Unbiased Analysis of Today's Healthcare Issues
When you buy a typical product, the vendor does its best to make the purchasing process as easy as possible. There is a reason for this, clearly; they want your business. State and federal governments, however, have no such incentive. In fact, oftentimes reducing the number of people using government services saves money. Thus, it…
A new paper by Sharma et al. (2017) finds that Medicaid patients living in states with lower Medicaid reimbursement have more challenges accessing primary care services. We found that states with higher Medicaid fees had higher probabilities of appointment offers and shorter wait times for Medicaid patients, and lower probabilities of appointment offers and longer…
In general the answer is yes, but often with some difficulty. AJMC recaps the findings from a the CDC Morbidity and Mortality Weekly Report (MMWR) Quick Stats section from July 21, 2017. 88.9% of primary care physicians said they are accepting new patients, based on 2015 data from the National Electronic Health Records Survey. However,…
In short, the reason is that Medicaid reimbursement rates for providers is too low. Saurabh Jha, however, explains the point a bit more artistically in his Health Care Blog piece. Medicaid pays a cardiologist, with years of training, $25-40 for a consultation to manage a complex patient with multiple comorbidities, on polypharmacy, where the cardiologist…
One of the primary changes in the healthcare system directed by the Affordable Care Act was providing funding for states to expand Medicaid. Many states did so; many others did not. Some states expanded Medicaid but put additional hurdles in front of beneficiaries to receive this coverage at no cost. Consider the case of the State of Iowa.…
The answer may be yes. One of the big inpediments to value-based pricing of pharmaceuticals was that any discount given to any single organization based on outcomes needed to be reflected in the Medicaid price. Since outcomes are subject to random noise, there will inevitably be health plans that end up getting a low price due to worse than expected…
How will Medicaid expansions affect patient access to pharamceuticals? This question is particularly relevant for patients with serious mental illness. The answer is complicated by the increasing presence of Medicaid managed care plans. Increasingly, states have turned to contracts with Medicaid managed care plans in order to better control costs and reduce budgetary uncertainty. However, in…
Does Medicaid use pay-for-performance (P4P) for providers? If so, how does it work? And does it affect quality and cost? These are the questions of interest to Rosenthal et al. (2015) in their study of P4P programs in Alabama, Minnesota, and Pennsylvania. Although all three focus on physicians, the Alabama program is a “medical home ”…
In the U.S., the answer is largely the government. An NBER paper by Mariacristina De Nardi, Eric French, John Bailey Jones, and Jeremy McCauley provide some helpful statistics using data from 1996 to 2010 waves of the Medicare Current Beneficiary Survey (MCBS). The government pays for two-thirds of health care spending by the elderly, with Medicare…
A physician shortage may be a bit much, but it appears that physicians overestimate their availability based on a study by Coffman et al. (2016). The percentage of callers posing as Medicaid patients who could schedule new patient appointments was 18 percentage points lower than the percentage of physicians who self-reported on the survey that…