Ezekiel J. Emanuel

You are viewing 24 posts with the tag Reducing Medical Costs

Apr 5

Next Phase in Effective Cost Control in Health Care

Glickman A, DiMagno SSP, Emanuel EJ.

JAMA, March 2019.

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Categories: Academic Writing

Apr 5

Effect of Financial Bonus Size, Loss Aversion, and Increased Social Pressure on Physician Pay-For-Performance: A Randomized Clinical Trial and Cohort Study

Navathe AS, Volpp KG, Caldarella KL, Bond A, Troxel AB, Zhu J, Matloubieh S, Lyon Z, Mishra A, Sacks L, Nelson C, Patel P, Shea J, Calcagno D, Vittore S, Sokol K, Weng K, McDowald N, Crawford P, Small D, Emanuel EJ. 

JAMA Network, February 2019.

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Categories: Academic Writing

Apr 5

National Representativeness of Hospitals and Markets in Medicare's Mandatory Bundled Payment Program

Liao JM, Emanuel EJ, Polsky DE, Huang Q, Shah Y, Zhu J, Lyon ZM, Dykstra SE, Dinh CT, Counsins DS, Navathe AS. 

Health Affairs, January 2019.

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Categories: Academic Writing

Apr 5

Pricing a Year of Progression-Free Survival: When is the Cost of Cancer Drugs Unreasonable?

DiMagno SSP, Emanuel EJ.

JAMA Dermatology, December 2018.

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Categories: Opinions , Academic Writing

Mar 29

Redesigning Provider Payment: Opportunities and Challenges From the Hawaii Experience

Volpp KG, Navathe AS, Lee EO, Mugishii M, Troxel AB, Caldarella K, Hodlofski A, Bernheim S, Drye E, Yoshimoto J, Takata K, Stollar MB, Emanuel EJ.

Healthcare (Amsterdam, Netherlands), September 2018.

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    Abstract

    Objectives

    To describe the process of developing a new physician payment system based on value and transitioning away from a fee-for-service payment system

    Study design

    Descriptive. This paper describes a recent initiative involving redesign of primary care provider payment in the State of Hawaii. While there has been extensive discussion about switching payment from volume to value in recent years, much of this change has happened at the organizational level and this initiative focused on changing the incentives for individual providers.

    Methods

    Descriptive paper. In this paper we discuss the approach taken to shift incentives from fee-for-service towards value using behavioral economics as a conceptual framework for program design. We summarize the new payment system, challenges in its design, and our approach to piloting of different behavioral economic strategies to improve performance.

    Results

    None.

    Conclusions

    This paper will provide useful guidance to health plans or health delivery systems considering shifting primary care payment away from fee-for-service towards value highlighting some of the design challenges and necessary compromises in implementing such a system at scale.

     
    Categories: Academic Writing

    Mar 12

    The Real Cost of the US Health Care System


    Mar 12

    Characteristics of Hospitals Earning Savings in the First Year of Mandatory Bundled Payment for Hip and Knee Surgery

    Navathe AS, Liao JM, Shah Y, Lyon Z, Chatterjee P, Polsky D, Emanuel EJ. 

    JAMA, March 2018.

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    Categories: Academic Writing

    Mar 12

    Volume Increases and Shared Decision-making in Joint Replacement Bundles

    Navathe AS, Liao SM, Emanuel EJ. 

    Annals of Surgery, January 2018.

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    Categories: Academic Writing

    Mar 12

    Measuring the Burden of Health Care Costs on US Families: The Affordable Index

    Emanuel EJ, Glickman A, Johnson D. 

    JAMA, November 2017

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    This Viewpoint proposes a new Affordability Index measure, the ratio of the mean cost of an employer-sponsored family health insurance policy divided by median household income, to describe US families’ ability to pay for health care.

    Categories: Academic Writing

    Mar 11

    The Case for Resource Sensitivity: Why is it Ethical to Provide Cheaper, Less Effective Treatments in Global Health

    Persad GC, Emanuel EJ.

    Hastings Center Report, September 2017. 

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    Abstract

    When Dr. Hortense screens her patients in Chicago for cervical dysplasia and cancer, she conducts a pelvic exam, takes a sample of cervical cells, and sends them for Pap cytology and human papilloma virus DNA co-testing. But when she conducts cervical cancer screening in Botswana, she employs a much simpler diagnostic strategy. She applies acetic acid to highlight precancerous lesions and visually inspects the cervix-a technique known as the VIA (visual inspection with acetic acid) method. She treats suspicious lesions with cryotherapy. There are multiple reasons that Dr. Hortense uses VIA in developing countries. It requires no specialized laboratory facilities or highly trained personnel. With immediate results, there is no delay in diagnosis and treatment, ensuring that patients are not lost to follow-up. Most importantly, VIA is considerably cheaper than Pap and HPV co-testing. This difference in care between Chicago and Botswana presents an ethical dilemma in global health: is it ethically acceptable to provide some patients cheaper treatments that are less effective or more toxic than the treatments other patients receive? We argue that it is ethical to consider local resource constraints when deciding what interventions to provide. The provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.

    Categories: Academic Writing

    Mar 11

    The Next Generation of Episode-Based Payments

    Navathe AS, Song Z, Emanuel EJ. 

    JAMA, June 2017.

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    This Viewpoint discusses bundled payment models and suggests ways in which the next generation of episode-based payments can better align with population health.

    Categories: Academic Writing

    Mar 20 '17

    Reassessing the Data on Whether a Physician Shortage Exists (JAMA Viewpoint)

    JAMA, May 2017

    This Viewpoint argues that there are sufficient numbers of primary care physicians in the United States and that any appearance of a shortage is attributable to factors such as unequal geographic distribution and management inefficiencies.

    Categories: Academic Writing

    Jul 24 '13

    Will Physicians Lead on Controlling Health Care Costs? (JAMA)

    Read this article  JAMA, July 2013

    Categories: Academic Writing

    May 28 '13

    The Transparency Imperative (Annals of Internal Medicine)

    Read this article Annals of Internal Medicine, 2013

    Categories: Academic Writing

    Apr 29 '13

    Toward Accountable Cancer Care

    Read this article JAMA Internal Medicine, 2013

    Categories: Academic Writing

    Apr 17 '13

    The Future of Biomedical Research


    Mar 25 '13

    What Does a Hip Replacement Cost?

    Read this article JAMA Internal Medicine, 2013

    Categories: Academic Writing

    Feb 11 '13

    What Does a Hip Replacement Cost? The Transparency Imperative in 2013 Comment on “Availability of Consumer Prices From US Hospitals for a Common Surgical Procedure”


    Jan 3 '13

    Shared Decision Making to Improve Care and Reduce Costs

    New England Journal of Medicine 2013

    Categories: Academic Writing

    Oct 16 '12

    Price and Utilization: Why We Must Target Both to Curb Health Care Cost

    Annals of Internal Medicine 2012

    Categories: Academic Writing