Health Affairs: The Department Of Justice Withdraws 'Outdated' Antitrust Health Care Guidance (4/5) – The withdrawals signal continued and perhaps even more vigilant antitrust enforcement and attention to potential abuses flowing from health market concentration. An ever-growing body of research demonstrates that consolidation in health care markets leads to higher prices for commercially insured patients. At the same time, however, antitrust law is relatively powerless to unwind consolidation, and antitrust enforcement will necessarily be confined to boundary-setting rather than invigorating competition in health care markets that are already consolidated.
Becker's ASC Review: Why don't private practice physicians have more power in healthcare? (4/3) – It is becoming increasingly difficult for private practice physicians to devote any time to anything other than the practice of medicine, what with the diminishing compensation for services, time spent in keeping up to date with recent developments and the administrative time spent on maintaining a place of business. Nor is it easy for them to acquire the qualifications and skills needed for administrative work. Furthermore, we have relinquished our control of the environment in which we practice (such as hospitals) to people who are either not physicians or physicians who have given up the practice of medicine, realizing that it is far more lucrative to lead physicians than to be one.
Health Affairs: Hospital Survival in Rural Markets: Closures, Mergers, And Profitability (4/3) – Financial distress among rural hospitals in the US has increased in recent years. Using national hospital data, we investigated how the decline in profitability has affected hospital survival, either independently or with a merger. A minority of unprofitable hospitals (seven percent) closed. A larger share (17 percent) merged, most commonly with organizations from outside of their local geographic market. Most unprofitable hospitals (77 percent) continued to operate through 2018 without closure or merger. Overall, our results suggest that rural markets are experiencing meaningful rates of hospital closures and mergers, yet many hospitals have survived despite poor financial performance. Policies targeting access to care will continue to be important. Similar attention will be needed to address the competitive effects of hospital closures and mergers on prices and quality.
Health Affairs: Increased Medicare Advantage Penetration Is Associated With Lower Postacute Care Use For Traditional Medicare Patients (4/3) – Value-based payment and health care delivery innovations have targeted suspected excesses in Medicare postacute care spending. Our findings indicate that the expansion in Medicare Advantage during the period 2013–2017 was associated with less use of postacute care for traditional Medicare beneficiaries after hospitalization for three common conditions, without any consistent decline in the quality of care. This spillover effect was magnified in markets with a greater share of traditional Medicare accountable care organizations (ACOs), suggesting that the combination of these two separate programs results in greater efficiency in postacute care delivery.
HIT Consultant: Value-Based Administration Enables All VBC Network Stakeholders to Benefit (4/3) – Though structural and technological barriers impeding value-based care adoption persist, many large health care organizations are working with technology partners to improve patient outcomes and reduce healthcare costs. Implementing value-based administration to manage value-based care initiatives will empower healthcare organizations to deliver on the full promise of patient-centered, value-based healthcare.
Washington Post: Medicare faces challenges — but there are potential fixes – op-ed by David J. Skorton, Association of American Medical Colleges (4/2) – We cannot afford to gut Medicare’s role in training the next generation of physicians and preserving access to care. Congress should build on recent bipartisan successes and increase investment in Medicare-supported graduate medical education and other programs. This will help ultimately address our looming workforce shortage. We can save lives by investing in physician training, which enhances the research, education, clinical care and community collaboration efforts of academic medical centers. Let’s not abandon the health of our patients, families and communities to ill-considered strategies.
Harvard Gazette: Doctors not the only ones feeling burned out (3/31) – Although much focus has been placed on physician and nurse burnout, a new study finds the COVID-19 pandemic increased stress across the entire health care workforce. “Teams are crucial for good health care delivery and our study emphasizes a need to improve the well-being of the many role types that comprise our health care teams,” said corresponding author Lisa S. Rotenstein, a primary care physician at the Brigham and assistant professor at Harvard Medical School. The prevalence of perceived work overload ranged from 37.1 percent among physicians to 47.4 percent in other clinical staff. And this work overload was significantly associated with both burnout and intent to leave the job.
AAMC: What's the Value in Value-Based Care? (3/30) – While value-based care has not proved to be a silver bullet for U.S. health care spending, several large-scale value-based care models have delivered on the promise of modestly reducing cost while improving quality of care. Future efforts in the public and private sectors should build on these successes with the understanding that one size will not fit all. Finding additional savings may be contingent on providers having greater control over where patients assigned to a provider seek care. But to ultimately achieve value for all, value-based care must do a better job of incorporating health care equity and clinical outcomes, which are both key measures of quality, and of engaging patients and clinicians.
Health Payer Intelligence: Vertical Integration Raises Spending for Medicare Advantage Plans (3/29) – Owning related businesses was associated with higher health care expenditures for Medicare Advantage plans, pointing to some of the consequences of vertical integration, a report from the USC-Brookings Schaeffer Initiative for Health Policy highlighted. Vertical integration in the health care sector can lead to differing results when it comes to quality and spending. Between 2016 and 2019, around 77 percent of Medicare Advantage plans had parent companies that owned related businesses. The findings suggest that the plans associated with parent companies that own related businesses are larger than those that do not. Researchers found plans with a higher share of their costs being accounted for by related businesses had higher gross and risk-adjusted spending.
Kaiser Health News: A Progress Check on Hospital Price Transparency (3/29) – Regardless of the differences in how the hospital disclosures are evaluated, experts generally agree that CMS should require data be reported in a standardized format for ease of comparison and enforcement. CMS has developed a template, but hospitals aren’t required to use it. For price transparency to work, enforcement also needs consistent attention, experts say. The Biden administration increased the maximum potential penalty to more than $2 million annually per hospital for 2022. Still, last year CMS penalized just two hospitals for noncompliance even though 30 percent of hospitals didn’t meet the requirement to post both a machine-readable file of prices as well as a shoppable list.
Reuters: Enforcement trends and caution points in health care private equity investing (3/29) – Enforcement trends indicate that private equity companies should exercise healthy caution when acquiring, controlling, or otherwise being involved in health care entities. With government agencies targeting not only misrepresentation but the knowledge of misrepresentation, private equity companies should ensure careful compliance with all aspects of state and federal law, including billing regulations, corporate practice of medicine prohibitions, and antitrust concerns. A robust due diligence process is essential in selecting an appropriate and compliant health care partner.