Ashish Jha, MD, MPH

Ashish Jha is an associate professor of health policy and management, Harvard School of Public Health, Boston, MA. He blogs at An Ounce of Evidence and can be found on Twitter @ashishkjha.

Addressing racial disparities in health care

Ashish Jha, MD, MPH

Policy

July 1, 2013

Racial disparities in health and healthcare are a persistent and troubling problem for the U.S. Despite substantial policy efforts to the contrary, racial and ethnic minorities, especially African-Americans, often receive a lower quality of care and have worse outcomes. The key questions, of course, are why do these disparities exist, and what might we do about them?

Over the past decade, two primary theories have emerged to explain disparities and propose …

A far more interesting lesson from the Oregon experiment

Ashish Jha, MD, MPH

Policy

June 21, 2013

It has been a couple of weeks since the landmark Oregon experiment paper came out, and the buzz around it has subsided. So what now? First, with passage of time, I think it is worth reflecting on what worked in Oregon. Second, we should take a step back, and recognize that what Oregon really exposed is that health insurance is a small part of a much bigger story about …

Why the Oregon Medicaid study is misunderstood

Ashish Jha, MD, MPH

Policy

May 19, 2013

Much has already been written about the Oregon Medicaid study that came out in the New England Journal of Medicine. Unfortunately, the vast majority is reflex, rather than reflection. The study seems to serve as a Rorschach test of sorts, confirming people’s biases about whether Medicaid is “good” or “bad”. The proponents of Medicaid point to all the ways in which Medicaid seems to help those who were enrolled …

Access to care isn’t enough: It’s about access to high quality care

Ashish Jha, MD, MPH

Policy

April 26, 2013

Ensuring that Americans who live in rural areas have access to healthcare has always been a policy priority. In healthcare, where nearly every policy decision seems contentious and partisan, there has been widespread, bipartisan support for helping providers who work in rural areas. The hallmark of the policy effort has been the Critical Access Hospital (CAH) program– and new evidence from our latest paper in the Journal of the …

Our healthcare system is far more resilient than we think

Ashish Jha, MD, MPH

Policy

April 19, 2013

In 2006, Governor Mitt Romney signed Chapter 58 of the Acts of 2006 entitled “An Act Providing Access to Affordable, Quality, Accountable Health Care.” It has been described by many names, including Massachusetts Healthcare Reform (MHR), Romneycare, or simply, as the template for the Affordable Care Act. The goal of the act was straightforward: to ensure near-universal access to health insurance for citizens of the Commonwealth of Massachusetts. …

One way to think correctly about P4P programs

Ashish Jha, MD, MPH

Policy

March 4, 2013

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Over the past decade, there has been yet another debate about whether pay-for-performance, the notion that the amount you get paid is tied to some measure of how you perform, “works” or not. It’s a silly debate, with proponents pointing to the logic that “you get what you pay for” and critics arguing that the evidence is not very encouraging. Both sides …

Trust but verify: Medicare’s approach to detecting EMR fraud

Ashish Jha, MD, MPH

Policy

January 14, 2013

A recent New York Times headline read that “Medicare Is Faulted on Shift to Electronic Records.” The story describes an Office of Inspector General (OIG) report, released November 29, 2012, that faults the Centers for Medicare and Medicaid Services (CMS) for not providing adequate oversight of the Meaningful Use incentive program. Going after “waste, fraud, and abuse” always makes good headlines, but in this case, the story is not …

Reducing medical errors should take priority over readmissions

Ashish Jha, MD, MPH

Policy

December 19, 2012

I’ve been getting emails about the New York Times piece and my quotation that the penalties for readmissions are “crazy.” It’s worth thinking about why the ACA gets hospital penalties on readmissions wrong, what we might do to fix it—and where our priorities should be.

A year ago, on a Saturday morning, I saw Mr. “Johnson,” who was in the hospital with a pneumonia. He was still breathing hard …

A high volume, efficiency-driven institution that delivers great care

Ashish Jha, MD, MPH

Physician

November 13, 2012

I visited Safdarjung Hospital in New Delhi recently – an institution with 1,531 beds and 145% occupancy rate. Yes, 145%. You do the math. A lot of bed sharing and asking families to bring in cots. It’s right across the street from the All India Institute of Medical Sciences (AIIMS), the premier public healthcare institution in India. While both AIIMS and Safdarjung are run by the federal government, …

Stop setting hospital benchmarks at the state average

Ashish Jha, MD, MPH

Policy

October 12, 2012

Recently, I discovered the statewide report on quality of stroke care in Massachusetts. It’s a plain document, mostly in black and white, much of what you might expect from a state government report. Yet, this 4-page document is a reminder of how we have come to accept mediocrity as the standard in our healthcare delivery system.

The report is about 1,082 men and women in Massachusetts unfortunate enough to have a stroke …

Which hospital should I choose? How to use hospital rankings

Ashish Jha, MD, MPH

Physician

September 8, 2012

After years of breaking down, my sedan recently died. Finding myself in the market for a new car, I did what most Americans would do – went to the web. Reading reviews and checking rankings, it quickly became clear that each website emphasized something different: Some valued fuel-efficiency and reliability, while others made safety the primary concern. Others clearly put a premium on style and performance. It was enough to …

Ashish Jha, MD, MPH

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