in California’s newly approved state budget will eliminate the asset test for the 2 million Californians enrolled in both Medi-Cal and Medicare, the federal health insurance program for people 65 and older and people…
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…
How does payment reform affect access to care? And what does payment reform mean? Payment reform can mean manythings but in this context we will mean substituting fee-for-service or cost-plus reimbursement schemes for fixed reimbursement for a fixed episodes of care or fixed bundles of services during a specific time frame. One example of how payment reform worked,…
In the case of elderly care services in Sweden, the answer is ‘yes’. In Bergman et al. (2016), the authors… assemble a large data set on elderly care services in Sweden between 1990 and 2009 and estimate how opening to private provision affected mortality rates – an important and not easily contractible quality dimension –…
Medicare’s move towards bundling payment for acute and post-acute care means that hospitals have an incentive to carefully monitor care received after discharge. But what are the key drivers of post-acute care cost: hospital readmissions? use of any post-acute care? type of post-acute care used? A paper by Huckfeldt et al. (2016) examines Medicare claims data…
It has long been posited that increased used of home health care will decrease the use of long-term care. Clearly, there are some patients who need assistance, but for whom long-term care is not needed. If most of these people who would use home health care would otherwise be in long-term care, home health care…
Many adults spend significant time caring for sick, elderly parents. What is the cost of providing this informal care? Would it be better to have family members outsource the care to formal caregivers? A paper by Chari, Engberg, Ray and Mehrotra (2014) attempt to answer this question. They use data from the American Time Use Survey…
Medicare pays home health agencies (HHAs) to care for patients who cannot care for themselves in their own homes. HHAs, however, have experienced significant changes in the way Medicare pays them over the past 30 years. A recent paper by Huckfeldt et al. (2014) summarizes these changes: 1983: Medicare switches to an inpatient prospective payment…