Unbiased Analysis of Today's Healthcare Issues
The Economist reports that adverse events occur relatively frequently when physicians insert catheters: placing needles inside veins deep in the body is notoriously difficult. Some 15-30% of attempts suffer complications, mainly punctured arteries that can lead to infection (around 250,000 cases in America annually), but also bleeding, collapsed lungs and even cardiac arrest. Failure rates in…
The answer is likely “It depends.” To see why this is the case, let us consider the case of some proposed health reforms in Switzerland to force physicians into managed care (MC) networks. As described in Rischatsch (2015): In 2012, Switzerland held a referendum…aimed at encouraging the nationwide development of MC networks. Among other changes…the legal…
CMS has stated that they want 30% of all fee-for-service payments to be transitioned to alternative payment models–such as pay for performance–in the upcoming years. A future where all providers are paid capitation or based on some measure of value is not here yet. And in the interim, providers are dealing with a complex system…
The sustainable growth rate (SGR) was implemented by Congress in1998. The SGR’s aim was to slowly bring down or at least decellerate Medicare compensation for physicians compensation. However, each year, it gets reversed by Congress. Now, instead of a gradual decline, the implementation of SGR would result in about at 25%pay cut for Medicare docs.…
Why are doctor’s always complaining about the sustainable growth rate (SGR) issue? What is the SGR? The Brookings blog has a nice primer on the SGR. What is the SGR Put in place through the Balanced Budget Act of 1997, the SGR is a system designed to control the costs of Medicare payments for physicians.…
Medicare is working hard to make sure that doctors are efficiently providing high-quality care. Programs such as the Physician Quality Reporting System (PRQS) and the Value-Based Payment Modifier all are aimed to improve quality and lower cost. The downside of such programs, however, is that the impose reporting burdens on physicians. For instance, Medicare can…
Residency has been a right of passage for physicians. Long 36-hour shifts mix with the excitement of new learning. However, recent regulations have now capped residency weekly hours at 80. Although patient medical care in the short-run may improve (because physicians are less tired), in the long run, are physicians exposed to as wide a…
In pay-for-performance (P4P) or value-based purchasing (VBP) schemes, health care provider reimbursement rates depend on performance. Physicians can receive bonuses for following best practices, and hospitals can increase reimbursement rates from Medicare if they improve clinical processes and patient satisfaction. As an economist, rewarding good performance with financial payments makes perfect sense. Or does it?…
The cost of operating a physician practices differs across states. For instance, rent is much higher in New York City than Nebraska. Labor costs are much higher in Los Angeles than in La Crosse, Wisconsin. To account for differences in the cost of operating a practice, Medicare adjusts reimbursement rates in their standard physician fee…
File under “least shocking development of the day”: The American Medical Association opposes cuts to physician salaries. In a letter on Monday, the AMA stated that it expreses: …strong support for the “SGR Repeal and Medicare Provider Payment Modernization Act of 2014” (H.R. 4015/S. 2000)…Previous Congresses have spent more than $150 billion over the past…