A quick post on something we do not think about often.

We look at the world through our own professional lens.  If you toil at a big urban hospital, your sphere of interest encompasses GME, training, research, and safety net care.  Conversely, if you work at a small, rural hospital, you concentrate on ER and ward coverage, adequacy of services, and connectivity to neighboring facilities and unavailable technology.

Remember this?  Ezra Klein does, and so do I:

Uwe Reinhardt, a prominent health economist at Princeton (and prior SHM plenary speaker) writes a bi-monthly column for the NY Times.  Provocative and whip smart–whether you agree with him or not–he scribed an interesting column last week on hospital governance.  Part of his column focused on nonprofit IRS filing statements.

I am a huge fan of Dan Ariely.  A behavioral economist from Duke, his sense of humor and intellectual curiosity make him immediately appealing (watch a video and see).

AHRQ released a helpful brief in 2013 assessing costs (not prices) for hospital stays.

Inpatient health care costs for Medicare, longer term, exhibit a downward growth rate–still ascending but slowing.  However, prices for employed individuals moved upward and at an accelerating rate (distinct from Medicare).  The number of admissions from both groups also decreased. 

For readers not familiar with Ashish Jha’s prodigious output, his published work focuses on quality measurement, and in particular, CMS’s Hospital Readmission Reduction Program (HRRP).  Two of his papers were released this month: A Path Forward on Medicare Readmissions (NEJM), and Insurance Expansion In Massachusetts Did Not Reduce Access Among Previously Insured Medicare Patients (Health Affairs).  He also writes a first-rate blog at An Ounce of Evidence, which I highly recommend.  A current post on the 30-day readmit rule continues to garner attention and speaks unambiguously on the subject.

He generously offered to answer a few questions for the blog:

I have been deliberating on Medicare (again), since the release of Time Magazine’s Brill piece last week.  The quote below gets at my thinking:

I clipped sentences while reading the last few weeks with the intent of compiling them for this post.  I want you to examine below and glean a pattern.

I am not a nihilist.  Just be careful what people tell you, what you believe, and how data does not links to incentives.   I am just sayin’.

The very few words edition:

The rules for the Physician Payments Sunshine Act dropped:

Drug, device and medical supply companies must report all payments over $10 to U.S. physicians and teaching hospitals. The data must include date of payment, a description of the service provided, the amount paid and which of a company’s products the payment involved.