Physician Consolidation and the Spread of Accountable Care Organizations
Accountable Care Organizations (ACOs) are groups of physicians and hospitals that jointly contract to care for a patient population. ACO contracts incentivize coordination of care across providers. This can lead to greater consolidation of physician practices, which can in turn generate higher costs and lower quality. Given this, the study asks, as ACOs enter health care markets, do physician practices grow larger?
New "Tradeoffs" Podcast Show Launches
Long-Term Care Financing in the United States
In the United States, people who need long-term care (LTC) face a system with large gaps in care, which they must rely on friends and family to fill. Medicaid finances the majority of paid LTC, but people must exhaust their resources to qualify. Medicare and private health insurance do not cover LTC, and the private market for long-term care insurance is failing. Unpaid family and friends provide most long-term services, but the value of their services is rarely reflected in debates about LTC financing and delivery. Beyond the value of the services, this system has costs to the economy, as spouses and adult children reduce paid work to care for their loved ones. As the population ages and families are less able to shoulder the burden of LTC, the current system may be unable to meet the growing need without an alternative, sustainable financing mechanism.
Health Care Podcast “Tradeoffs” to Launch at Penn
Welcoming New Senior Fellows to the Leonard Davis Institute
Health Care Safety-Net Programs Continue to Serve Most Vulnerable
[cross-posted from the United States of Care blog]
Beyond Physicians: Interdisciplinary Teams in Integrated Care
In our recent blog post, we explore barriers to behavioral health care in the United States and discuss an alternate strategy: integrated care. Traditionally, integrated care has entailed behavioral health care delivered by a primary care provider.
Patrick Conway's Quest to Revolutionize North Carolina Health Care
Achieving Value in Substance Use Disorder Treatment: Paying for What Works (and Not Paying for What Doesn’t)
[cross-posted with CHERISH
Advancing Bundled Payments Through Radiation Oncology Episodes
[Reposted: Amol S. Navathe, Justin E. Bekelman and Joshua M. Liao. Advancing Bundled Payments Through Radiation Oncology Episodes, Health Affairs Blog, August 1, 2019. https://healthaffairs.org/do/10.1377/hblog20190729.824220/full/: Copyright ©2019 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.]
What's Happening at Skilled Nursing Facilities on Day 20?
There’s something unusual happening on patients’ 20th day in skilled nursing facilities (SNFs).
Penn Medicine's Amol Navathe Appointed to MedPAC
Five-Year Cost of Dementia: Medicare
[dropcap]A[/dropcap]bout 5.5 million older adults are living with dementia, a chronic, progressive disease characterized by severe cognitive decline. This number will likely grow significantly as the U.S. population ages, which has cost implications for the Medicare program. A full accounting of these additional expenses will help policymakers plan for them in their Medicare budgets. In this study, Norma Coe and colleagues examined survival and Medicare expenditures in older adults with and without dementia to estimate dementia’s incremental costs to Medicare in the five years after diagnosis.
Payment and Care Innovation at the VA
At first glance, it appears that the new Veterans Affairs (VA) Center for Innovation for Care and Payment shares much in common with the Center for Medicare and Medicaid Innovation (CMMI). Both are charged with implementing payment and care models that address rising costs, while maintaining or improving quality of care.
Medicaid and Nursing Home Choice: Why Do Duals End Up in Low-Quality Facilities?
Hari Sharma, Marcelo Coca Perraillon, Rachel M. Werner, David C. Grabowski, R. Tamara Konetzka
ABSTRACT [FROM JOURNAL]
We provide empirical evidence on the relative importance of specific observable factors that can explain why individuals enrolled in both Medicare and Medicaid (duals) are concentrated in lower quality nursing homes, relative to those not on Medicaid. Descriptive results show that duals are 9.7 percentage points more likely than nonduals to be admitted to a low-quality (1-2 stars) nursing home. Using the Blinder–Oaxaca decomposition approach in a multivariate framework, we find that 35.4% of the difference in admission to low-quality nursing homes can be...