Should providers participating in accountable care organizations (ACOs) be exempt from existing regulations that prevent financial conflicts of interest in physician referrals? On the one hand, these regulations, collectively known as the Stark Law, can impede efforts to coordinate care across providers and facilities. On the other hand, ACOs and other alternative payment and delivery models do not necessarily obviate the need for regulations that prohibit physician kickbacks or self-referrals.
Abstract [from journal]
Forty years after the publication of the first systematic study of adverse medical events, there is greater access to information about adverse medical events and increasingly widespread acceptance of the view that patient safety requires more than vigilance by well-intentioned medical professionals. In this essay, we describe some of the ways that medical liability insurance organizations contributed to this transformation, and we catalog the roles that those organizations play in promoting patient safety today. Whether liability insurance in fact...
Lack of transportation has been an enduring barrier to care, especially for low-income and rural patients. Many of these patients are covered by Medicaid, which, since 1966, has provided non-emergency transportation (NEMT) to medical appointments for free or at a heavily subsidized rate. Although NEMT is built into the foundation of Medicaid, some state governments are seeking leeway to drop that benefit. The movement stems from persistent budget constraints and a view that NEMT is ineffective.
On October 22, policymakers, researchers, advocacy group representatives, physicians, and other experts will convene for CHOP PolicyLab's 10th anniversary forum: Charting New Frontiers in Children's Health Policy & Practice. Attendees will discuss the most pressing health issues facing children, adolescents, and families across the country. The post below from PolicyLab Faculty Member and LDI Sen
[Reposted: Sara F. Jacoby, Elinore J. Kaufman, Therese S. Richmond, Daniel N. Holena. When Health Care And Law Enforcement Intersect In Trauma Care, What Rules Apply?, Health Affairs Blog, October 1, 2018. https://www.healthaffairs.org/do/10.1377/hblog20180926.69826/full/: Copyright ©2018 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.]
Abstract [from journal]
Differential pricing—manufacturers varying prices for on-patent pharmaceuticals across markets—can, in theory, lead to increased patient access and improved research and development (R&D) incentives compared with charging a uniform price across markets. Theoretical models of price discrimination and Ramsey pricing support differentials based inversely on price elasticities, which are plausibly related to average per capita income. However, these models do not address absolute price levels and dynamic efficiency. Value-based differential pricing theory...
As the country faces an unprecedented opioid epidemic, there’s an active national conversation about how inappropriate prescribing contributes to chronic opioid use, misuse, and addiction. Evidence is rapidly evolving to inform the policy debate, especially regarding best practices for prescribing in acutely painful conditions, like an injury or surgery, but the evidence is less clear on the best policy solutions.
[Editor's note: on August 1, 2018, California Insurance Commissioner Dave Jones recommended that the United States Department of Justice sue to block the proposed merger.]
The proposed $69 billion merger of CVS and Aetna drew sharp criticism in a June California Insurance Commission hearing, including from LDI Senior Fellow Lawton R. Burns, PhD, MBA, Professor of Health Care Management in the Wharton School.
With policies rooted in the 1960s, it’s time to change how Medicare pays for nurse education. In a New England Journal of Medicine Perspective, LDI Senior Fellow Linda Aiken and colleagues present a compelling case for funding a new consortium model that trains nurse practitioners (NPs) in the community settings where they are a crucial source of primary care.
Last month, the American Dental Association (ADA) announced a new policy on opioid prescription. This is the latest in a series of statements issued by the ADA in response to the prominent role of dentistry in the opioid epidemic.
Our health and social systems are ill-equipped to meet the needs of the growing population of older adults with chronic conditions and their family caregivers. We are living longer, but are we living better?
Tradition can be a great thing, but we need to re-evaluate how the practices and lessons of the past apply to the present. That was one message stressed by Dr. Mark Smith as he delivered Penn LDI’s Charles C. Leighton, MD Memorial Lecture. Dr.