Public Policy

2011 Hospitalist Salaries and Food For Thought

We have additional 2011 hospitalist salary data out for consideration.  The title of the linked piece, "Has hospitalist pay finally peaked?," asks the right question.  Today's Hospitalist culled the data from 1000 hospitalists from various regions and venues. (more…)

OIG Update: Can Your Hospital Pay For ER Coverage?

The OIG finally weighed in this month on a practice our hospitals engage in, but because of anti-kickback statutes, left them uneasy about violating federal law.  At issue is first, hospital inability to fill ER call positions and second, specialist per diem payment to plug the void: (more…)

Pay for Performance in Healthcare: Do We Need Less, More, or Different?

The debate over pay for performance in healthcare gets progressively more interesting, and confusing. And, with Medicare’s recent launch of its value-based purchasing and readmission penalty programs, the debate is no longer theoretical. Just in the past several months, we’ve seen studies showing that pay for performance works, and others showing that it doesn’t. We’ve heard from some theorists who describe P4P as sapping intrinsic motivation and doing violence to professionalism, and others who feel that its effects are as natural and predictable as water running downhill. Some commentators beg us to stop it, while others denounce P4P’s current incarnations as too wimpy to work and recommend they be turbo-charged. If we weren’t talking about the central policy question of a field as important as healthcare, we could call this a draw and move on. But the stakes are too high, so it’s worth taking a moment to review what…

The Hospital Transitions Emperor Has No Clothes

When reading international comparisons of health system performance, a cautious eye never hurts. I do not believe elaboration is required, but each country approaches measurement a tad differently, and we unwittingly omit meaningful population characteristics using available variables when examining outcomes. The nuances embedded within cultures do not express themselves readily, even to keen eyed investigators. (more…)