Explore the latest in health care economics, insurance, and payment, including cost-effectiveness, value-based purchasing, and payment reform.
This Viewpoint discusses the increasing investments managed care organizations are making in social services to improve members’ health and decrease costs, and argues that the trend could free up resources for investment in the health of groups not covered by managed care plans.
This cohort study examines the prevalence of high out-of-pocket health care spending across health plans with different deductible levels among adults in low-income families who have chronic conditions.
This Viewpoint argues for reform of the US health care system, starting with the elimination of employment-based insurance.
This Viewpoint calls out the limited evidence supporting current pay-for-improvement incentives in the US, and argues that performance improvement programs that emphasize nonfinancial rewards, resources for quality improvement, and team-based recognition would be more consistent with physician motivation and professionalism and would be worth evaluating as a means to reduce health care costs and waste and improve quality.
This survey study examines the association between delayed or foregone preventive and nonpreventive health care service use and the level of understanding of health insurance coverage among US adults.
In this Viewpoint, the authors review Medicare & Medicaid Services 340B Payment program and recent rules to curtail expansion of drug discounts beyond serving poor patients.
This Viewpoint explains how group purchasing organizations (GPOs) – companies that purchase devices, supplies, and medication from multiple manufacturers and serve as single supply sources for hospitals and medical centers – contribute to supply shortages, higher prices, and limited product selection, and proposes policy solutions to overcome the adverse effects of the arrangements.
This cross-sectional study analyzes data from the National Anesthesia Clinical Outcomes Registry to determine the incidence of anomalous billing among anesthesia practitioners in the United States.
This in silico cohort study uses data from the Medical Information Mart for Intensive Care (MIMIC-III) to investigate whether discussions documented in narrative clinical notes about financial concerns between patients and clinicians are associated with health care decision making in the intensive care unit.
This quality improvement study compares the outcomes and costs of Medicare and Medicaid participants who took part in an acute care intervention or a community intervention in Baltimore, Maryland, vs a comparison group drawn from similar Maryland hospitals.
This population-based study uses data from the Surveillance, Epidemiology, and End Results database to examine the association of the Patient Protection and Affordable Care Act with rates of insurance coverage and access to care among patients with head and neck squamous cell cancer.
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