KPI Ninja’s Nextera analysis: more than enough problems.

Three major adjustments are needed, even without correcting the IP admit rate problem or arriving at a more reasonable risk adjustment. Comparing data from Nextera patients and non-Nextera patients in the SVVSD programs requires three major adjustments which KPI Ninja never attempted. Computations here. Because of the different benefit structures, the district’s claim costs forContinue reading “KPI Ninja’s Nextera analysis: more than enough problems.”

FFS primary care is higher quality than DPC. “Proved.”

One pet theme of most D-PCPs is, “Who can better determine quality better than my patient?”, a question invariably coupled to its speaker’s brag about a high patient retention rate. And yet, in the Union County employee DPC clinic study, the actuaries observed a huge risk selection bias against the DPC, enough to require aContinue reading “FFS primary care is higher quality than DPC. “Proved.””

DPC’s narratives can be just as misleading as their quantitative studies.

Advocates for the DPC movement have many stories to tell the public about how great DPC is. Some of their most potent narratives, however, are as misleading as their slew of quantitative studies. One root cause is that DPC advocates seem unable to imagine anyone else being as clever as they are. The ur-brag ofContinue reading “DPC’s narratives can be just as misleading as their quantitative studies.”

KPI Ninja’s Nextera study: a “single blunder” introduction

The KPI Ninja report on Nextera’s school district program claims big savings when employees chose Nextera’s direct primary care rather than traditional primary care. But the analysis reflects inadequacy of a high order. Here’s a starter course of cluelessness, actually one the report’s smaller problems. The report ignored the effect of an HRA made availableContinue reading “KPI Ninja’s Nextera study: a “single blunder” introduction”

Nextera did not reduce inpatient hospital admissions by 92.7%.

Abstract: KPI Ninja’s report on Nextera’s direct primary care plan for employees of a Colorado school district clinic claims profoundly good results: nearly $1000 per year in savings for every Nextera clinic member and a staggering 93.7% reduction in inpatient hospital admissions. Both claims rest on the proposition that a population of middle-aged. middle-class, white-color,Continue reading “Nextera did not reduce inpatient hospital admissions by 92.7%.”

Nextera’s Next Era in Cherry-Picking Machine Design

Note: revised and redated for proximity to related material. Original version June 27, 2020. In June of 2020, Nextera HealthCare had a hot new brag: These results were not risk adjusted. But they desperately needed to be. The St Vrain Valley School District had this health benefit structure for its employees during the period studied:Continue reading “Nextera’s Next Era in Cherry-Picking Machine Design”

HSA breaks for DPC defeat the purpose of HSA breaks

HSAs are intended to encourage more cost-conscious spending by placing more of the health care financing burden on out-of-pocket spending by the users of services, as opposed to having the costs of those services incorporated in payments shared over a wider group of plan enrollees regardless of service use. H/T Blumberg and Cope. HSAs areContinue reading “HSA breaks for DPC defeat the purpose of HSA breaks”

DPC from 30,000 feet, on September 2020

Even with all the overhead reductions that come from not taking third party payment and/or from not billing on a fee for service basis Even with those reductions transformed to increased primary care access that results in clear reductions on ED visits and other urgent care needs Still, Direct Primary Care with panels of 600Continue reading “DPC from 30,000 feet, on September 2020”

Helping those patients most dependent on DPC means defeating the DPC/HDHP/HSA “fix”.

Plus, two more reasons to reject the “fix”. Direct Primary care clinicians and advocates often point out, accurately, that they serve a broad socio-economic range of patients. The range is well illustrated by a pair of oft-appearing themes, “concierge care for the middle class” and “affordable care for those who fall between the cracks”. InContinue reading “Helping those patients most dependent on DPC means defeating the DPC/HDHP/HSA “fix”.”

DPC is way different than you paying Neflix. Notes

The State of New York has the financial capital of the country (arguably the world), has the most insurance companies in the country, and was the biggest state for the longest time. For these reasons it is generally looked to for leadership in the law on financial subjects primarily governed by state law. Here’s theirContinue reading “DPC is way different than you paying Neflix. Notes”