Unbiased Analysis of Today's Healthcare Issues
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)…
According to a paper by Rodriguez et al. (2022), the answer is ‘yes’. They use data from the 2017–18 National Survey of Healthcare Organizations and Systems (NSHOS), to determine if a physician practice has a “robust set of care management capabilities.” The specific capabilities that were used to determine whether the health system was robust…
The concept of moral hazard is well-known. If patients pay a small share of drug or other medical cost, they may decide to overuse such services. Physicians, however, may also have an incentive to overprescribe if either their reimbursement is tied to prescriptions written. For instance, CMS pays physicians 103% of wholesale acquisition cost (WAC)…
Alternative payment models (APM) are the new trend of the past few decades. High quality, efficient providers should be paid more; low-quality, less efficient providers should be paid less. These APM reimbursement arrangements, however, are typically paid at the health system level and it is unclear whether these incentives trickle down to individual physicians. A…
Over time, physicians are less likely to operate in solo or small group practices. In fact, the share of physician-owned practices has fallen below 50% in recent years. A key question then is how does a physician’s environment or the group they have join affect their practice patterns? Previous research has found that a physician’s…
There is mixed evidence about whether hospital mergers improve quality. On the one hand, economies of scale could lead to more investment in information technology, or allow for further specialization of services. A recent paper by Wang et al. (2022) investigates the impact of a recent hospital merger on quality in New York. The merging…
Recent news articles have spilled much ink about the current nurse shortage. According to Pew, due to nursing shortages “Hospitals nationwide are canceling nonemergency surgeries, struggling to quickly find beds for patients and failing to meet the minimum nurse-patient ratios experts recommend.” Nursing wages are rising as well. The Baltimore Sun reports that the University…
There is much policy discussion about the need for increased care coordination. AHRQ defines care coordination as “deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care.” OECD defines care coordination as “…policies that help create patient-centred care that is…
Medicare pays higher reimbursement to teaching hospitals through indirect medical education (IME) payments to hospitals that train a high share of residents. IME inflate standard reimbursements in an attempt to compensate hospitals for these additional costs. Medicare also pay hospitals directly for some cost of training residents through the graduate medical education (GME). A key…
While the COVID-19 pandemic continues, the worst part of the pandemic is largely past us (see NYT graph) with more people getting vaccinated. One would expect that as vaccine uptake has risen and cases have fallen, interest in the nursing profession would rise and those who left the nursing profession due to COVID-19 may return.…