November 2, 2015
In the years since the passage of the Patient Protection and Affordable Care Act (PPACA, or, colloquially, Obamacare), most of the discussion about it has been political. But as the politics fade and the law’s many complex provisions take effect, a much more interesting question begins to emerge: How will the law affect the American health care regime in the coming years and decades?
This book brings together fourteen leading scholars from the fields of law, economics, medicine, and public health to answer that question. Taking discipline-specific views, they offer their analyses and predictions for the future of health care reform. By turns thought-provoking, counterintuitive, and even contradictory, the essays together cover the landscape of positions on the PPACA’s prospects. Some see efficiency growth and moderating prices; others fear a strangling bureaucracy and spiraling costs. The result is a deeply informed, richly substantive discussion that will trouble settled positions and lay the groundwork for analysis and assessment as the law’s effects begin to become clear.
Source: The Future of Healthcare Reform in the United States, Malani, Schill
March 3, 2015
What makes a top hospital? Four services that publish hospital ratings for consumers strongly disagree, according to a study in the journal Health Affairs.
No single hospital received high marks from all four services—U.S. News & World Report, Consumer Reports, the Leapfrog Group and Healthgrades—and only 10% of the 844 hospitals that were rated highly by one service received top marks from another, the study published Monday found.
The measures were so divergent that 27 hospitals were simultaneously rated among the nation’s best by one service and among the worst by another.
via What Are the Best Hospitals? Rankings Disagree – WSJ.
March 3, 2015
Dr. Macip presented the case on Saturday to a meeting of the American Academy of Hospice and Palliative Medicine. The presentation’s dispiriting title: “The 30-Day Mortality Rule in Surgery: Does This Number Prolong Unnecessary Suffering in Vulnerable Elderly Patients?”
Like Dr. Macip, a growing number of physicians and researchers have grown critical of 30-day mortality as a measure of surgical success. That seemingly innocuous metric, they argue, may actually undermine appropriate care, especially for older adults.
via A Surgery Standard Under Fire – NYTimes.com.
February 21, 2015
One of ObamaCare’s many unfortunate effects is its centralization of the nation’s health-care debate. Even Republicans now assume only Washington can fix America’s broken health-care system—look at the various federal-centric ObamaCare replacement plans that have been released in recent months. But state lawmakers can play an important role in improving health outcomes, lowering costs and increasing choices for patients.
Fortunately, elected officials in some states are showing promise in this regard. For example, legislators in South Carolina, Georgia, New Hampshire and Washington have recently introduced bills to weaken or repeal their states’ “certificate of need” laws, which increase health-care costs and empower bureaucrats and lobbyists rather than patients.
via Nancy Pfotenhauer and Nathan Nascimento: States Strike a Blow for Freedom in the ObamaCare Age – WSJ.
February 2, 2015
The U.S. government will begin releasing Medicare physician-payment records every year, cementing public access to how tens of billions of dollars are spent annually on everything from office visits to radiation therapy.
Last April, a year’s worth of the data was released for the first time in more than three decades after Wall Street Journal parent Dow Jones & Co. challenged a 1979 injunction that prohibited Medicare from disclosing its payments to doctors. It was unclear at the time if any more records would be released.
The data provided the first comprehensive look at a central part of the taxpayer-funded program for the elderly and disabled. It detailed payments to 880,000 individuals and organizations totaling more than $77 billion from the Medicare program in 2012, covering more than 5,000 different procedures.
via Medicare to Publish Physician-Payment Data Yearly – WSJ.
January 13, 2015
There’s a fascinating story out of North Carolina about that state’s largest insurer unexpectedly publishing information on how much it pays healthcare providers for a wide range of elective, non-emergency services.
Providers were not pleased. More surprisingly, consumer advocates were sharply critical. But more such efforts are on the way and providers should stop complaining and get prepared.
Blue Cross and Blue Shield of North Carolina suddenly released its all-inclusive payment rates for services including kidney transplants, knee replacements, coronary bypass procedures, screening colonoscopies and other services. The insurer’s online look-up tool includes all payments for a service, including facility fees, doctor fees and pathology.
via North Carolina Blues plan unloads price transparency surprise – Modern HealthcareVital Signs | The healthcare business blog from Modern Healthcare.
November 9, 2014
“You should be able to walk into a provider’s office and say, ‘I want a copy’ — you are legally entitled to that,” said I. Glenn Cohen, a professor at Harvard Law School, noting that there were only a few exceptions, such as for prisoners. But the reality is that many hospitals and doctors have created a series of hurdles that must be cleared before patients can get their information. And many of those hurdles, experts say, are based on the economics of medicine.“The medical record is held hostage,” Professor Cohen said. “The reason is often to keep a customer or keep a patient from leaving the practice.”
via Medical Records: Top Secret – NYTimes.com.