Unbiased Analysis of Today's Healthcare Issues
Why have a physician do a job when a nurse could do it? Why have a nurse do it if a home health aide could do it? Clearly, the latter group in each sentence is lower cost; however, the former group may provide higher quality care. The balance of who can do what in terms…
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…
Many of Medicare’s alternative payment models are based on the premise that there is a lot of waste in health care. If that is the case, we could reduce cost with little to no effect on quality. While that would be nice, is that really the case? Consider two articles from the most recent edition…
Not all medical problems can or should be treated by a nurse practitioner (NP). However, may can be. Increasing access to care through NPs can reduce wait times through expanding access and decrease cost. The access and cost issues are not in doubt; the question is, can NPs improve or at least maintain patient care? …
Aaron Caroll does a nice job summarizing these viewpoints in his article in the N.Y. Times’ Upshot: Researchers for a study published in the American Journal of Medical Quality talked to patients who sought out care at retail clinics. Patients who had a primary care physician, but still went to a retail clinic, did so…
The popularity of home births has been rising in recent years. One question is whether they are as safe as in-hospital births. A new study in NEJM found that most home births are safe, but hospital births are safer. As the N.Y. Times reports: The study analyzed nearly 80,000 pregnancies in Oregon, and found that…
Using data from the Online Survey Certification and Reporting system and Medicare Part B claims on the use of nurse practitioners (NPs) and physician assistants (PAs) between 2000 and 2010, a paper by Intrator et al. (2015) finds: [Nursing homes] NHs using any NPs/PAs increased from 20.4 to 35.0 percent during 2000–2010. Average NP/PA [visit per bed year]…
Each year, more than $15 billion of taxpayers’ money is spent to support physicians in residency training. About one-third of this amount comes from Medicaid, the Department of Veterans Affairs, and the Health Resources and Services Administration. The remaining nearly $10 billion flows through the Medicare program, primarily to academic medical centers via a complex…
A study by Glied, Ma and Pearlstein (2015) says the answer is no. High worker wages are a reasonable place to start for explaining why US healthcare costs are so much higher than other countries as about half of healthcare spending is spent worker compensation. The study by Glied, Ma and Pearlstein does find that:…
CMS has stated that they want 30% of all fee-for-service payments to be transitioned to alternative payment models–such as pay for performance–in the upcoming years. A future where all providers are paid capitation or based on some measure of value is not here yet. And in the interim, providers are dealing with a complex system…