Unbiased Analysis of Today's Healthcare Issues
At the end of last year, CMS finalized a rate cut for Medicare reimbursement to physicians. The CMS Fact Sheet states: …average payment rates under the PFS [Physician Fee Schedule] will be reduced by 2.93% in CY 2025, compared to the average amount these services were paid for most of CY 2024 This sounds like…
This questions may be harder to answer than it may seem. While some physicians are fully independent, and others are full employees, other physicians can be affiliated with hospitals, without being hospital-employed. There are various approaches for measuring whether a physician is integrated within a hospital system: Basic TIN-based measure. The standard approach to identifying…
As of 2007, about half of physicians had noncompete clauses (“noncompetes” for short) in their contracts. However, a recent FTC rule severely limits when they could be used. What specifically did the new FTC rule say about non-competes? Fuse Brown et al. (2024) provide a helpful summary. The final FTC rule declares all new noncompete clauses or…
One reason is that reimbursement rates for Medicaid are lower than for Medicare or commercial insurance. Another (often overlooked) factor, however, is physician’s risk of payment denials and the administrative hassle they face trying to get reimbursed by Medicaid. A paper by Dunn et al. (2024)–cleverly named “A Denial a Day Keeps the Doctor Away“–shows…
That is the title of a paper by Bodnar et al. 2023. A summary of this interesting paper is below. Overview of general practitioners in the UK Under the English National Health Service (NHS) program, …patients register with a single general practice that acts as the gatekeeper to most other NHS services, including non-emergency hospital…
This is a question that can be answered empirically but doing so is challenging. While cross-country comparisons are feasible for comparing public and private health care provisions, often there are many other differences between health care systems across country. Within any given country, there is significant selection bias in terms of who receives public vs.…
There has been much research showing that fee-for-service (FFS) leads to increased provision of medical services and capitation leads to decreased provision of medical services. My own research shows that there are system-wide effects and that the impact of capitation for primary care physicians on services may depend on whether specialists are also reimbursed via…
How did the number of pediatrician and family medicine physician (FMP) change between 2010 and 2020, particularly for rural areas? A paper by Ramesh and Yu (2023) use data from the Health Resources and Services Administration (HRSA) Area Health Resources Files and and county characteristics from the American Community Survey and find that: From 2010…
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…
That is the conclusion from a recent report from some of my colleagues at FTI Consulting’s Center for Healthcare Economics and Policy. In the report titled “Protecting the Pipeline: How a Public Option Could Impact Our Nation’s Health Care Workforce“. An excerpt and some empirical findings are below. …government rate setting under a public option…