My monthly review of the content of Health Affairs, which carries health services research. This issue focused on vaccine economics, the role of private equity in health care and Medicare Advantage. What did we learn? We learned that you can tell that a study is biased when the abstract says “CV-19 vaccines have been shown to be highly effective”. Really, when, where and how was that shown? In any event, this particular study claimed that during the acute phase of a CV-19 infection medical spending was slightly less for vaccinated persons, with no change after that acute phase. The study failed to account for variables like health care-seeking behavior. I do think the vaccines had some effectiveness but it was minimal and didn’t last long and I resent the researchers who are doing their best to convince people to get those vaccines forever, when there is no real need to do so for most people.
Another study looked at ownership of cardiologist and gastroenterologist practices and subsequent pricing. Hospital-owned practices charged 16% for cardiac procedures and 21% more for gastric ones than did independent practices. Private equity-owned practices charged 6% more for cardiac and 10% more for gastric procedures. The real villains in high health care spending, as I keep saying, are the large monopolistic health systems. There is zero justification for this pricing. We need to forbid hospital ownership of physician practices. The editors want to make private equity look bad, and they do look worse on pricing, but not nearly as bad as hospitals.
Another article finds that private equity ownership of hospices results in lower patient care spending and higher profits compared to other types of ownership. Non-profit hospices spent the most, largely on nursing salaries. The private equity firms kept administrative costs low.
Medicare Advantage market concentration has slightly declined, but not by much. More competition is needed, concludes another study. Lower concentration is linked to better benefits and lower costs for enrollees. Another likely false claim that MA plans engage in favorable selection, i.e., seeking lower-cost members, among dual Medicare/Medicaid beneficiaries.
As I noted in an earlier post, one study points out the egregious pricing for the same procedure at a hospital outpatient department compared to an ambulatory surgery center. (HA Issue)
