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“Greed in a Good Cause is Still Greed”

by Laura Medford-Davis, MD in Affordability & Delivery System

The government is spending $24.6 billion every year on tax breaks for approximately 2,100 nonprofit hospitals in the United States. But in return, these nonprofit hospitals [...]


Quality of Care

Continuity of Care

Health care costs

Access to Care

  • Source: Flickr/CC

    Less is More: HIE Prevents Repeat Tests

    Health Information Exchange (HIE) lets doctors see all of their patients’ records online, no matter where patients choose to go for care. If a patient has a doctor they really like in one hospital, but wants their labs drawn and prescriptions filled at a more convenient location in their neighborhood, then winds up in the ER across town after falling at a shopping mall, their ER doctor can see which medicines they are taking, and their bone specialist can see the results of the X-rays done at [...]
  • Source: DigiTaL~NomAd (Flickr/CC)

    Good Riddance to Closed Hospitals

    Payment changes under the Affordable Care Act reduces the rate of growth in reimbursements for hospital services and reduces critical funding many hospitals rely on from disproportionate share and graduate medical education. These measures could strain hospital finances and accelerate widespread hospital closures. Source: DigiTaL~NomAd (Flickr/CC) While many believe ACA insurance expansion might offset some of the financial pressure on hospitals, many stakeholders are concerned it will not be [...]
  • Source: Chris Potter (Flickr/CC/

    Higher drug spending lowers other costs

    Medicaid expansion has dramatically increased the number of Americans with health insurance. However, many have raised concerns over the costs to federal, state, and local government. It is estimated that the 2013 Medicaid expansion cost a total of $449 billion. Given the sizable price tag, policymakers have proposed structural changes to Medicaid pharmaceutical benefits aimed at containing costs. Source: Chris Potter (Flickr/CC/ One recent study examined Medicaid claims data [...]
  • Source: NIH/NIAID (Flickr/CC)

    The Economic Benefit of Preventing HIV

    In May 2014, the CDC released guidelines for pre-exposure prophylaxis (PrEP) for individuals considered high risk for HIV infection: those in relationships with HIV positive partners, those engaged in high-risk sexual behavior, and those with ongoing intravenous drug use. The recommendations include daily Truvada, an antiretroviral drug, and follow-up visits with STI/HIV testing and lab work every 3 months. These guidelines represent a significant investment estimated at $13,000 annually [...]
  • Source: John Campbell (Flickr / Public Domain)

    Quality Disparities exist between Payers

    Although providing health insurance to Americans who didn’t have prior coverage sounds like a good thing; not all insurance provides equal quality of care. Disparities exist in the quality of care specifically with Medicare patients. From facing higher risk of inpatient mortality to experiencing more adverse safety events – patients with Medicaid may not see the same inpatient health benefits as others with private insurance. A recent study examined whether differences exist in rates of [...]
  • Source: Liz West (Flickr/CC)

    “Greed in a Good Cause is Still Greed”

    The government is spending $24.6 billion every year on tax breaks for approximately 2,100 nonprofit hospitals in the United States. But in return, these nonprofit hospitals are only spending 3% of their budgets on charity care. Seventy-one percent of these nonprofit hospitals charge uninsured patients more than insured patients for the exact same services, 66% of nonprofits neglect to tell patients when they are eligible for charity, and 17% aggressively collect debt from uninsured patients by [...]
  • Source: Mishio (Flickr/CC)

    Should We Subsidize the Sick?

    The projected savings from the Affordable Care Act (ACA) are not solely from the health care exchanges: a large portion of savings stem from re-allocating medical resources towards the sickest patient populations. By improving the health of the sickest patients with high levels of health care utilization, the ACA directs savings toward other provisions such as insurance subsidies. Source: Mishio (Flickr/CC) A new study in Medical Care Research and Review collected information on patients with [...]
  • Source: Christiaan Triebert (Flickr/CC)

    Expanding ACO’s Beyond Medicare

    In 2012, the Center for Medicaid and Medicare Services (CMS) implemented a novel program in their efforts toward achieving the Triple Aim: Thirty-two organizations with experience in care coordination enrolled in the Medicare Pioneer accountable care organization program. During the first two years, Pioneer organizations were judged on 33 quality measures with a shared savings and risk payment policy. This article evaluated year one performance of Pioneer ACOs by comparing outcomes and cost for [...]
  • Source: Time Green (Flickr/CC)

    Foreshadowing Pitfalls for the Affordable Care Act

    Several countries have implemented healthcare systems that seek to attain universal health insurance through private markets. Germany, the Netherlands, and Switzerland have already embarked on this journey and can serve as guides for the United States. Source: Time Green (Flickr/CC) Some observers would say that the Affordable Care Act’s health insurance exchanges are an attempt to “Swissify” America and its health insurance marketplace. I, for one, agree. All four nations possess a [...]
  • Source: Kris Krüg (Flickr/CC)

    Primary Care is Still the Answer

    Though the patient-centered medical home has been praised as the ultimate strategy in keeping patients out of emergency departments and hospitals, so far the actual results have been mixed. A new study out of California, however, provides more positive evidence for the benefits of a continuous, longitudinal relationship with a primary care physician. Source: Kris Krüg (Flickr/CC) The Health Care Coverage Initiative in California created a provider network and defined benefits for a previously [...]

Health IT

Public Health

Lessons from Abroad

Affordable Care Act

  • Source: Bob the Lomond (Flickr/CC)

    The Dynamics of Health Insurance Post-ACA

    July 20, 2015 // 0 Comments

    We know that the number of uninsured in the United States has decreased significantly (by 16.9 million) since the Affordable Care Act (ACA), but how are people moving between [...]
  • Source: (Flickr/CC)

    ACA Contraception Mandate is a Success

    September 28, 2015 // 0 Comments

    One of the most impactful aspects of the Affordable Care Act (ACA) on public health is the mandate that insurers cover all contraceptive methods. The mandate predictably [...]
  • Source: Kevin Dooley (Flickr/CC)

    Quality over Quantity: Reforming Payment

    October 17, 2011 // 2 Comments

    A new research report from the RAND Corporation and sponsored by the National Quality Forum offers insight into new concepts of payment methods for medical services. A [...]
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    The First Five Years of the ACA in Review

    June 11, 2015 // 0 Comments

    The Affordable Care Act (ACA) turned five in March of this year and the authors of this Health Policy Report in The New England Journal of Medicine describe the milestones [...]
  • Getting rid of the free rider problem in health care (Source: Flickr/CC)

    Beyond the Individual Mandate

    August 29, 2011 // 1 Comment

    There are pros and cons of using an individual mandate for health insurance as a policy lever to promote universal health care in the United States. From a pure policy [...]
  • Employer Mandate Infographic - QS 94

    Employer Mandate: Is it needed?

    August 2, 2014 // 0 Comments

Medicaid Expansion Map