Right now the prospects for passage of comprehensive health reform appear dim. If nothing is passed, what are the implications for various participants in the health system? Is it more of the same, or will there be significant program, provider and payer initiated changes?
The current issue of Health Affairs has several articles focusing on the use of telemedicine and HIT to solve health problems in the developing world. The articles describe some success stories, challenges and opportunities for use of wireless and health information technologies to provide desperately needed improvement for persons in these areas.
Yet another sampling of health care items, relating to personalized medicine, telemedicine, wellness, disease management and using health data for comparative effectiveness research.
New research published in Health Affairs finds that geographic variation in Medicare spending is not strongly driven by price variation. Utilization differences appear to be the major cause of that variation.
Value-based insurance design attempts to use cost-sharing to maximize use of health services that lead to good health outcomes. Two recent analyses demonstrate that cost-sharing features of health care coverage can lead to good and bad outcomes.
Many states have created workers’ compensation fee schedules based on Medicare reimbursement for physicians. Doing so can create traps if the frequent changes in the Medicare payment mechanisms are not carefully followed. A new NCCI report examines these issues.
CBO analyzes a Republican proposal on federal spending, finding that the health care-related provisions would significantly reduce federal spending and national health expenditures, while increasing covered persons by an unspecified number.
The Massachusetts Attorney General investigates and discovers that hospitals and some physicians have market power and consequently are able to demand high payments and those payments are the main cause of increases in the cost of health insurance, not utilization increases.
Four times a year public companies regale us with their (usually optimistic) views of the firm’s past performance, future prospects and market environment. Interesting information can occasionally be found by reviewing analyst call transcripts. Some current releases are discussed.
Rhode Island released a report on payments to hospitals from various sources and looked at factors accounting for significant differences in payment levels. The variation is likely entirely due to hospital bargaining power by large systems, which in turn is driving health insurance premium increases.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
© 2023 Healthy Skeptic.
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