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Protecting the Good Doctors

by Regina Bailey, MD, JD, LLM in Health care costs

A new study published in the New England Journal of Medicine examined whether protecting doctors from unwarranted lawsuits could curb unnecessary health care costs, [...]

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Quality of Care

Access to Care

Health care costs

Affordable Care Act

  • Source: Francois Karm (Flickr/CC)

    States opt for lower smoking fees

    The Affordable Care Act (ACA) allows insurance companies to charge smokers up to 50% higher premiums than nonsmokers. However, this study found that most insurance companies are charging much less than the 50% maximum surcharge allowed. Source: Francois Karm (Flickr/CC) All states included in the study offer at least one plan with a less than 50% surcharge, and 89% of plans overall charge less than 50%. Many states (41%) have at least one plan with no tobacco surcharge at all. The states that [...]
  • Source: Ged Carroll (Flickr/CC)

    CMS demands technology utopia in hospitals

    The advancement of health information technology is surely becoming one of the foremost changes in the American health care system. Assuming the adoption of more advanced technologies will improve quality and efficiency, several recent federal policies have encouraged (if not demanded) that hospitals and physicians get on the bandwagon and incorporate health IT into their clinical practice. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, meaningful use [...]
  • Source: Marc Dalmulder (Flickr/CC)

    Will Medicaid gains offset DSH cuts?

    The Disproportionate Share Hospital (DSH) program was developed to provide financial assistance for hospitals that care for large numbers of Medicaid and uninsured patients. During the development of the Affordable Care Act (ACA), policymakers reevaluated the program’s funding as they expected the Medicaid expansion to decrease hospitals’ frequency of uncompensated care. Subsequently, Congress predicted health systems would require fewer DSH payments and scheduled funding cuts to finance [...]
  • Source: Nate Smith (Flickr / CC)

    The Patient-Centered Medical Home

    In a 2014 article published in Health Services Research, researchers compared health care utilization and payments between the National Committee for Quality Assurance (NCQA) recognized patient-centered medical home (PCMH) practices and practices without such recognition. The study conducted three annual observations between 2008 and 2010, in which the authors compared selected outcomes between practices. Source: Nate Smith (Flickr / CC) Variation in difference estimates indicated that relative [...]
  • Source: Rod Waddington (Flickr/CC)

    Is non-expansion a death sentence?

    The journey to health care reform has surely been a long one, but for all of the twists and turns, the road to the Affordable Care Act may culminate in an unanticipated dead-end. Now that we have established health insurance exchanges and expanded Medicaid eligibility, will state governments and ultimately the American people simply let the opportunity to obtain coverage pass them by? Source: Rod Waddington (Flickr/CC) Despite the expansion of Medicaid eligibility, many states have declined the [...]
  • Source: Minnesota Historical Society (Flickr / CC)

    Who’s Responsible for Decreased Health Care Spending?

    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 Great Recession using the Medical Expenditure Panel Survey (MEPS) database. Noncitizens were further divided into those in the U.S. less than or equal to 5 years or >5 years. Source: Minnesota Historical Society (Flickr / CC) The study found a statistically significant association between uninsured noncitizens more often [...]
  • Source: JD Hancock (Flickr/CC)

    Protecting the Good Doctors

    A new study published in the New England Journal of Medicine examined whether protecting doctors from unwarranted lawsuits could curb unnecessary health care costs, particularly in the emergency department where patients are high-risk and information about patients is often incomplete. This environment, the researchers contend, lends itself to defensive practice and increased costs. Source: JD Hancock (Flickr/CC) Texas, Georgia, and South Carolina enacted laws in the last decade that changed [...]
  • Source: Lauren Nelson (Flickr/CC)

    Bundled payment experiment fails

    As stakeholders implement the Affordable Care Act (ACA), innovative payment models are developing faster than practical applications. Bundled payments, defined as “a fixed payment that covers the average cost of a bundle of services” are the latest fad touted as a means to reduce cost and improve quality of care. Recently, the Integrated Healthcare Association (IHA) of California experimented with bundled payments with a $2.9 million evaluation grant. The goal was to determine whether [...]
  • Source: Bryan Mills (Flickr / CC)

    ER Closures & Mortality at Nearby Hospitals

    There has been an increase in demand for emergency care in the U.S., yet access to emergency rooms is diminishing. From 1996 to 2009, annual visits to Emergency Departments (EDs) increased by 51% while the number of EDs decreased by 6%. This has led to increased crowding, wait times, and ambulance diversions in our emergency care system, ultimately delaying care for those patients who need it most. Source: Bryan Mills (Flickr / CC) ED closures pose a threat to the care of vulnerable [...]
  • 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 [...]

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