David Howard
@CostAnEffect
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Health economist interested in policies to better align medical practice with evidence. Emory University faculty since 2000. All opinions are entirely correct.
Decatur, GA
Joined July 2016
Public health has drawn controversy since it began ~150 years ago, but the disputes have only grown more heated since Covid. Even though we unquestionably live longer and healthier lives than our ancestors, there’s so much discontent that we now have RFKJr.— 1/11
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Link: Drug pricing and pharmaceutical innovation: a false promise - The Lancet
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and large pharma is only willing to pay a premium acquire smaller companies with new drugs because they can charge high prices.
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Open faculty positions at @EmoryUniversity Department of Health Policy and Management. https://t.co/K58erlf9SJ
https://t.co/K58erlf9SJ
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faculty-emory.icims.com
Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contrib...
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Our PhD applications are open! If you are hard working, driven, and want to make a difference, apply! We at @EmoryEconomics are highly invested in our students and our package is competitive! Plus, we are growing stronger every day! Apply!
🎓 Exciting News for current and future @EmoryEconomics Scholars! We’re happy to announce an increase in the stipend for current and incoming @laneygradschool PhD students! $42K per year for 5 years + tuition waiver, 100% health insurance premium, and more💰Learn more and apply⬇️
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Now in print! Led by @GoldsteinYoav, we found how a single challenging encounter can shift PCP testing decisions in subsequent, unrelated cases, an instance of intra-person variation in judgment. 1/
My master's thesis is now published in @REStatJournal 🥳 With @ityshurtz and @danzeltzer , we show how challenging medical encounters trigger short-term changes in docs' decisions: For ~1 hour after seeing a newly diagnosed cancer patient, PCPs order more tests in unrelated cases
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Extremely interesting post on barriers facing firms that have AI tools to read radiology images. BTW I have heard that AI image readers don't store the AI reading or follow-up recommendation because of liability concerns.
New post - What happened to all of those AI radiology startups? Why hasn't AI automated radiology We go through seven big problems that the first wave of AI radiology companies ran into
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▶️ New study: Conflicts of interest on CDC vaccine panel were at historic lows prior to RFK Jr dismissal In our @JAMA_current study , we looked at disclosed conflicts of interest (COIs) in ACIP and VRBPAC (FDA vaccines committee) between 2000 and 2024. We found that: ▪️although
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There are some good things happening behind the scenes, especially w.r.t. site neutral payment.
I’m not sure whether Trump’s executive orders to lower drug prices will work, but I salute the effort. Meanwhile, out of the spotlight, the federal health agencies are making real progress to cut costs and improve the healthcare system. A thread of specific actions underway: 1/10
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Interesting in light of other changes at DHHS that Medicare will expand coverage of PrEP and Hepatitis B vaccine.
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Has anyone made the case that the benefits of MIPs outweigh the costs? Most of the quality measures seem unrelated to actual quality and outcomes.
27/ “Worse, 13% of small practices and 29% of solo practitioners are receiving the maximum MIPS penalty of -9%.” “MIPS has yet to demonstrate better health outcomes for Americans or lower avoidable spending…steep compliance costs on physicians.” https://t.co/RMQ2UNHLsm
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Great to see @CMSGov testing prior authorization. I know MDs hate it, but we need to pursue every opportunity to improve value in Medicare.
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This is actually a good health policy/economics exam question: Is the case for single payer stronger or weaker if there is a lot of competition in the health insurance market? I suspect that due to problems w/ cherry picking, it is stronger.
When he used the "public option, but for produce" line, I came to realize just how horrifically unserious this is. The theory behind a public option for health insurance is because pricing in health insurance often isn't truly competitive. That's not true with groceries.
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This Niskanen agenda includes some good policies, but it’s very much incomplete (don’t think @lawsonhmansell would dispute that?), & at times falls into the deregulatory trap—eg making it easier for private equity to own medical providers by relaxing CON.
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Article: United Health Inks $9.3M Deal In Cancer Treatment Denial Suit - Law360
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United Healthcare @UHC has settled a class action suit over non-coverage of proton beam radiotherapy for prostate and other cancers. Lawsuits and regulations are chipping away at insurers' ability to hold down costs by denying investigative and unnecessary care.
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And, it looks like CMMI will continue to push alternative payment models and require more downside risk, which was not a given at the outset of the new administration.
Some very interesting ideas included in CMMI's outlook for the next few years. One that caught my eye: possible demonstrations in Medicare Advantage related to risk scores, benchmarks, and quality measurement. Could be very impactful.
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Some good advice here. I've tried to give writing assignments that are more difficult to do using AI, but its getting harder.
OK, I'm not an educator, but for fun I'm going to compile a few ideas for trying to defeat AI cheating on assignments, inspired partly by my life as a professional word typer and talker. Curious for thoughts from actual teachers and professors. Less obvious stuff first.
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Some thoughts from the discussion of scholarship vs activism in academia: Considering normative questions does not make one an activist. For example, being a philosopher who studies ethics does not make one an activist.
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Medicare spends over $1T per year, so even small cuts to wasteful spending represent huge savings. @maggieshi311 and I have a new @nberpubs on a policy targeting *just medically unnecessary physical therapy* and it would have easily have made the @DOGE leaderboard. Quick🧵
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