Why is end-of-life spending so high?

The answer is because using more intensive services does reduce mortality. This is the finding of a recent JAMA paper. After controlling for patient case mix, the authors examine variation in hospital spending in the last year of a patient’s life. The authors note that “Higher-spending hospitals differed in many ways, such as greater use…

How Health Reform will affect Hospital’s Business Strategy

For many years, fee for service payment was the status quo. FFS model encourages hospitals to adopt the following strategies to maximize market share and profits: Centered on short-term acute care Focused on specialist alignment Driven by a volume-based service-line strategy Using expensive medical equipment purchases to encourage physician referrals Attracting patients with new construction…

Medicare’s Agenda for Hospital Accountability

CSC provies a nice overview of some of Medicare’s hospital quality initiatives. These initiatives include a value-based purchasing (VBP) program, reduced reimbursement for excessive hospital readmissions, and reduced reimbursement for hospital-acquired conditions (HAC).  Each of these three broad quality initiatives is described in more detail after the jump. It is important to note that these…

Negotiating Power

On Monday I attended a talk at AcademyHealth on the impact of market consolidation on the cost of health care.  Particularly interesting was Robert (Bob) Berenson’s analysis of the effect of provider consolidation on negotiating power and health care prices.  Particularly, provider have been gaining market power of late, according to recent CTS site visits.…