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Healthcare Economist – Unbiased Analysis of Today's

Details: Demand curves still slope downwards. Unsurprisingly, high-deductible health plans lead to lower utilization of healthcare services. A study by Sandoval et al. (2021) use data from 2007-2019 from Switzerland to show that this is the case. Participants with high-deductible plans reported forgoing health care more frequently than those with low

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Who are Health Economists

Details: A paper by Morrisey and Cawley (Health Econ 2008) attempts to answer this question. The authors conducted an online survey to achieve a better understanding of what health economists do. Training. Ninety-three percent of health economists have a Ph.D. A few health economists have an MD (2.6%), an RN (1%) or a JD (<1%) in addition to their PhD.

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Is Health Care a Right

Details: Health is a perception. “Health” is in fact a cultural and personal issue. There are several definitions of “health”, that change between cultures, historical periods or even between different people. Doctors (and in the last times, the pharmaceutical and biomedical industry) have had the power to define the health-illness in recent years.

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Health Care Around the World: Norway – Healthcare Economist

Details: This is a universal, tax-funded, single-payer health system. Compared to France, Italy, Spain and Japan, Norway has the most centralized system. Percent Insured. 100%. All Norwegian citizens and residents are covered. Funding. The National Insurance Scheme is funded by general tax revenues. There is no earmarked tax for health care.

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Is health care demand elastic

Details: Most experts believe that health care demand is fairly inelastic. If you are sick, you will not be very price sensitive. There are exceptions to this rule (e.g., elective surgery such as plastic surgery, purchases of eyeglasses) but most studies find that patients are fairly insensitive to changes in health …

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How San Francisco’s provides Health Care for the Uninsured

Details: Where can they get health care? An article in San Francisco Magazine discusses how the Bay Area provides health care for the uninsured. Healthy San Francisco (HSF) is the city’s two-year-old health-access plan that provides healthcare access most uninsured resident aged 18 to 64, regardless of employment, citizenship, or preexisting

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Health Wonk Review to the “Rescue” – Healthcare Economist

Details: HEALTH REFORM. Anthony Wright of Health Access California writes a post titled So no child can be denied or priced out of coverage. The post can be summarized as follows. Obama: Private insurers cannot deny coverage to children with preexisting conditions. Insurers: That’s fine…then we just won’t offer insurance products for any children.

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What is the difference between DRGs, AP-DRGs, and APR-DRGs

Details: The New Jersey State Department of Health used DRGs as the basis of a prospective payment system in which hospitals were reimbursed a fixed DRG specific amount for each patient treated. In 1982, the Tax Equity and Fiscal Responsibility Act modified the Section 223 Medicare hospital reimbursement limits to include a case mix adjustment based on

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Why providers love ACOs – Healthcare Economist

Details: Thus, most health plan provider networks are very broad. “A Fresno benefit manager’s analysis found that physician overlap in two prominent health plan networks was 97–98 percent.” Additionally, consumers often want to have the superstar, “must have” hospitals in their plans.

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July 2009 – Healthcare Economist

Details: House Democrats have agreed to a health reform bill in the house, but one that would exempt small businesses from having to provide health insurance. The L.A. Times reports that “The House bill originally exempted small businesses with payrolls of less than $250,000 from the penalty.

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U.S. spends $700 billion on unnecessary medical tests

Details: “A Health Fed, as former Sen. Tom Daschle has proposed, would set national goals for health-care spending and patient outcomes based on the potential gains for integrated care.” This I think is a horrible idea. Having the federal government try to reduce costs and improve quality at such a high level is likely to be expensive and counter

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Public Health vs. Medicine – Healthcare Economist

Details: What are the major differences between medicine and public health? What challenges do public health officials frequently ignore? On Tuesday, I attended a seminar by Dr. Richard Schieber. Dr. Schieber was a practicing pediatrician, however for the last fifteen years he has worked as a medical epidemiologist for the CDC.

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How to Assess Quality of Care – Healthcare Economist

Details: The first says to measure quality against a ‘best practice’ which is the maximum health improvement regardless of cost. This is the school to which most American physicians ascribe. The optimalist says that “care must stop short of including elements that are disproportionately costly compared with the improvements in health they produce.”.

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How do the Amish pay for medical care

Details: Health Insurance Hospitals Information Nursing Homes 8 July 2008 Jason Shafrin 3 Comments There is an interesting article a few weeks back in the Wall Street Journal (“ Opting Out “) which describes the plight of Amish and Old Order Mennonites who refuse to buy health insurance.

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Risk Adjustment Models – Healthcare Economist

Details: Risk adjustment is important for many aspects of health care. Medicare uses risk adjustment to modify payments to Medicare Advantage (Part C) plans based on the health of the beneficiaries they cover. Private insurance companies can use risk adjustment to fine-tune capitation payments to physicians or determine a potential enrollee’s premium.

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Hospitals – Healthcare Economist

Details: Health care costs are high in the U.S., making up 17.9% of the U.S. economy. The Economist reports on recent key drivers of US health care cost…and the answer isn’t drugs. Mr Trump has correctly identified a big villain behind health-care cost inflation, and it is not Big Pharma. Hospitals account for over 30% of…

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The truth about the RAND HIE – Healthcare Economist

Details: Recently, there has been much controversy regarding whether or not the RAND Health Insurance Experiment (HIE) results are truly robust. Many blogs have been questioning the results (see here, here and here).One of the major conclusions of the HIE are that higher co-insurance rates lead to lower levels of medical utilization and lower medical cost, but do not have any adverse impact on health

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About the Author – Healthcare Economist

Details: Dr. Jason Shafrin is the founder, editor, and chief writer of Healthcare Economist. Jason is a Senior Managing Director at FTI Consulting in the Center for Healthcare Economics and Policy. The opinions expressed on this blog are only Jason’s and do not represent the opinions of FTI Consulting in any way. Jason’s research interests include

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The Four-Party System – Healthcare Economist

Details: The language of health insurance contract is extremely opaque and makes comparison shopping between health plans nearly impossible. Further, there may be fraud in experience-rated systems. The GAO has long identified large-scale public programs, such as Medicare and Medicaid, as notoriously rife with provider-based fraud.

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The Marginal Utility of Consumption and Health

Details: Individuals can purchase a health insurance benefit, b, to protect them against income risk from becoming sick. The authors find that the optimal health insurance level depends not only on risk aversion, but also on how marginal utility changes between healthy …

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Jason Shafrin – Healthcare Economist

Details: Unsurprisingly, high-deductible health plans lead to lower utilization of healthcare services. A study by Sandoval et al. (2021) use data from 2007-2019 from Switzerland to show that this is the case. Participants with high-deductible plans reported forgoing health care more frequently than those with low-deductible plans (331 [13.5%] vs 591 [8

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Are WHO rankings entirely worthless

Details: The WHO health statistics are biased, not just meaningless. The WHO itself ranks the US #1 in health care delivery that is important to patients. It issues another ranking of 37th because this quality of care costs more and is not delivered by government! Critics of US health care always refer to the 37th ranking.

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Defining a Hospital Catchment Area – Healthcare Economist

Details: There have been many attempts to define a hospital’s catchment area. The Dartmouth Atlas Group uses hospital referral regions (HRRs) and hospital service areas (HSAs). One method is to determine a minimum admission rate for a given geographic unit (e.g., county, census tract, zip code). For instance, a given zip code would be placed in a

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Health Care Around the World: Great Britain – Healthcare

Details: Health Care Around the World: Great Britain. Great Britain represents all that is good and bad with centralized, single-payer health care systems. Health care spending is fairly low (7.5% of GDP) and very equitable. Long wait lists for treatment, however are endemic and rationing pervades the system. Patients have little choice of provider and

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Welfarists vs. Extra-welfarists – Healthcare Economist

Details: Health economists, policy makers, physicians and public health officials all want to maximize the well-being of society. These groups evaluate different medical treatments or public health interventions and then determine if the benefit is worth the cost.

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Do I need an Annual Wellness Visit

Details: The Affordable Care Act (a.k.a. Health Reform, Obamacare) mandates that Medicare provide an annual wellness visit (AWV) to all beneficiaries free of charge. Today, I answer some questions related to CMS’s implementation of the mandated annual wellness visit requirement.

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Current Events – Healthcare Economist

Details: No, this is not coming nation-wide, but it may be on its way in California. Kaiser Health News reports: A provision in California’s newly approved state budget will eliminate the asset test for the 2 million Californians enrolled in both Medi-Cal and Medicare, the federal health insurance program

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2008 – Page 32 – Healthcare Economist

Details: “The Employee Health Insurance Program requires all companies with 700 of more employees to provide workers with health insurance among some 1,800 ‘society-managed’ plans. Nearly 85% of these plans cover a single company…Most of the rest of the [health insurance plans] are industry-based.” Small…

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Data – Healthcare Economist

Details: According to Chambers et al. (2019), the answer varies widely depending on the health plan. The authors use a data from the Tufts Medical Center Specialty Drug Evidence and Coverage (SPEC) database. 203 specialty drugs issued by 17 of the 20 largest US commercial health plans are included in the database.

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RVU costing – Healthcare Economist

Details: RVU costing sets physicians’ fees by employing various accounting procedures to determine the relative worth of each service they provide. An article by Mark Berlin in Healthcare Financial Management (1997) details how the RVU costing system works.. First let us examine the four types of cost accounting group practices traditionally use.

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Your doctor says you have six months to live. Should you

Details: This was done using 3 measures: (1) the point prediction is an answer to a question about the physicians’ best estimate of how long this patient has to live; (2) the communicated prediction is an answer to a question about what prognosis the doctor would communicate to the patient if the patient or the family insisted on receiving an estimate

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Is Ireland a Single Payer System

Details: Private health insurance, however, is under attack. In June 2012 there were 61,000 less people privately insured than in June 2011. The reason for this is the rise in cost of private health insurance, due in part to a 40 per cent increase in the Government levy on private health insurance announced at the beginning of the year.

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Econometrics – Healthcare Economist

Details: In many clinical trials, the outcome of interest may be some form of time to event outcome. This could be time until death, time until hospitalization, or time until some other (typically negative) health event. One simple way to model this is to use a Cox proportional hazard (a.k.a. exponential) model. The Cox model is….

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Jason Shafrin – Page 481 – Healthcare Economist

Details: Health insurance, however, is tax deductible when it is received from an individual’s employer while wages are not. A Health Affairs report shows that this tax expenditure from excluding health insurance from the federal income…

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Money Driven Medicine: A Review – Healthcare Economist

Details: Any health economist will of course say ‘duh’, but for those who believe that medicine is purely an altruistic endeavor, this may be an eye opening film. Some of the problems they document include: Doctors get paid to provide more services whether or …

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Poisson Distribution Estimation – Healthcare Economist

Details: The Poisson distribution is one that is often used in health economics. Wikipedia has a nice basic summary of the Poisson distribution; Wolfram MathWorld gives a more sophisticated analysis. The distribution is. where ‘λ‘ is equal to the number of expected occurrences in a period. The distribution expresses the probability of a number of events (‘k‘) occurring in a fixed period of

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Roemer’s law – Healthcare Economist

Details: Roemer’s law. Supplier induced demand has become a common phrase for health policy wonks. Yet this phenomenon was first discovered by Milton Roemer when he investigated how the number of hospital beds per capita affected hospitalization rates. According to the Dartmouth Atlas Project, Roemer’s law can be stated as follows: “Supply may

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HC Statistics – Healthcare Economist

Details: Using data from the National Center for Health Statistics (NCHS) and US Census Bureau, Woolf et al. (2021) find: Between March 1, 2020, and January 2, 2021, the US experienced 2 801 439 deaths, 22.9% more than expected, representing 522 368 excess deaths…The excess death rate was higher among non-Hispanic Black (208.4 deaths per 100 000) than non-Hispanic White…

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Providers for Underserved Populations: RHC and FQHC

Details: The Rural Health Clinics Act (P.L. 95-210) was passed by Congress and signed into law by President Carter in 1977. The goal of this Act was twofold. First, it encouraged the utilization of PAs and NPs by providing reimbursement for services these health professionals provided to Medicare and Medicaid patients, even in the absence of a full

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Optimal Contracts in the British NHS – Healthcare Economist

Details: There are three types of payment contracts between the NHS and health authorities. The first is a block contract where hospitals receive a flat contract to care for a patient population regardless of the actual care given. The second contract is a cost-per-case contract where the hospital is paid based on the cost of the medical services supplied.

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Job Lock: A Literature Review – Healthcare Economist

Details: Health insurance is a major issue in the United States. Nearly everyday, residents can pick up a newspaper and read a story expounding on the worsening `health care crisis.’ Many workers fear losing their job, not simply due to the loss in wages, but even more due to the loss in health insurance coverage. In fact

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Pharmaceuticals – Page 34 – Healthcare Economist

Details: The UK Medicines and Healthcare products Regulatory Agency (MHRA) has released a scathing report criticizing the medical procedures Parexel used in testing the TGN1412 drug.

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January 2006 – Healthcare Economist

Details: A recent Health Affairs article by Cynthia Smith, Cathy Cowan, Stephen Heffler and Aaron Catlin details the trends in health care spending over the last 25 years. I have compiled their results into a handy graph. In addition the the general overall increase, there are other significant findings. Between 1970 and 2004, out-of-pocket payments

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Medicare more likely to deny claims than commerical health

Details: Medicare more likely to deny claims than commerical health insurers. According to an article on TheHill.com, Medicare denies more claims than commercial insurers. “ Medicare was the most likely to deny any part of a claim, with a 6.9 percent rate. Aetna was a close second at 6.8 percent while the others ranged from 2.7 percent to 4.6 percent.

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ANOVA – Healthcare Economist

Details: This is because there are 3 doctors, we have 3-1=2. Our answer here is: 98.8/2 = 49.4. Now we can calculate the F statistic as: F = MS between /MS within = 49.4/146.77 = .337. If we look this up on an chart for F-statistics, we see that the probability that all 3 doctors are equally good is .721.

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What do Nonprofit hospitals maximize – Healthcare Economist

Details: “Perhaps the most convincing evidence for the effect of market mix is the results for home health and skilled nursing, post-acute services that were first ambiguously profitable, then profitable, then less profitable again. During the most profitable period, nonprofits were more likely to offer them in high, compared to low for-profit markets.

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Obama v. Nixon – Healthcare Economist

Details: Obama v. Nixon. In 2009, President Barack Obama addressed the nation calling for healthcare reform. In 1974, President Richard Nixon also addressed the nation calling for healthcare reform. Let us analyze Nixon’s speech and compare it to Obama’s. “ Today the need [for reform] is even more pressing because of the higher costs of medical care.

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Innovation – Healthcare Economist

Details: Innovation in health care often improves quality but also increases cost. That is not always the case. Consider the case of an innovative Bangladeshi physician who was interested in improving care for patients with pneumonia who could not afford the $15,000 cost of the ventilators used in a developing work: However, after a second piece…

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April 2012 – Healthcare Economist

Details: The movement of mental health care from mental hospitals to treatment in outpatient settings and nursing homes began in the 1950s. Here is how it happened. “The field of medicine where the ‘rediscovery of community’ found an immediately welcome reception was mental health services.

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