“[..] spending on hospital care makes up the largest single component of personal health care spending, an estimated 39 percent of the total in 2023, compared to 24 percent for physician and clinical services and 10 percent for prescription drugs. National spending on hospital care is projected to exceed $1.5 trillion in 2023, and is expected to grow by about 5.6 percent per year over the coming decade (a rate likely to significantly exceed general inflation). Much of this growth is driven by consolidation among hospitals and health systems, which then use their size and local market power to demand … Read More
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“Screening colonoscopy has been shown to reduce colorectal cancer (CRC) incidence and mortality by enabling detection and removal of precancerous lesions. However, the available evidence about the optimal screening interval is limited. [..] More targeted screening offers would potentially reduce the burden of testing and demand of capacities and costs associated with colonoscopy, thereby also counteracting the frequently reported overuse and underuse of screening examinations in considerable proportions of the population. [..] Anonymized registration of screening colonoscopy findings and the use of the anonymized data for program evaluation by the Central Research Institute of Ambulatory Health Care in Germany is … Read More
“we examine real-world data from a cohort based in a UK primary care clinic offering a low-carbohydrate approach to people with T2D [type 2 diabetes] from 2013 to 2021. The physiological mechanisms behind remission induced by dietary weight loss were first demonstrated in 2011. Since then the idea of drug-free T2D remission has gained international momentum. [..] Advice on lowering dietary carbohydrate was offered routinely by our team of nine specially trained GPs and three practice nurses to patients with T2D (defined as HbA1c >48 mmol/mol on two occasions) starting in March 2013. Our protocol includes important information around the deprescribing of … Read More
“[Authority Magazine’s Jake Frankel] can you articulate for our readers a few of the main benefits of having a patient in front of you? [Co-founder and CMO of HealthTap Geoff Rutledge] The most important point to emphasize is that the essential physician–patient interaction is direct face-to-face communication that allows a doctor to connect with their patient, engage with them, and enable them to share in detail what is going on with their lives and their health. And that this critical face-to-face communication can occur equally well either in an in-person, in-office setting or via high-resolution video and audio consultation. It’s … Read More
“There are 3 main takeaways from the existing research on the rule. First, the compliance rates have been low. In March 2021, a random sample of 100 hospitals indicated that only 33% reported the negotiated commercial prices for some services. [..] In response to the low compliance, the CMS raised the penalty for noncompliant hospitals to $300 per day for small hospitals and up to $5500 per day for large hospitals beginning from January 1, 2022. Despite the steeper penalties, the compliance rate remains low. For example, Gul et al note that as of March 2022, only 29% to 56% … Read More
“Having analyzed health outcomes data from the independent National Committee for Quality Assurance, health plan member satisfaction surveys from J.D. Power, and internal data from our own organizations, we are confident that full implementation of five opportunities would improve clinical quality nationwide by 20%, increase access to care by 20%, and reduce health care spending by 15% to 20%. Reduce expensive and unnecessary trips to the ER – [..] Kaiser Permanente members in Virginia, Maryland, and Washington, DC [..] can access a 24/7 video health center that connects them with a doctor who can quickly assess the problem and offer … Read More
“The concept of value-based payment became widespread among U.S. health policymakers and analysts during the 2000s. It collectively refers to interventions that offer doctors and hospitals financial incentives that, in theory, induce them to improve both components of health-care value — cost and quality — without generating the hostility provoked by managed care insurance companies during the HMO [health maintenance organization] backlash of the late 1990s. [The Center for Medicare and Medicaid Innovation reviewed 54 models of value-based payment. Only four were certified to be expanded:] The Home Health Value-based Purchasing Model demonstration cut Medicare spending by 1% with mixed … Read More
“recent research demonstrates that hospital mortality rates can vary by a factor of 3 to 1 and health plans by 4 to 1, and publicly available quality ratings of health care plans and services do not correlate well with outcomes. What is more, lack of transparency among health plans and provider organizations prevents purchasers from making informed choices based on relative quality of provider organizations and health plan networks. Currently available outcomes data are limited to Medicare fee-for-service. [..] For at least five decades, the public health care conversation has focused primarily on rising costs, while the US has lagged … Read More
“US data from the period 1996–2016 are now available on health care spending by cause from the Disease Expenditure Project (DEX) and on DALYs [disability-adjusted life-years] by cause from the Global Burden of Disease (GBD) Study 2017. DALYs are the sum of years of life lost due to premature mortality, as well as years lived with disability among people living with a given cause. Intuitively, DALYs are a measure of burden, and therefore the goal of health systems is to avert DALYs. A decrease in DALYs is a measure of health gain referred to as DALYs averted. [..] We estimated … Read More
David H Jiang et al. published an article in Health Affairs last month arguing for a set of diabetes quality measures that are actually linked to optimal diabetes health. Composite measures that include “all-or-nothing” components will incentivize providers to focus on patients who are most likely to achieve the measure rather than those who would benefit the most clinically. This would also adversely affect patients with socioeconomic barriers to optimal health, as those patients are more likely to have multiple unmet measures or not meet a measure that is more difficult to achieve (e.g., smoking cessation). A more equitable approach … Read More