Unbiased Analysis of Today's Healthcare Issues
Medicaid currently accounts for roughly 50% of all nursing home expenditures and 70% of all bed days. The government mandates that nursing homes provide a uniform level of quality to all residents, regardless of the payer type. Yet one may ask: does this mandate hold in reality? Nursing homes may have an incentive to segregate private insurance…
Generalists can give holistic, cost-effective care to patients, but may be limited in their ability to treat complex diseases. Specialist may offer a superior quality of medical services and advance knowledge in their field, but this premium medicine comes at a high cost. Generalist or specialist…Specialist or generalist…which to chose? A 1996 New England Journal of…
There is a dynamic relationship between generalists and specialists. Currently, 4.5% of visits to PCPs result in a referral. A RAND study and my own investigation of the 1998-1999 Community Tracking Survey show that about 10% of individuals are hospitalized at least once each year. How should we model the decision patients face between generalist and specialist care.…
In the early- and mid- 1990s, hospitals were under pressure. Managed care was taking off and forcing hospitals to reduce prices. These managed care plans had the upper hand because: Competition between hospitals was intense. Each hospital had to fight to secure contracts from managed plans in order to direct large chunks of patients to their…
Yesterday, I reviewed one paper claiming PPS along with competition reduced cost, but these cost reductions occurred mostly for the most expensive (read most sick) patients. Continuing the PPS theme, today we will look at a 1995 article in Econometrica in which David Cutler attempts to measure “The Incidence of Adverse Medical Outcomes under Prospective…
Prospective Payment Systems (PPS) and competition go hand in hand. Without competition, a PPS gives hospitals and physicians the incentive to minimize health care outlays. A competitive fee-for-service (FFS) system-to which most Americans were accustomed to in the 1980s-can lead to severe cost increases due to the problem of moral hazard. Combining PPS and competition…
You may be used to calling your doctor and being told by the staff that you must wait weeks to see your family practice physician. Now imagine calling your doctor and hearing, “I can see you this afternoon…or tomorrow if you like…which one is best for you Mr. Shafrin?” How can a practice be able to do…
We are now in the information age. Let’s take a look at the following numbers: Internet World Stats reports that approximately 70% of Americans now have access to the Internet. (This puts it 7th in the world in terms of Internet penetration). Over 85% of physicians have access to high speed internet in their offices.…
Many studies have claimed that Nurse Practitioners (NPs)–as well as Physician Assistants (PAs)–are adequate substitutes for primary care physicians. Researchers claim that NPs can perform a great majority of the tasks currently carried out by primary care physicians, and should be used more frequently since NP and PA salaries are usually half of primary care…
According to the Milwaukee Journal-Sentinel (“Orthopedic hospital…“), the Orthopaedic Hospital of Wisconsin posted profit margins of 52%. The article claims that the healthcare industry generally only has profit margins of around 3%-5%. Does this mean that the Orthopaedic Hospital of Wisconsin is providing highly valued services? Is it good at cutting costs? Or is it…