Posts Tagged “Providers”
ShowHide 3rd Party PapersInstitute of Medicine: The Importance of Nurse Education – 4 Suggestions
Sermo and Athena Health: 2010 Physician Sentiment Index℠: Taking the Pulse of the Physician Community
Fredrikson & Byron: Stark’s October 1, 2009 Compliance Deadline for Modifying or Unwinding Certain Health Care Business Arrangements is Almost Here
GW University: Using Primary Care to Bend the Curve
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Pay for Performance in Lower Income Countries
by Kevin Roche on Tuesday, April 9, 2013
While we often focus our attention on the health care problems of the developed world, lower income countries have bigger issues, many of which are being addressed with the same “innovations” used in the richer nations. An NBER paper looks at the use of pay-for-performance in these countries.
AHIP on Out-of-Network Charges
by Kevin Roche on Monday, February 4, 2013
A new report from America’s Health Insurance Plans exposes the unbelievable ripoff charges that many providers place on out-of-network services. Much of these charges is paid by the insured person. Where are the regulators now!!
Health Care Associated Infections
by Kevin Roche on Wednesday, December 19, 2012
We would all like to think that receiving health care services isn’t going to make us sicker, but occasionally untoward things happen. A new report from the Agency for Healthcare Research and Quality looks at efforts to prevent one such harm, health care associated infections.
Tags: Health Care Quality, Providers
2012 Potpourri XXXVIII
by Kevin Roche on Friday, December 14, 2012
In this holiday season, it is a time for giving presents and our latest Potpourri presents you with many gifts of health information, including some positive news about an ACO program, some cautions for the success of ACOs, an apparently successful disease management program, lung cancer screening, earnings growth for physicians and other health professionals and lessons in bundled payments.
Tags: ACO, Bundled Payments, Disease Management, Health Care Costs, Physicians, Providers, Wellness and Prevention
New Paper on Provider Pricing Power
by Kevin Roche on Wednesday, November 28, 2012
Another extensive research paper details the effects of provider consolidation and consequent market power on the health care industry in the United States, and specifically on the growth of health spending. Not a pretty picture, and the effect of the reform law is to exacerbate the problem.
Tags: Health Care Costs, Hospital, Providers
KPMG Report on Health System Change
by Kevin Roche on Wednesday, November 7, 2012
Another consultant’s report on the American health system, this one from KPMG and focusing on the supposed transformation from a volume-based system to one founded on value. While leaders of health care system participants recognize the likelihood of significant change, they also seem determined not to let their share of health system spending drop.
Tags: Drugs, Health Care Costs, Health Care Reform, Health Insurance Exchange, Providers
AHRQ on Quality Reporting
by Kevin Roche on Thursday, October 11, 2012
An Agency for Healthcare Research & Quality report looks at the evidence for the effectiveness of public reporting of providers’ performance on various quality measures in actually creating quality improvements at those providers.
Tags: Health Care Quality, Providers
New Health Care Spending Breakdown
by Kevin Roche on Tuesday, October 2, 2012
The Health Care Cost Institute releases a report on spending and utilization in the employer-based health care coverage market for 2011. Spending continues to rise faster than inflation or economic growth and is largely driven by higher prices charged by providers, not by increases in utilization.
Tags: Health Care Costs, Providers
AHRQ on Bundled Payments
by Kevin Roche on Thursday, September 27, 2012
Bundled payments are designed to change the incentives for providers so that they manage patient care in a more cost-effective manner, hopefully without negatively affecting quality. A report from the Agency for Healthcare Research and Quality examines the research evidence to date on the effect of bundled payment approaches, finding that spending and utilization are probably lower, with an uncertain effect on quality.
Tags: Bundled Payments, Health Care Costs, Health Care Quality, Providers
Variation in Episode Cost in a Commercial Health Plan
by Kevin Roche on Thursday, September 13, 2012
Research based on data from UnitedHealth Group’s commercial health plans finds wide variation in episode of care costs across both selected procedures and chronic diseases. The research also showed that for care provided by physicians meeting certain quality and efficiency benchmarks, episode of care costs were generally lower than for care provided by other physicians.
Tags: Health Care Costs, Health Care Quality, Health Insurance, Providers
KPMG on Health Care Transformation
by Kevin Roche on Wednesday, August 15, 2012
KPMG releases a report on the ongoing transformation of the United States’ health care system, which affects payers, providers and patients. The firm gives its perspective on the forces driving the transformation and on what responses are needed by participants if they are to continue to be successful.
Useful Consumer Health Reporting
by Kevin Roche on Monday, March 19, 2012
Can all the public reporting on provider quality and cost performance actually be used by consumers to make good choices for their health care services? That is the question explored in a Health Affairs study and the research gives a positive answer.
Tags: Consumers, Health Care Quality, Providers
CBO on Medicare’s Value-Based Payment Demos
by Kevin Roche on Thursday, February 2, 2012
Another excellent paper from the Congressional Budget Office is issued, this one on Medicare’s demonstration projects on value-based payments to providers. Once again, the demonstrations had very mixed results, with only one demonstration generating savings for the Medicare program.
Tags: Bundled Payments, Health Care Costs, Health Care Quality, Pay For Performance, Providers
Public Reporting of Performance Measures
by Kevin Roche on Thursday, January 5, 2012
The Agency for Healthcare Research and Quality examines the supposed mechanisms by which public reporting of provider performance on quality measures will improve outcomes and details the evidence which supports or fails to support that theory.
Obesity and Weight Management Interventions
by Kevin Roche on Wednesday, December 7, 2011
Obesity is often fingered as a leading cause of health care spending and health spending growth. It also causes significant personal discomfort to those who are overweight. A pair of articles in the NEJM describe the outcomes of interventions to help patients lose weight.
Tags: Care Management, Chronic Disease, Consumers, Providers, Wellness and Prevention
Trends in Patient Satisfaction
by Kevin Roche on Wednesday, November 30, 2011
A Press Ganey report describes trends in patient satisfaction for hospitals, outpatient departments, emergency rooms, physicians and home care and lists top priorities for patients in improving their experience of care.
Tags: Consumers, Health Care Quality, Patient Satisfaction, Providers
Massachusetts’ Cost Dilemma
by Kevin Roche on Tuesday, November 15, 2011
Massachusetts Special Commission on Provider Price Reform has released its momentous report on how to address the surging health care costs in the state, which appear to be largely caused by “excessive” provider prices and price increases. Someday regulators might learn that the more you regulate, the more you regulate.
Tags: Government, Health Care Costs, Health Care Reform, Providers
GAO on Price Transparency
by Kevin Roche on Monday, November 7, 2011
A significant trend affecting all of health care in the last decade is consumerism, specifically the effort to engage consumers in managing their health and health care and to make care more patient-centered. A new report from GAO shows how hard these efforts can be when data, in this case data on provider prices, is hard to obtain and give to consumers.
Tags: Consumers, Health Care Costs, HIT, Providers
Massachusetts Report on Effect of Global Payments
by Kevin Roche on Thursday, June 30, 2011
The second annual report by the Massachusetts AG on health care spending trends continues to find that provider market power is a major factor and that using a risk-based payment methodology does not reduce payment variation or lower medical spending or utilization.
Tags: ACO, Health Care Costs, Health Care Reform, Providers
More Data Available from CMS
by Kevin Roche on Thursday, June 9, 2011
CMS has proposed a rule to implement a PPACA provision allowing access to extracts of provider-level Medicare data to evaluate performance, primarily on quality measures. This is a good first step, but just a first step in being able to completely profile physician practice patterns.
Tags: Comparative Effectiveness, Health Care Costs, Health Care Quality, Medicaid, Medicare, Providers
Malpractice and Tort Reform
by Kevin Roche on Thursday, May 12, 2011
Malpractice reform is stymied at the federal level and state efforts appear to have run out of steam, despite the likelihood that reform would significantly reduce wasteful spending. New approaches are being tested but their effect is uncertain.
Tags: Health Care Costs, Malpractice, Providers
Lessons from German Disease Management Programs
by Kevin Roche on Wednesday, March 23, 2011
McKinsey publishes an article on disease management, focusing on overseas experience and finding that properly designed and managed programs can lower costs, improve outcomes and increase patient satisfaction.
Tags: Consumers, Disease Management, Providers
Rand on Payment Reform Methods
by Kevin Roche on Tuesday, March 1, 2011
A new report from the Rand Corporation reviews various proposals for changing payment methods to providers. The researchers categorize payment reforms into 11 models and review appropriate performance measures for each.
2010 Potpourri XLI
by Kevin Roche on Saturday, November 13, 2010
The holidays approach, the Potpourri rolls on, this week unveiling information on potential savings for Medicare and Medicaid dual eligibles; EHR use’s effect on physician revenue; likely physician reaction to the SGR cuts, if implemented; characteristics of California health plan enrollees; CBO’s view of the impact of the reform law on drug prices and a health plan allowing nurse practitioners to be primary care providers.
Tags: Consumer Directed Health, Drugs, HIT, Medicaid, Medicare, Physicians, Providers
Paper on Accountable Care Organizations
by Kevin Roche on Friday, October 29, 2010
CSC put out a White Paper on Health Information Requirements for Accountable Care which examines the necessary functions an effective ACO will have and what health information technology will be needed to support those functions.
Tags: Care Management, HIT, Providers
IOM’s Report on Nursing
by Kevin Roche on Monday, October 18, 2010
The Institute of Medicine’s report on The Future of Nursing discusses many issues, but one that catches the eye relates to the role of restrictions on nurse scope of practice in impeding better access and lower costs.
Tags: Health Care Costs, Health Care Quality, Physicians, Providers
2010 Potpourri XXXVIII
by Kevin Roche on Saturday, October 16, 2010
More health care tidbits in this week’s potpourri, including medication adherence; the benefits of workplace wellness programs; the costs to employers of obesity; hospital prices in Oregon; reimbursement methods for drugs and potential savings from health IT.
Tags: Drugs, Health Care Costs, HIT, Hospital, Providers, Wellness and Prevention
Health Affairs Articles on Malpractice
by Kevin Roche on Tuesday, October 12, 2010
Because of political considerations, medical malpractice and its health spending effects is a controversial topic. A recent issue of Health Affairs carried several articles on this topic.
Tags: Health Care Costs, Malpractice, Providers
Quality of Care and Patient Satisfaction
by Kevin Roche on Thursday, October 7, 2010
There has been a major push to expand measurement of provider quality, as defined by process of care and outcomes. A study suggests that having good quality doesn’t necessarily mean patients will be more satisfied.
Tags: Consumers, Health Care Quality, Providers
CSC Papers on Meaningful Use
by Kevin Roche on Thursday, September 16, 2010
The meaningful use provisions of the stimulus bill provide incentive payments to providers who implement EMRs, and ultimately penalties for those who don’t or who don’t use those systems in certain ways. A pair of new briefs outline challenges for providers to meet the meaningful use requirements.
Tags: Government, HIT, Providers
Variation in Medicare Spending
by Kevin Roche on Monday, June 7, 2010
Dartmouth Atlas researchers largely created and fueled the perception that the significant variation in use of medical procedures and spending across geographic regions reflects likely unnecessary care. Their latest research focuses on joint replacement.
Tags: Medical Care, Providers
2010 Potpourri XV
by Kevin Roche on Saturday, May 1, 2010
The latest in our weekend selection of health news and research developments, including any willing provider laws, emergency room visits, the link between insurance and health outcomes, hospital rankings and rising insurance premiums.
Tags: Health Insurance, Hospital, Medical Care, Providers
Maybe It’s the Providers that Are the Cause of Spending Increases.
by Kevin Roche on Monday, March 1, 2010
Two more studies suggest that provider price increases, particularly those of hospitals, are the cause for overall spending rises and notes that there is little competitive check on providers’ ability to raise prices. When are policy-makers going to start paying attention?
GAO Report on Medicare Use of Physician Profiling
by Kevin Roche on Thursday, November 5, 2009
The General Accounting Office gives its perspective on the viability of the per capita method of physician resource use profiling by Medicare and provides useful insight into the topic of variable physician practice patterns.
Tags: Health Care Costs, Physicians, Providers
More Variation in Spending Research
by Kevin Roche on Monday, October 19, 2009
A study reported in Circulation indicates that California teaching hospitals that utilize more resources in treating heart failure had lower rates of mortality. The study results call into question the methods and findings of some Dartmouth Atlas research. Another report looks at supply and variation in MRI usage.
Tags: Care Management, Health Care Costs, Hospital, Medical Care, Providers
Updated CBO Look At Malpractice Costs
by Kevin Roche on Tuesday, October 13, 2009
The Congressional Budget Office has provided a revised estimate for savings from malpractice reform, showing greater and significant reductions both in total health spending and the federal deficit.
Tags: Malpractice, Providers
A Better Way to Deliver Health Care?
by Kevin Roche on Tuesday, October 13, 2009
One way to address our health system challenges may be to change who delivers much of our medical care, creating less reliance on physicians, and to redesign how providers interact with patients and are paid for care.
Physician Group’s Health Reform Ideas
by Kevin Roche on Friday, October 9, 2009
The American College of Physicians presents its reform ideas.
Tags: Government, Health Care Reform, Physicians, Providers
Maryland’s Approach to Hospital Pricing
by Kevin Roche on Friday, September 18, 2009
A WSJ articles reports on Maryland’s experience with hospital price controls.
A New Study Analyzing Retail Clinic Use
by Kevin Roche on Thursday, September 17, 2009
Rand Corporation has published a study comparing use of retail clinics with emergency room and primary care physician visits.
Tags: Medical Care, Providers, Retail Clinics
House Calls Returning?
by Kevin Roche on Tuesday, September 15, 2009
The Los Angeles Times reports on a possible return of house calls.
Tags: Care Management, Medical Care, Physicians, Providers
Geographic Variation in Health Spending
by Kevin Roche on Monday, September 14, 2009
Geographic variation in health spending is hot, but the reasons for it are still murky.
Tags: Health Care Costs, Health Care Reform, Medical Care, Providers
Interesting Data About American Physicians
by Kevin Roche on Thursday, September 10, 2009
A survey of physicians reveals useful observations.
Tags: Physicians, Providers
California Pay for Performance Results
by Kevin Roche on Wednesday, September 9, 2009
The Integrated Healthcare Association has released its latest report on California’s physician pay for performance system.
Tags: Pay For Performance, Providers
A Medical Home Pilot Evaluation
by Kevin Roche on Thursday, September 3, 2009
Group Health in Washington State has released a study evaluating its medical home pilot.
Tags: Medical Homes, Providers
Getting Physicians to Participate in Research
by Kevin Roche on Monday, August 17, 2009
An article examines barriers to physician participation in medical research.
Tags: Medical Care, Medical Research, Pharmaceutical, Physicians, Providers
Looking at Hospital Input Costs
by Kevin Roche on Friday, August 14, 2009
One relatively unexplored method for reducing health spending is lowering providers’ input costs. A New York Times article examines one category of hospital costs.
Tags: Health Care Costs, Hospital, Providers
AHIP Survey Illustrates Physician Fee Issues
by Kevin Roche on Wednesday, August 12, 2009
Insurers have been under sharp attack for causing many of the problems reform is designed to address. One response has been to shift the responsibility for these problems to other components of the health system; in this case physicians’ fees.
Tags: Health Care Costs, Health Insurance, Physicians, Providers
Patients Asked to Pay More
by Kevin Roche on Thursday, August 6, 2009
Patients are responsible for an increasing share of their medical expenses, which has increased provider bad debt and collection expense. In response, providers are asking to be paid at the time of service.
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