Unbiased Analysis of Today's Healthcare Issues
That is the subtitle of an NBER working paper by Charles Gray, Abby E. Alpert & Neeraj Sood. The author examine recent mergers between pharmacy benefit managers (PBMs) and health insurers. On the one hand, integration may beneficial to consumers. It could: (i) improve operational efficiencies, and (ii) better align PBM incentives with those of…
A paper by Hsia et al. (2023) shows that California emergency department capacity is not keeping up with demand and is increasingly concentrated in fewer facilities. Using data from the California Department of Health Care Access and Information and US Census, the authors find that: In the prepandemic period (2011-2019), the total population of California…
That is the topic of a recent paper Tyan, Lam and Milligan (2023). Using newly created database from financial databases combined with press releases, news sources, clinic websites, and financial 10-K reports, the authors found that: During 2003 to 2022, 724 oncology clinics (53% radiation, 32% medical, 15% multi-oncologic) became affiliated with a PE-backed platform…
A Minnesota bill would expand the MinnesotaCare Medicaid system to incorproate a public option. The public option would reduce uninsurance rates, but would also have some negative impacts on providers. An FTI report (“Evaluating the Potential Impact of a Public Option on Minnesota’s Hospitals and Patients“) reviews the implications of the public option in Minnesota.…
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…
Yes, this appears to be the case. Medscape reports: In one of the largest healthcare deals to date, Kaiser Permanente is acquiring Pennsylvania-based Geisinger Health and investing $5 billion to fold it into a new nonprofit subsidiary called Risant Health, which is set to purchase additional medical groups in coming years.While regulators still must review…
An interesting article by Mor (2023) examines the history of the requirement for a 3-day hospital stay for Medicare to cover a skilled nursing facility (SNF) transfer. The 3-day requirement: …was introduced very early in the history of the Medicare SNF benefit at a time when most nursing homes (NHs) offered primarily custodial care and…
Hospital admissions are typically paid largely based on DRGs. DRGs account for the type of admission (e.g., heart failure, hip fracture, COPD) and some measure of patient characteristics and disease severity. However, should hospital structural factures be incorporated into reimbursement? On the one hand, if the structural factor is a cause of less efficient care,…
A commentary from Sheehy et al. (2023) argues that the hospital readmissions reduction program has been a disappointment. “If you can’t measure it, you can’t improve it”—a quote featured prominently on the Centers for Medicare & Medicaid Services (CMS) Measures Management website.3 But like any initiative intended to improve quality, evaluation, and iteration is key…
In Bangladesh, seasonal floods occur due to snow melt from the Himalayas as well seasonal monsoons. How can villages in Bangladesh get health care if they don’t have a boat to transport them to regional health care centers? The answer–according to a recent article in The Economist–is that the hospital comes to them. Three hours’…