David Howard

Health economist interested in policies to better align medical practice with evidence. Emory University faculty since 2000. All opinions are entirely correct.

[David Howard @CostAnEffect]

Proceed with caution. Hospice can save money. This isn't like home health where extra services are additive. Hospice substitutes for other, potentially more expensive care.

[Grant Hesser @GrantHesser]

I spent two years studying the hospice industry - this isn't surprising to me at all.

It's an industry overrun with bad actors taking advantage of seniors and their families in their most vulnerable moments. Ironically though, it's also full of some of the best and most caring nurses you'll ever meet.

An industry badly in need of innovation.

[Anthony LoSasso @EconTony]

I have a new piece in @rc_markets that reflects on the broader implications of recent @US_FDA controversies for innovation. My argument is not that the agency should lower standards, but that clarity, consistency, and institutional stability matter enormously in a sector built around long timelines and high uncertainty. https://t.co/WTXKPHc4lc

[David Howard @CostAnEffect]

@InvisibleGoril1 @cblatts Yes. This is the future.

[David Howard @CostAnEffect]

@johnarnold True, but these trials have had an impact: https://t.co/ZMA89qlY5z

[David Howard @CostAnEffect]

@ashishkjha The elimination of the inpatient-only list (being phased in out starting in 2026) is a little-noticed but consequential cost-saving change.

[David Howard @CostAnEffect]

Well put.

[Ashish K. Jha @ashishkjha]

When I worked in government, I learned a pretty simple lesson:

There aren't many villains in healthcare

Pharma, insurers, hospitals all respond to incentives

Want different outcomes? Change the incentives

its easier to find villains

But changing incentives actually works

[David Howard @CostAnEffect]

@ClaesBackman Thank you. I look forward to putting this to use.

[David Howard @CostAnEffect]

Atlanta Development Authority (@InvestAtlanta) issued $370M in bonds to finance a proton beam center on prime midtown Atlanta real estate. It is now bankrupt. They probably don't have much health expertise & should have sat this one out
@emoryhealthcare to buy for $100M.

[David Howard @CostAnEffect]

@MercuriusFilius Shoot the first one who tries to escape?

[David Howard @CostAnEffect]

@ashdgandhi Same, where I'll be watching the group stage from the corners of @MBStadium

[David Howard @CostAnEffect]

Something about this seems off: "The number of urban hospitals that also classify as rural facilities has increased dramatically since 2017.."
@modrnhealthcr

[David Howard @CostAnEffect]

@ashdgandhi Not to mention that there is little risk or variation in earnings over time. Neurosurgeons don't get laid off.

[David Howard @CostAnEffect]

@jbcarmody But are you assuming that medical students' preferences for specialties are well-formed and immutable? I bet most of the rejected medical school applicants would be happy to accept a slot if told that they could only go into primary care or another less popular field.

[David Howard @CostAnEffect]

We absolutely need to embrace cost-saving technology in health care. Hopefully the nurses strike at Kaiser Permanente over the use of AI for mental health care will not discourage more adoption.

[David Howard @CostAnEffect]

@anup_malani Fragmentation also makes it more difficult for rulers to appropriate the gains from innovation (David Landes).

[David Howard @CostAnEffect]

Great report by @CBSNews
CBS News Investigation: Hundreds of LA hospices have multiple indicators of fraud | @CBSNews https://t.co/Sq8meA7LpU

[David Howard @CostAnEffect]

@richiebratton @rickdicksonreal ha. Went there last summer. Rented clubs.

[Victor Kumar @victorckumar]

First we had one child and I thought I knew what children are like. Our second child was completely different; I’d overgeneralized. There are actually two types of children.

[David Howard @CostAnEffect]

@AssumeNormality And removing a convenient phrase from the language that does not have a close substitute.

[David Howard @CostAnEffect]

@Allie_Elisabeth So sorry to hear that.