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Years ago, many health insurance companies were excited at the prospect of pay-for-performance programs. The premise was that providers often did not act in the best interests of their patients because they weren't paid to and were too busy doing lower-value work. By paying doctors for performance (quality), then doctors would have an incentive to focus on the high-value work, which often centered around prevention. The idea was that everyone would then experience a win: providers would be paid more for doing quality work, patients would have better health outcomes, and insurance companies would overall pay less because emergency operations would be averted. That was the theory.

Years ago, many health insurance companies were excited at the prospect of pay-for-performance programs. The premise was that providers often did not act in the best interests of their patients because they weren't paid to and were too busy doing lower-value work. By paying doctors for performance (quality), then doctors would have an incentive to focus on the high-value work, which often centered around prevention. The idea was that everyone would then experience a win: providers would be paid more for doing quality work, patients would have better health outcomes, and insurance companies would overall pay less because emergency operations would be averted. That was the theory.

STAT published an opinion piece that compiled a number of studies showing that the confidence in these programs might be misplaced. It appears that objectors were right about at least one unfortunate side effect: some providers appear to have denied care to individuals because those individuals were sick enough that providers thought they would effectively be penalized for treating them. Some of the objections appear addressable by a different risk-adjustment algorithm; one can imagine, for example, a risk-adjustment algorithm under which some providers would actually seek out the sickest and poorest patients. Risk-adjustment has been frequently debated, and coming to a consensus would not be easy. Some of the other objections also seem difficult to address, such as causing some providers to game the system by incorrectly characterizing infections. Although the list of studies were presented as negatives against pay-for-performance, a number of them appear to qualify their conclusions, citing methodological limitations or mixed results. The overall effect of pay-for-performance programs is undoubtedly a difficult one to fully understand.

High healthcare costs in the United States are a large burden on American consumers, but they also allow for innovations in medicine that offer worldwide benefits. As this New York Times piece notes, the United States is a leader in the healthcare industry, with the most clinical trials, the most patents, and the most Nobel laureates in physiology or medicine compared to other countries. We also have a large healthcare market that companies can tap into, directing profits to research and development that could potentially produce the next life-saving drug or other such technologies.

High healthcare costs in the United States are a large burden on American consumers, but they also allow for innovations in medicine that offer worldwide benefits. As this New York Times piece notes, the United States is a leader in the healthcare industry, with the most clinical trials, the most patents, and the most Nobel laureates in physiology or medicine compared to other countries. We also have a large healthcare market that companies can tap into, directing profits to research and development that could potentially produce the next life-saving drug or other such technologies.

Do these innovations justify higher prices in health care? As the New York Times piece states, in the past, healthcare innovation has led to increased life expectancy for premature newborns and patients with cardiovascular disease, and a bigger potential market for a type of drug leads to the development of more new drugs of that type. However, work by health economists such as Craig Garthwaite suggests that drug makers can charge prices that exceed the value of drug innovations. In such cases, the cost burden on American consumers only increases, perhaps unjustifiably.

Some might consider redesigning the healthcare system a solution to the issue of rising healthcare costs, with many being excited about the prospect of a single-payer system. While alternative systems may contain costs by regulating prices, they do so at the risk of limiting healthcare profits and therefore the amount of investments companies make in research and development. The authors of this New York Times piece propose a more thoughtful approach to spending, with a system that better measures health outcomes and incentivizes meaningful innovation. This strategy calls for more meaningful spending that leads to more tangible health benefits for consumers - benefits that would not only affect Americans, but patients worldwide.

For a while now, we have heard about how investing in preventative care essentially pays for itself. The theory is that preventative care is cheap relative to treating advanced conditions, and that preventative care done early enough can help prevent those advanced conditions from developing. Hence, if society made preventative care more readily available, then the theory is that society would spend less on health care in the long-run. An example of how this theory affected public policy is how the Affordable Care Act mandated that qualified insurance plans include free annual wellness exams.

For a while now, we have heard about how investing in preventative care essentially pays for itself. The theory is that preventative care is cheap relative to treating advanced conditions, and that preventative care done early enough can help prevent those advanced conditions from developing. Hence, if society made preventative care more readily available, then the theory is that society would spend less on health care in the long-run. An example of how this theory affected public policy is how the Affordable Care Act mandated that qualified insurance plans include free annual wellness exams.

Unfortunately for the theory, The New York Times published a piece summarizing various studies showing that preventative care does not actually save money (except for childhood immunizations and the counseling of adults regarding the use of aspirin). That's not to say that society should not invest in preventative care, but rather that there might not be the easy choice of investing in better health and reaping financial savings to more than offset the original investment. If society wants its members to have better health, it might just need to pay for it.

The United States is notorious for its ballooning healthcare costs. A recent New York Times article considered the cause of the price discrepancy between the United States and its peers when it comes to healthcare spending. According to the article, several decades ago, the United States more closely matched its peer nations in healthcare spending. However, in 2016, spending totaled 17.9% of gross domestic product ($3.3 trillion) - nearly double that of other nations.

The United States is notorious for its ballooning healthcare costs. A recent New York Times article considered the cause of the price discrepancy between the United States and its peers when it comes to healthcare spending. According to the article, several decades ago, the United States more closely matched its peer nations in healthcare spending. However, in 2016, spending totaled 17.9% of gross domestic product ($3.3 trillion) - nearly double that of other nations.

So why are Americans spending twice as much of their economy on health care compared to other nations? Citing a JAMA study, the New York Times finds that the biggest cause of rising costs comes down to a combination of factors. Less than half of the growth in healthcare costs can be accounted for by population growth and aging, and by some measures, Americans have gotten healthier, spending less on health care. This decrease isn't offset by an increase in spending by the more sickly. Over sixty percent of the increase in spending is due to higher prices and higher intensity of services.

We're happy to help prospective patients find healthcare providers that meet their criteria. It turns out, however, that sometimes people want to use our service for more than personal use. For such usage, we ask people to pay for professional subscriptions to help support the site.

We're happy to help prospective patients find healthcare providers that meet their criteria. It turns out, however, that sometimes people want to use our service for more than personal use. For such usage, we ask people to pay for professional subscriptions to help support the site.

This past week, we rolled out self-service professional subscriptions so that people can sign up with a credit card. Again, we anticipate that this would only be relevant to people who use our site for reasons other than finding a healthcare provider for personal consultations. You can find out more here.