This issue contained the summary of the latest release on national health spending, which I posted on separately. A study reviews the Medicare bundled episode of care initiative, finding that it failed to result in net savings to Medicare. Skilled nursing facility payments were reduced, but overall payments to hospitals outweighed that savings. These initiatives aren’t necessarily bad ideas, but they almost universally fail to produce the supposed spending savings.
Another study found that a lot physicians who supposedly see Medicaid patients and are listed as providers for that program, don’t actually see a single Medicaid patient. Doctors spend a lot of time on electronic health records, which may not be the best use of their labor, according to another article. In another study related to technology, doctors get lots of alerts on prescribing behavior but almost never accept the recommendations.
Medicare Advantage enrollees are increasingly switching plans outside of the open enrollment period, and it is generally the sicker patients who do this switching, which suggests they are looking for a different provider not in their current plan’s network. Federally qualified health centers are low cost providers focused on low-income populations. Apparently they are not always included in Medicare Advantage networks, which seems odd to me.
Guaranteed income programs can increase food security. They also minimize already bad behavior in regard to working and are another stress on already overwhelmed budgets.
Optum, a unit of UnitedHealth Group, has acquired a huge number of providers of various types, including physician practices and surgery centers. Those acquisitions are typically followed by an increase in prices. This vertical integration is anti-competitive, raises costs and typically does nothing for quality. It also allows evasion of state and federal minimum percent of premium devoted to health care regulations.
