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Learning Pricing from the Airline Industry

by Nii Darko, DO, MBA in Delivery System & Affordability

Source: Kevin Dooley (Flickr/CC) Traveling by air during the 1950s and 1960s during the Golden Age of Flying was different from what most of us are used to today. Lavish [...]

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Quality of Care

Access to Care

Health care costs

Affordable Care Act

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    Global Payments Change Spending & Quality

    In an effort to slow the growth of health care spending, Blue Cross Blue Shield (BCBS) of Massachusetts, an early reform state, entered into alternative quality contracts (AQC) with providers. AQCs are two-sided contracts that share savings if spending is below budget and share risk if spending exceeds the budget. In this analysis, the authors discuss savings, risk payments, and incentive payments for 2009-2012 in comparison to a control cohort. The intervention group consisted of 4 cohorts of [...]
  • Source: Flickr/CC

    Don’t Sue Me Bro

    You walk into your doctor’s office with a headache. Like most people, before you made the appointment you did a quick Google search with your symptoms, and are now convinced you have a brain tumor—a meningioma maybe. WebMD says that meningiomas can be fatal, so you call your mom to let her know you love her but she ought to mentally prepare herself for the inevitable. Though your doctor knows that patients with headaches with no other symptoms have a less than 1% chance of having a [...]
  • Source: Donnie Ray Jones (Flickr/CC)

    Barking up the wrong tree

    Medical liability accounts for only 2.4% of all health care costs, yet medical malpractice reform is often hailed as a critical ingredient to reducing costs. Though capping non-economic damages—those that compensate patients for their pain, suffering, emotional distress, and disfigurement following a negligent medical error—reduces liability payments, it doesn’t accomplish what it’s meant to do. Costs are still sky-high, and patients that have proven in a court of law that they were the [...]
  • Source: Allen Skyy (Flickr/cc)

    Medicaid crowd out: hype or reality?

    With Medicaid expansion underway, questions about whether Medicaid coverage “crowds out” private coverage have reemerged. Critics of Medicaid expansion contend that public health insurance causes individuals to forego private coverage. A recent study published in Inquiry sought to quantify this phenomenon—specifically, to determine how many new Medicaid enrollees had private insurance at the time of Medicaid enrollment and, of those new Medicaid recipients, how many dropped their private [...]
  • Source: Saad Faruque (Flickr/CC)

    The New Tech Disparity

    Electronic health record (EHR) systems are poised to become the backbone of future healthcare delivery in the United States. For over a decade, EHR systems have been touted as the solution to improving efficiency in medical practices and the panacea for the reduction of medical errors. The government has recognized EHR systems and health information technology (IT) implementation as a national priority. Modernizing the country’s health IT backbone and improving physician adoption of EHR [...]
  • Source: pixabay.com (CC)

    Happy accident lowers health care costs

    The Affordable Care Act (ACA) increased emphasis on quality reporting for doctors and hospitals in an effort to improve care and, hopefully, improve health outcomes for patients. Whether or not this will be accomplished is yet to be seen. However, Medicare’s Hospital Compare tool, implemented prior to the ACA in 2005 by the Centers for Medicare and Medicaid (CMS), has had another unanticipated effect: lowering costs. Source: pixabay.com (CC) A new study published in Health Affairs by public [...]
  • Source: Sean MacEntee (Flickr/CC)

    Cheating the system

    The controversial practice of using electronic health record (EHR) systems to “upcode” Medicare claims has attracted the attention of policymakers and triggered targeted audits by the Department of Health and Human Services. “Upcoding” refers to the selection of billing codes that, “reflect more intensive care or a sicker patient population, thus leading to higher reimbursement.” However, a recent study published in Health Affairs found no evidence that upcoding was associated with [...]
  • Source: Daniel Aguilera Sánchez (Flickr/CC)

    Taking a Lesson from Taiwan

    Government payers like Medicare and Medicaid are attempting to move away from the current fee-for-service model of health care billing—which some believe provides incentive for doctors to perform unnecessary tests and procedures—in favor of a new payment model: Pay-for-performance. Pay-for-performance programs link performance on clinical quality benchmarks to the salaries of physician-employees. Source: Daniel Aguilera Sánchez (Flickr/CC) To get a better idea of how this might pan out, we [...]
  • Source: Kevin Dooley (Flickr/CC)

    Learning Pricing from the Airline Industry

    Source: Kevin Dooley (Flickr/CC) Traveling by air during the 1950s and 1960s during the Golden Age of Flying was different from what most of us are used to today. Lavish layouts, complimentary drinks, and exorbitant ticket prices made air travel for the majority of people out of reach. Nowadays, the average person can travel around the country at a fraction of the cost by using websites that compare among discount and premium airlines. There is a great lesson in airline industry history that, [...]
  • Source: Jeffrey Zeldman (Flickr/CC)

    To privatize or not to privatize?

    As the business of health care continues to evolve, so does the strategic structuring of many health care organizations across the nation. With diminishing funds from local or state governments, reductions in Medicare and Medicaid payments, and intensifying competition, many public hospitals are forced to re-align their already strained resources to provide quality care for all regardless of insurance status or ability to pay. Public facilities are financially backed by government entities and [...]

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The Uninsured

  • Source: U.S. Army Corps of Engineers Europe District (Flickr/CC)

    Give the people what they want

    January 19, 2015 // 0 Comments

    Under the Affordable Care Act, eligibility for Medicaid benefits was expanded to include low-income childless adults. This provision has proven to be immensely controversial, [...]
  • Source: Minnesota Historical Society (Flickr / CC)
    A recent study explored whether there is a relationship between the healthcare spending of uninsured individuals – sorted by citizenship status – prior to and during the [...]
  • Source: www.GlynLowe.com (Flickr / Creative Commons)

    ACA Progress Report: What has changed so far?

    August 11, 2014 // 2 Comments

    The first open enrollment period for the Affordable Care Act closed on March 31, with 8 million Americans enrolled by the deadline. The marketplace re-opens in November, [...]
  • Source: Kaiser Family Foundation analysis. Original data and detailed source information are available at http://kff.org/jama_062514
Produced by: Jessica Stephens, MPH; Samantha Artiga, MHSA; Barbara Lyons, PhD; Anne Jankiewicz; and David Rousseau, MPH.
    Source: Kaiser Family Foundation analysis. Original data and detailed source information are available at http://kff.org/jama_062514Produced by: Jessica Stephens, MPH; [...]
  • Source: Alan Cleaver (Flickr / Creative Commons)

    Does Health Insurance Help?

    June 30, 2014 // 1 Comment

    Source: Alan Cleaver (Flickr / Creative Commons) While it has been estimated that 45,000 Americans perish unnecessarily each year due to lack of health insurance, there has [...]