Unbiased Analysis of Today's Healthcare Issues
An interesting report from the Robert Wood Johnson Foundation summarizes the literature describing the effect of hospital concentration in a market on prices and quality. The general consensus from the literature is the following: Increases in hospital market concentration lead to increases in the price of hospital care Hospital mergers in concentrated markets generally lead…
Medicare will increase payments to hospitals by 2.8 percent in 2013. This net change is due to five major adjustments. Hospital market basket Adjustment: 2.6 percentage points Multi-factor productivity adjustment: 0.7 percentage points Affordable Care Act Provisions: -0.1 percentage points Remaining FY 2008 and FY 2009 Prospective Documentation and Coding Adjustment: -1.9 percentage points Restoration…
A number of studies have found that economic growth (in the short-run) has adverse affects on individual’s health and economic downturns actually cause health improvements. During an economic downturn, individuals work less, sleep more and reduce their alcohol and cigarette usage; all these actions have a salutatory effects on health. For working adults, recessions decreased…
…is poor according to Moody’s. “By limiting the expansion of insurance coverage, the ruling blunts the impact of one of the law’s few credit positive features. Uncertainty regarding which states will and will not participate in the Medicaid expansion adds to the political gridlock regarding healthcare reform, making it increasingly difficult for hospitals to perform…
Do report cards improve quality or simply incentivize hospitals and physicians to stratetically choose which patients to treat? To answer this question, a paper by Chen and Meinecke (2012) examine coronary artery bypass graft (CABG) report cards introduced in Pennsylvania. Report cards can improve quality but they can also induce selection behavior not only by…
The answer is by using exceptions/loopholes to payment rules. The Medicare Wage Index adjusts payments to hospitals based on hospital worker wages wages in the hospital’s labor market. Payment exceptions, in this case the rural floor, causes payments to hospitals in Massachusetts to increase by 16.4 percent simply by having one hospital reclassify. Here is…
More evidence: “One patient who gave the hospital low satisfaction scores, particularly on room cleanliness, was contacted to explain why, [Jim] McManus [vice president of finance at St. Joseph’s Health system in Southern California] said. It wasn’t that the room was dirty, the patient replied. He wanted the cleaning schedule to mirror a hotel experience—cleaned…
The Wall Street Journal reports: “…research showing that the majority of U.S. spending also highly concentrated on a small group of high-cost patients. These typically include people with one or more chronic conditions, such as diabetes, high cholesterol, arthritis and cancer, said Steven B. Cohen, a director at the federal Agency for Healthcare Research and…
DRGs measures case mix for inpatient admissions. One question is how to define a more severe case. Six dimensions along which case mix could be measured include: Severity of Illness. Extent of physiologic decompensation or organ system loss of function. Risk of Mortality. Likelihood of dying. Prognosis. Probable outcome of an illness including the likelihood…
Medicare recently released the Medicare Spending per Beneficiary (MSPB) measure on Hospital Compare. This measure includes all payments to doctors, hospitals or other facilities for services provided to a patient during the three days before the hospital stay, during the stay, and during the 30 days after discharge from the hospital. Kaiser Health news provides…