The Affordable Health Care Act (AHCA or “Trumpcare”) will cut 24 million from insurance by 2026 including 410,600 from Colorado (use this interactive feature to see how many will be impacted in your state). Colorado’s own Senator Cory Gardner has expressed his reservations about the 14 million projected to lose Medicaid, describing Medicaid as providing “access to life-savingContinue reading “Fact Check: the Colorado Case for Repeal of the Affordable Care Act (and replacement with the Affordable Health Care Act) is a False Narrative”
Category Archives: Health Services Research
The Affordable Care Act is Good for Colorado (and Repeal is Not)
The effects of the Affordable Care Act of 2010 in each state depend on various factors, such as the number of uninsured individuals in the state and the governor’s receptiveness to the law’s provisions. In this post, I focus on the benefits of the Affordable Care Act (ACA) in Colorado, primarily from the perspective of my job as anContinue reading “The Affordable Care Act is Good for Colorado (and Repeal is Not)”
What we miss when we look only at the cost of healthcare coverage
With the Republicans on the verge of dismantling the Affordable Care Act and Medicaid, much of their focus has been on how much healthcare insurance “costs”. I thought it would be timely to revisit a 2015 analysis in the American Journal of Public Health, “Considering Whether Medicaid is Worth the Cost: Revisiting the Oregon Health Study.” (fullContinue reading “What we miss when we look only at the cost of healthcare coverage”
Retail Urgent Care Clinics Do Not Decrease Emergency Department Visits
A study published online today in Annals of Emergency Medicine (“Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits”) demonstrated that, contrary to expectations, retail clinics had little effect on rates of low-acuity visits to nearby emergency departments (EDs). This contradicts the popular theory that retail clinics would reduce ED visits. A 2015 report “Building aContinue reading “Retail Urgent Care Clinics Do Not Decrease Emergency Department Visits”
Paid Sick Leave Lowers Costs
An Upshot column “The High Costs of Not Offering Paid Sick Leave” argues that employees and their co-workers may be better off with an incentive to take time off when sick. About 45 percent of the American work force does not have paid sick leave; that’s about 50 million workers. Families with less ability to afford unpaid time off are moreContinue reading “Paid Sick Leave Lowers Costs”
Obamacare Succeeds in Expanding Insurance Coverage
Amidst news of the increasing premiums and decreasing choice of plans in some healthcare markets, the New York Times‘ Upshot column brings us this visual display of the impressive and varied impact of Obamacare on insurance coverage rates from 2013-2016. States that decided to expand their Medicaid programs saw much larger declines in their uninsured ratesContinue reading “Obamacare Succeeds in Expanding Insurance Coverage”
AHRQ and CMS Public Reporting Measures Fail to Describe the True Safety of Hospitals
A new study from the Johns Hopkins Armstrong Institute for Patient Safety and Quality, published in the journal Medical Care, performed a systematic review and meta-analysis of two sets of safety measures used for pay-for-performance and public reporting The measures evaluated in the study are used by several public rating systems, including U.S. News and World Report’s Best Hospitals, Leapfrog’s Hospital Safety Score,Continue reading “AHRQ and CMS Public Reporting Measures Fail to Describe the True Safety of Hospitals”
Pay for performance penalties fail again
The Incidental Economist astutely deconstructs the assumptions leading to the failure of the nationwide Hospital-Based Purchasing Program’s pay-for-performance penalties to reduce 30-day mortality. These assumptions include: 30-day mortality is the right outcome measure because it is feasible to measure 30-day mortality is a valid proxy for the quality of inpatient care delivered. As shown with readmissions based penalties and with other payContinue reading “Pay for performance penalties fail again”
The Minimum Wage and the Social Determinants of Mental Health
A new study in Health Economics shows a temporal association between Britain’s minimum wage law and substantially improved mental health of the low wage workers benefitting from the policy. Source: The Minimum Wage and the Social Determinants of Mental Health
Should Doctors Undergo Opioid Prescribing Risk Training?
Earlier this week, an advisory panel recommended that the Food and Drug Administration require doctors who prescribe painkillers s to undergo training aimed at reducing misuse and abuse of the medications. The New York Times notes: It is the second time since 2010 that an F.D.A. panel has recommended expanding safety measures for painkillers. But the trainingContinue reading “Should Doctors Undergo Opioid Prescribing Risk Training?”
Marion R. Sills, MD, MPH 