The AEG/WP plan still isn’t likely to work. A $95 PMPM fee, increasing at the same rate as other medical expenses, and coupled to a 12.6% reduction down stream would evaporate all of AEG/WP’s claimed billion savings. “Healthcare Innovations in Georgia:Two Recommendations”, the report prepared by the Anderson Economic Group and Wilson Partners (AEG/WP) forContinue reading “Attn: AEG/WP. Milliman study implies 12.6% downstream care cost reductions for DPC.”
Tag Archives: AEG/WP
The Nextera/DigitalGlobe study design made any conclusion on the downstream effect of subscription primary care impossible.
The study indiscriminately mixed subscription patients with pay-per-visit patients. Selection bias was self-evident; the study period was brief; and the study cohort tiny. Still, the study suggests that choosing Nextera and its doctors was associated with lower costs; but the study’s core defect prevents the drawing of any conclusions about subscription primary care. ADDENDUM ofContinue reading “The Nextera/DigitalGlobe study design made any conclusion on the downstream effect of subscription primary care impossible.”
A single-post critique of AEG/WP’s recommendation on direct primary care.
In “Healthcare Innovations in Georgia:Two Recommendations”, the report prepared by the Anderson Economic Group and Wilson Partners (AEG/WP) for the Georgia Public Policy Foundation, the authors clearly explained their computations and made clear the assumptions underlying their report. The report’s authors put a great deal or energy into demonstrating that billion dollar savings could beContinue reading “A single-post critique of AEG/WP’s recommendation on direct primary care.”
A few brags from a few DPC companies is not a sound basis for public policy decisions.
Leave aside the specific critiques of the last twenty or so posts. The support for direct primary care in the report Healthcare Innovations in Georgia: Two Recommendations ultimately turns on the source material from which the report authors drew the key assumption that direct primary care reduces downstream care cost by 15%. That material comprisesContinue reading “A few brags from a few DPC companies is not a sound basis for public policy decisions.”
Total claims cost caution: when DPC is implemented primary care claims vanish. AEG/WP’s 15% estimate is not conservative in the least.
When the direct primary advocates toss out figures about overall claims cost reductions, it’s important to carefully separate overall cost, downstream care claims costs, and overall claims costs. For example, the authors of the AEG/WP pitch for DPC in Georgia, have assumed a 15% reduction in downstream care costs and claimed that it “represents theContinue reading “Total claims cost caution: when DPC is implemented primary care claims vanish. AEG/WP’s 15% estimate is not conservative in the least.”
To learn how much direct primary care can do, try it first in the ACA-compliant, full-benefit individual market.
If Georgia must mandate the availability of direct primary care, here’s how. For some future open enrollment period, the individual market will offer paired plans that differ only by how primary care is paid for and how it is received. Bigco, for example, offers Bigco Silver FFS and Bigco Silver Direct ; MajorCo probably offersContinue reading “To learn how much direct primary care can do, try it first in the ACA-compliant, full-benefit individual market.”
Three bad ways to bet the health of Georgia citizens on direct primary care.
Every published claim that direct primary care makes a significant dent in necessary health care spending is dubious at best. See, for example, here, here, here, here, here, here, here, here, here, here and here. When the data from the Union County clinic — a Georgia Public Policy Foundation favorite — is age-adjusted, it indicatesContinue reading “Three bad ways to bet the health of Georgia citizens on direct primary care.”
AEG/WP’s chosen actuary did not validate the assumption that direct primary care reduces downstream care costs.
AEG/WP report declares that “[Nyhart, an independent] actuary determined that “(1) the modeling assumptions are reasonable for this type of analysis and (2) the illustrative projections and savings are reasonable outcomes based on the modeling assumptions and data inputs selected.” This statement sounds like powerful support for report’s key assumption that direct primary care bringsContinue reading “AEG/WP’s chosen actuary did not validate the assumption that direct primary care reduces downstream care costs.”
Nextera’s marketing presentation establishes huge selection bias, while revealing modest evidence that Nextera cuts cost for some of its patients. But the data set is tiny, old, and contaminated by results for fee for service patients!
UPDATE 5/31/2019. This needs a correction, but I want to leave it intact below for the record. I have in the title above and the text below that the Nextera data is contaminated by FFS patient data. This is not correct. To preserve HSA tax advantages, many of the Nextera patients did not want toContinue reading “Nextera’s marketing presentation establishes huge selection bias, while revealing modest evidence that Nextera cuts cost for some of its patients. But the data set is tiny, old, and contaminated by results for fee for service patients!”
The two largest and most current AEG/WP examples of downstream cost reduction failed to adequately address selection bias.
“Healthcare Innovations in Georgia:Two Recommendations”, the report prepared by the Anderson Economic Group and Wilson Partners (AEG/WP) for the Georgia Public Policy Foundation, makes some valuable contributions to deliberations about direct primary care. The AEG/WP team clearly explained their computations and made clear the assumptions underlying their report. This facilitates the public discussion that theContinue reading “The two largest and most current AEG/WP examples of downstream cost reduction failed to adequately address selection bias.”