Paul Levy, former chief executive of Boston’s Beth Israel Deaconess Medical Center, recently made a compelling argument in a blog post about why value-based pricing for hospital services ultimately will fail.
In “The Game That Shows Why Value-Based Pricing Is Doomed” on AthenaInsight, Levy argues that the incentives in value-based pricing are all wrong. As a payment model, value-based pricing promotes selfishness but at the same time requires all parties to cooperate, he writes.
It’s not often that anyone criticizes value-based care, and why would they? That would be like opposing the use of grocery coupons. Continue reading
In two days in December, the Charleston Gazette-Mail published two blockbuster articles about the opioid crisis in West Virginia, the results of months of reporting by Eric Eyre, the paper’s statehouse reporter.
Anyone who read them would recognize that Eyre’s work was outstanding, if only for the numbers he included in each piece. Over six years, the nation’s largest drug distributors shipped 780 million hydrocodone and oxycodone pills to pharmacies in the state, he reported. In that same period, 1,728 West Virginians fatally overdosed on those two painkillers, he wrote. Drug distributors shipped enough hydrocodone and oxycodone for each of the state’s 1.8 million residents to have 433 pills. Continue reading
How often has this happened to you? Over the transom comes a report you believe will be the basis for a section-front story or maybe warrant page one. Many times, you’re right. You read the report, collect the highlights, conduct a few interviews, and fire off the story on deadline.
However, occasionally what you thought might be a solid report leaves important questions unanswered. Continue reading
On Monday, analysis from the Congressional Budget Office showed that 24 million more Americans would become uninsured over 10 years if the U.S. House Republican’s bill to replace the Affordable Care Act (ACA) becomes law. Coverage of the CBO report overshadowed other news last week that the proposed American Health Care Act also would slash insurance coverage for those who are addicted to opioids and other drugs, according to reporting in USA Today and the Cincinnati Enquirer.
Deirdre Shesgreen and Terry DeMio on March 9 reported the bill would freeze the ACA’s Medicaid expansion provisions and limit federal payments to the states for all beneficiaries. That would result in a disproportionately adverse effect on patients coping with mental illness and addiction, they wrote. Continue reading
We reported last month that the U.S. Department of Justice was investigating the risk-adjustment practices of UnitedHealth Group and WellMed Medical Management. At the time, a question remained about whether the DOJ would look into the risk-adjustment or claims-coding activities of other health insurers.
Turns out that Bob Herman, the health care business reporter for Axios, already had the answer. Continue reading