Unbiased Analysis of Today's Healthcare Issues
That is the question posted by a recent paper by Li and Dor (2024). However, they define competition not just by the number of community health center (CHC) competitors or market concentration (e.g., Herfindahl-Hirschman Index, HHI) but also the quality of care provided by their competitors. A key methodological question is how this should be…
That is the clever title of recent American Economic Review publication by Cyrus Aghamolla, Pinar Karaca-Mandic, Xuelin Li, Richard T. Thakor. The abstract is below. This study examines the link between credit supply and hospital health outcomes. We use bank stress tests as exogenous shocks to credit access for hospitals that have lending relationships with…
According to a paper by Smith et al. 2023, the answer is ‘no’. The authors use data from AHRQ’s Healthcare Cost and Utilization Project (HCUP) State Inpatient Data, Hospital Cost Reporting Information System Data, Office of Pharmacy Affairs Information System Data, and American Hospital Association Annual Survey for 15 states between 2008 to 2014. The…
That is the finding from a paper by Geruso, Layton and Wallace (2023). They exploit the random assignment of approximately 70,000 Medicaid beneficiaries to Medicaid managed care (MMC) plans from 2008 to 2012 in New York City. In short, beneficiaries in New York who did not actively choose a plan within a designated choice period…
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…
Patients want new treatments to improve their quality of life. However, do typical patient reported outcomes adequately capture new treatment’s impact on factors that patients care most about? A paper by Perfetto et al. (2022) argues that the answer is ‘no’. The article notes that not only do patients want improved functional status, but also…
For years, Medicare and other payers have used quality measures to evaluate the quality of care patients receive at various types of providers settings (e.g., hospital, home health agencies, skilled nursing homes). For some payers, higher quality scores/higher star ratings lead to direct increases in reimbursement through a value-based purchasing arrangement. Typically, value-based payment systems…
Is your hospital high quality? Well, this depends on what quality means. Does it have low readmission rates? Low rates of mortality? Do they follow clinical guidelines? Are patients satisfied? Are they good at cardiology care? What about cancer treatment? Combining all these different dimensions of quality is a complex task. The Centers for Medicare…
If you want to implement value-based care, you need to define what a ‘good’ outcome is. A good outcome may be different for different individuals. For instance, if you look at mortality rates for a given disease, it makes sense that individuals age 80 and above will have higher mortality rates than those 20-29 year…
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,…