Unbiased Analysis of Today's Healthcare Issues
Many people have feared that robots, computers, and other forms of technology will take people’s jobs. Conventional wisdom holds that healthcare workers have been largely immune from these technological changes to date. However, a new paper from Lu, Rui and Seidmann examines whether technological advances–specifically computerized provider order entry (CPOE)–affects employment at nursing homes. Using…
Value-based purchasing is supposed to tie reimbursement to quality of care and costs. Providers that are high quality and low cost are supposed to get higher reimbursement, those that are low quality and high cost the reverse. The key question is: does this reimbursement approach work in practice? According to a recent study by Grabowski…
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…
Why don’t payers adopt innovative approaches to treat mental illness? For instance, crisis intervention programs, recovery-focused consumer education programs, telehealth programs, and on-line treatment programs have sometimes have had problems receiving reimbursement from payers. Monica Oss of OpenMinds takes the payers’ perspective: Often, the organization proposing the new program comes to the table with an…
From a working paper by Karen A. Kopecky and Tatyana Koreshkova. …even though they are only a third of OOP [out-of-pocket] health expenses, the presence of nursing home expenses accounts for more than half of savings for all health expenses…We find that 27 percent of savings for old-age OOP health expenses, 3.7 percent of private wealth, is…
What are Long-Term Care Hospitals (LTCH)? These facilities are different from nursing homes. The New York Times explains the type of care they provide: These are no ordinary hospitals: Critically ill patients, sometimes unresponsive or in comas, may live here for months, even years, sustained by respirators and feeding tubes. Some, especially those recovering from accidents,…
Trends in long-term care spending and use has been rising over time. The graphs below, from Nadash et al. (2012) demonstrate this trend between 2000 and 2008. Annual Expenditures Long-Term Care Expenditures Annual Enrollment in Long-Term Care Programs Today, I review the long-term care systems in five European countries: Austria, England, France, Germany, and…
In the past, I have written about how Medicare pays for Skilled Nursing Facilities (SNF). Medicare uses a case-mix adjusted per diem rate. This approach, however, isn’t the only manner payers can use to reimburse nursing facilities. Consider how Australia pays for nursing care under their Australian National Sub-Acute and Non-Acute Patient Classification System (AN-SNAP):…