Unbiased Analysis of Today's Healthcare Issues
Health systems have been touted by some to be a cure to many of our health care systems ills by providing integrated, high quality care. Others claim that health systems are just a way for providers to big up prices through more bargaining power. Either way, it is not entirely clear to what extent health…
Haven was a high-profile effort whereby three industry titans–Amazon, Berkshire Hathaway and JP Morgan–created a joint venture with the hope of lower costs and improving quality. Today, Haven announced it is shutting down in February. What happened? I don’t know the answer, but below are a few possibilities. Scale. Although these are three large companies,…
What is better: public or private health care systems? This is a difficult question to answer. If we compare the British against the US health care systems, they differ for a large number of reasons beyond just public vs. private. Additionally, one must specify what one means by public vs. private. Is this public vs.…
How much are hospital CEOs getting paid? A paper by Mulligan et al. (2020) provides the answer: Between 2010 and 2015, mean hospital CEO compensation (in 2015 US$…) increased 7.8%, from approximately $639,000 to $689,000 (p = .05), and median compensation increased from $431,000 to $464,000. Not surprisingly, CEOs of larger hospitals systems get paid…
Last week I reviewed an article on some of the potential positives and negatives of large, integrated health systems. A recent 60 Minutes episode talks about some of the perils by examining how Sutter health system has become a near monopoly provider in Northern California. Consider the following interaction between Leslie Stahl of 60 minutes…
Integrated delivery networks. IDNs. Accountable Care Organizations. ACOs. Systems of care. Health systems. Whatever you call them, many health policy experts claim that they are the best way for the U.S. health care system to deliver high quality care in a cost-effective manner. But is that really the case? A commentary by UCSD professor and…
Interesting findings from an NBER working paper by Cronin and Evans (2020): Higher-quality nursing homes, as measured by inspection ratings, have substantially lower COVID-19 mortality. Quality does not predict the ability to prevent any COVID-19 resident or staff cases, but higher-quality establishments prevent the spread of resident infections conditional on having one. Preventing COVID-19 cases…
The Oncology Care Model is slated to end soon. Specifically, the last set of six-month episodes would initiate no later than December 31, 2020 and thus all episodes will be completed in June 30, 2021. Nevertheless, CMS is proposing a successor to the Oncology Care Model called the Oncology Care First (OCF) Model. CMS describes…
Physicians are increasingly becoming parts of larger and larger practice. Further, many physicians are shifting from firm owners to employees. In recent years, private equity investments have helped to accelerate this trend. A paper by Brusch et al. (2020) reviews this trend among women’s health practices (i.e., o bstetrics/gynecology (OB/GYN) or fertility services). They look…
Electronic health records (EHR) are supposed to improve quality. While EHRs certainly are highly useful for information sharing, they may have adverse consequences. One issue may be that EHRs may induce fatigue in physicians and sap their needed energy/concentration away from their primary task: caring for patients. To test whether EHRs increase physician fatigue and…