Although its reform effort appears to have gone amok, largely for cost reasons, the state of Massachusetts is producing a lot of useful data and research on medical service delivery, including three recent ones on avoidable emergency room and hospital use and the state of primary care services.
A study of diagnostic practices for Medicare beneficiaries reveals geographic variations. These variations not only may suggest either under or overuse of diagnostic tests but they can bias other research results and payment methods. A second study suggests that caution should be applied in analyzing regional variation to ensure that all possible sources of the differences are taken into account.
A lot of great items in this week’s potpourri, covering the acquisition of HealthGrades, what encourages men to get screenings, potential cheating on pay-for-performance schemes, the problems of a multi-payer system, improving heart failure care, Canada’s experience with EHRs and autonomous robot surgery.
There has been no more gnarly health care problem for Congress than how to deal with physician reimbursement. At some point, as a Health Affairs article points out, it will have to come up with a better solution than the temporary fixes it has used for years.
Trashing insurance companies is popular and one of the most frequent complaints is about their premium increases and profits. A NEJM perspective uses misleading information to continue dumping on health plans.
A study in JAMA suggests that process-of-care quality measures, which are frequently used for bonus or penalty reimbursement programs, may have little real relationship to ultimate health outcomes.
Workers’ compensation health cost trends may provide some insight into underlying medical cost issues across the system and vice versa. An NCCI report looks at factors driving trends in medical cost increases for workers’ compensation.
The notion of a health insurance exchange to assist individuals and small groups in finding affordable health insurance is a critical part of the coverage expansion in the recent health law. A Commonwealth Fund report reviews important issues to consider in the establishment and operation of these exchanges.
More midsummer musings, covering possible replacements for AWP, the effect of Part D on heart failure drug use, the VA’s telehealth programs, venture capital activity, self-management of high blood pressure, and of course, more problems with health insurance costs in Massachusetts.
More commentary on MedPAC’s Annual Report, focusing on the care of dual-eligible beneficiaries and the use of shared decision-making in the Medicare population.
MedPAC’s annual report always contains many useful analyses of health care issues, complete with research citations. This year’s report covers several topics of general interest, including effective benefit designs and improving quality efforts.
For several decades drug companies have taken a beating over their pricing and many governments have limited how those companies charge for their products. A new study suggests that such regulation does limit development of new medicines.
A key premise of the consumer-directed health movement and a number of other health reform concepts is that patients can understand health information and choices and make good decisions. An AHRQ report gives reason to question that notion.
HHS has issued its draft regulation on what preventive services health plans must cover without cost-sharing by the patient. Someone, of course, has to pay for all these “free” services, and it usually is the consumer.
Another week, another potpourri, this time with items on workers’ compensation drug spending, benefit consulting firm mergers, hospital readmissions, geographic variation in spending and use of mobile vans to deliver health care.