Brad Flansbaum asks in the comments on yesterday’s post: “Can you give some examples? Lets say you extend a stay from 10 to 20 days. Utility gain, patient, provider, and family become grateful recipients of care, but how does the cost go down?” The key (as always) is the counterfactual (as compared to what?). This […] […]

Has been released today. Chapter 5 (pp. 117-42) focuses on hospice policy and lays out some information on the ‘shape’ of what a U shaped hospice payment revision might look like. Figure 5-1 shows average labor cost per day of hospice stay (roughly, the variable costs of being in the hospice business), for differing lengths […] […]

This is the fifth post in a series on North Carolina’s nascent Medicaid reform, Partnership for a Healthy North Carolina, a reform option being pursued even as North Carolina does not proceed with the Medicaid expansion available in the ACA. First post: Logic of the N.C. plan Second post: Who is covered by Medicaid? Third […] […]

This is a handy comparison of HB 998 v. Senate modifications to it, released yesterday (h/t Elizabeth Malm via twitter). Several points following up on yesterday’s post: The Senate version reduces General Fund tax receipts by $684 Million from FY 2013-15; about a $300 Million larger tax cut than the House over this time period. […] […]

The North Carolina Senate today unveiled a revised tax reform strategy that moved away from a large shift toward sales taxes (bill summary, bill, fiscal note). I need to read through this, especially the fiscal note more carefully, but the big points are moving to repeal the corporate income tax by 2018 , and having […] […]

Austin Frakt has a post on a paper noting that re-admission rates are not strongly correlated with mortality or process measures of quality of care. At least some hospital re-admissions are related to problems with the long term care system available to patients; this reality should be added to the readmission mix, especially the discussion […] […]

This is the fourth post in a series on North Carolina’s nascent Medicaid reform, Partnership for a Healthy North Carolina, a reform option being pursued even as North Carolina does not proceed with the Medicaid expansion available in the ACA. First post: Logic of the N.C. plan Second post: Who is covered by Medicaid? Third […] […]

Five months into the North Carolina Republican Party’s total control of State Government for the first time since the 19th Century (Governor’s mansion, State House and Senate), several things are clear. First, Republicans have had gotten a lot of what they wanted quickly: voter ID, a soon-to-be repealed racial justice act, and a substantial reduction […] […]

This is the third post in a series on North Carolina’s nascent Medicaid reform, Partnership for a Healthy North Carolina, a reform option being pursued even as North Carolina does not proceed with the Medicaid expansion available in the ACA. First post: Logic of the N.C. plan Second post: Who is covered by Medicaid? I […] […]

Some quick thoughts on the “Hospice Evaluation and Legitimate Payment Act of 2013″ the so-called HELP hospice Act (h/t for the text to @HospiceAction). It is co-sponsored by a Democratic Senator (Ron Wyden of Oregon), and a Republican (Pat Roberts of Kansas). Until the unhinged and fact free death panel rants of August 2009 and […] […]