There’s no shortage of opinions about whether the FDA’s process of approving medical devices is too lax, too strict, or just right. After all, there’s a lot at stake, both for patients and for the $110 billion market for medical devices in the U.S. But evidence, one way or another, has been sorely lacking. A study by LDI Senior Fellows Matthew Grennan and Robert Town goes a long way toward filling that gap.
About 10 years ago, my primary care physician decided that she would no longer take insurance, and left the practice. Patients could pay directly to continue in her care in her new practice, or see another physician in the existing practice. I chose to stay in the practice with another physician.
The question of whether and how much hospitals cross-subsidize unprofitable services with more profitable ones is an important one, especially as wide variation in hospital pricing within and across markets is documented. If prices become more transparent, and a hospital’s revenues from high-margin services drops, will hospitals reduce the amount of less profitable services they provide?
In our last LDI/INQRI Brief, we looked at the evidence of nursing's role in increasing the value of health care, and we pointed out where "value" and "business case" may differ for hospitals. In our latest Brief, we analyze the three Medicare programs designed to align hospital incentives with value, and how nursing-sensitive quality indicators relate to those programs.
Last week, LDI Senior Fellow Scott Harrington, PhD presented detailed financial data on the beleaguered CO-OP health plans, created and funded by the Affordable Care Act. Of the 23 original CO-OPs, nine have now or will soon close their doors.
A new LDI/INQRI Brief tackles the complexities of assessing health care value and nursing’s contributions to value in terms of outcomes and costs. It highlights evidence published by researchers in the Interdisciplinary Nursing Quality Research Initiative (INQRI), an 8-year program funded by the Robert Wood Johnson Foundation.
With a price tag of $1,000 per pill and $84,000 for a 12-week course of Sovaldi (sofosbuvir), Gilead Sciences prompted widespread concern about whether its new treatment for hepatitis C (HCV) would bankrupt public and private payers. These concerns were particularly significant for state Medicaid programs, which face both limited state budgets and high HCV prevalence among beneficiaries.
In June, we described the first attempt to measure, in a consumer-friendly way, the breadth of physician networks offered by all silver plans on the 2014 health insurance marketplaces. We estimated network size based on the fraction of office-based physicians participating in the network within relevant rating areas in the state. We categorized networks using "T-shirt" sizes: x-small (less than 10%), small (10%-25%), medium (25%-40%), large (40%-60%), and x-large (more than 60%). We found that nationally, 41% of all networks were either “small” or “x-small”.
“Science has delivered solutions. The question for the world is: When will we put it into practice?”
In the mid-eighties, I coordinated a medical genetics clinic at Johns Hopkins Hospital. We shared our outpatient unit, the Moore Clinic, with the AIDS Care Program, which began in 1984. Every week, I would see the devastating and shockingly rapid decline of robust young men—men my age—in the waiting room outside my office. I came to recognize the pattern: two men would walk in, one weaker, one stronger.
As many of our blog readers know, LDI focuses on ways to improve our health care system. That’s our mission, and we’re sticking to it. But it’s worth remembering that some of the most powerful ways to improve health lie not in the health care system, but in strategies that directly change the places people live, work, and play.
A new report on maternal deaths in Philadelphia sheds light on a persistent problem and recommends concrete, doable steps to reduce pregnancy-related mortality. The 30 members of the Philadelphia Maternal Mortality Review (MMR) team, including LDI Senior Fellows Sindhu Srinivas and coauthor Pooja Mehta identified and reviewed all cases of Philadelphia residents who died within one year of the end of pregnancy from 2010-2012.
There’s been a lot of talk about "narrow" networks in ACA plans, which trade off limited provider coverage for lower premiums. Using a new integrated dataset of physician networks in plans on the federal and state marketplaces, our latest LDI/RWJF Data Brief describes the breadth of physician networks across all silver plans sold in 2014.
Although the ACA has cut the level of uninsurance dramatically, roughly 30 million adults remain uninsured, many of them in states that did not expand Medicaid. Can these self-pay patients get an appointment with a primary care provider, and if so, at what price?
Today, on the tax filing deadline, we can safely say that the ACA did not wreak havoc during tax season. Yes, there were surprised taxpayers who had to return portions of their premium tax credits (because they earned more than they had projected).