Unbiased Analysis of Today's Healthcare Issues
That is the topic of a commentary by Carroll et al. (2022) in Health Services Research. The first issue they discuss is access to care. A core challenge in rural communities is declining access to hospital care. Eight percent of rural hospitals have closed over the last decade, and closure rates have increased in recent…
How do efficiently is care provided for patients at Veteran Affairs’ hospitals as compared to private hospitals? This is not an easy question to answer as the composition of patients differs between these hospitals. Even among dually-eligible individuals–those with both VA and commercial insurance–individuals treated at VA hospitals are generally more severely ill. To better…
Interesting study from Hegland et al. (2022) in HSR. The authors used data from Healthcare Cost and Utilization Project (HCUP), American Hospital Association Survey, Hospital Compare, and American Community Survey data and find that: Non-Hispanic Black individuals live in zip codes supplied, on average, 0.11 more beds per 1000 population (SE = 0.01) than places where non-Hispanic…
Recently the CBO published a report compared the rates public and private insurers pay to hospitals for inpatient services, for services at hospital outpatient departments (HOPD), and at ambulatory surgical centers (ASC). A recent RAND report aims to do a similar exercise but contributes to the literature by using updated data from more states, allowing…
As the rates of COVID-19 increased the burden on hospitals in the early months of the pandemic, hospitals were decry a lack of beds and pressure on staff. While COVID-19 is of course a very acute case of over-crowding, a more general question is how much does hospital crowding impact health outcomes. A paper by…
Not surprisingly, the impact is significant. That is according to a study by Malone et al. (2022), estimated using a difference-in-difference design with data between 2001 and 2018. Specifically, they find: Of the 1759 nonmetro counties in our study sample, 109 experienced a hospital closure during the study period. Relative to the nonclosure counterfactual, closures…
In many countries including the US and England, hospitals are paid by payers (i.e., commercial insurers and governments) on a per-admission basis with more reimbursement for treating patients with more severe conditions and lower reimbursement for treating patients with less severe conditions. This system is known in the U.S. as the diagnosis-related group (DRG) system,…
The Public Health Service Act (PHSA) in 1992, created a program to allow hospitals providing care for underserved communities to be able to access discounted drugs. The program–known as the 340B Drug Pricing Program, has been described as follows: …[The] law requires pharmaceutical manufacturers participating in the Medicaid program to enter into a second agreement…
Many people might know that generally the answer is commercial health plans have the most generous reimbursement compared to government plans. However, a key question is how much more do they pay? Commercial vs. Medicare rates A January 2022 report by the Congressional Budget Office finds that commercial payers reimburse hospitals at 223% of Medicare…
That is the question asked by Horwitz and Nichols (2022) in their paper out this week in Health Affairs. I summarize their paper below. Data The authors use data from 2014-2019 American Hospital Association (AHA) annual member surveys among all acute care hospitals (both general medical and surgical) located within urban metropolitan statistical areas (MSAs)…