DiD – DPC Referee

That the Union County DPC experiment was a flop is clear from a careful reading of its two actuarial studies, including the one claimed to vindicate DPC.

This post in a three minute nutshell Union County created a direct primary care option for its health insured employees. There were two particularly salient features: the monthly DPC fees were extravagant; and the county sweetened the DPC option with cost-sharing reductions (CSR) for downstream care. Despite CSR, the DPC clinic was able to reduceContinue reading “That the Union County DPC experiment was a flop is clear from a careful reading of its two actuarial studies, including the one claimed to vindicate DPC.”

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.”

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 indicated that the Nextera data is contaminated by FFS patient data. This is a bit ambiguous. To preserve HSA tax advantages, many of the Nextera patients did notContinue 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!”