Unbiased Analysis of Today's Healthcare Issues
How do efficiently is care provided for patients at Veteran Affairs’ hospitals as compared to private hospitals? This is not an easy question to answer as the composition of patients differs between these hospitals. Even among dually-eligible individuals–those with both VA and commercial insurance–individuals treated at VA hospitals are generally more severely ill. To better…
I recently finished reading the book titled The Hospital: Life, Death and Dollars in a Small American Town by Brian Alexander. The premise of the book is very interesting. It takes a detailed look at a hospital in rural America, Bryan, Ohio to be specific. The book touches on the challenges a small-town hospital from…
Quality of care is difficult to measure. Even if you had a perfect measure of quality in terms of health outcomes, risk adjustment is imperfect. For instance, academic medical centers are often assumed to have high quality, but actual outcomes observed in the data may not be that good if they also receive the sickest,…
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…
Yesterday I noted that competition is key to driving down prices in health insurance markets. Competition is about expanding the number of suppliers available for a given product. Now let’s think about the demand side. Does reducing the number of purchasers increase or decrease price? One could think that price would fall because buyers would…
Conventional wisdom holds that in recent years the answer is ‘yes’, however what does the data show? A paper by Nipay, Richards and Penso (2018) uses an SK&A survey of physician office practices between 2007 and 2017 to find the answer. In short, conventional wisdom is largely true with the caveat that there is significant…
Sarah Kliff of Vox has an interesting article looking at hospital pricing. She provides examples of $629 for a Band-Aid in an emergency department to over $3,000 to look at a bruised finger. Part of these high costs are not just physician time and treatment materials but a facility fee. The facility fee is basically the…
The Economist‘s recent article “Prescription for the future” describes some new trends in health care treatment and predicts what the hospital of the future will look like. Some excerpts are below: When I think of the hospital of the future, I think of a bunch of people sitting in a room full of screens and phones,”…
The answer: more competition leads to more technology adoption. This is the finding from a study by Karaca-Mandic et al. (2016). They use data from 100% Medicare claim in 2003 and 2004 as well as linked information on hospitals [American Hospital Association (AHA) Annual Survey] and physicians [American Medical Association (AMA) Masterfile]. Competition is measured two…
In my previous work, I have examined regional variation in Medicare and Medicaid costs through reports to the Institute of Medicine and publications in peer-reviewed journals. We found significant variation in health care costs across regions, that high-cost regions tended to remain high cost over time, but that a region that is high-cost for treating one medical condition…