About health insurance
Medicaid Expansion and Health Assessing the Evidence After 5 Years: This article is a nice summary of how Medicaid has affected the population in states where it expanded after ACA implementation. The “short” bottom line is: “An increasing number of studies have provided rigorous evidence that Medicaid expansion, which has increased the number of Medicaid recipients by more than 10 million since 2013, has been associated with improved health of low-income US residents in various ways, including self-reported health, acute and chronic disease outcomes, and mortality reductions. However, this literature is less definitive than the evidence demonstrating that Medicaid increases access to care and promotes financial well-being.”
Spending On Postacute Care After Hospitalization In Commercial Insurance And Medicare Around Age Sixty-Five [Health Affairs- abstract only available]:This study compared “postacute care spending between patients with commercial insurance and those with Medicare around age sixty-five. Spending was 68–230 percent greater among fee-for-service Medicare beneficiaries than among similar commercially insured people across varied medical and surgical conditions. Despite greater spending, there were no differences in readmission rates. These findings suggest that postacute care utilization is highly sensitive to payer influence, and there may be an opportunity for additional savings in Medicare without sacrificing quality.”
Annual Spending per Patient and Quality in Hospital-Owned Versus Physician-Owned Organizations: an Observational Study: The authors found that “financial integration between physicians and hospitals raises patient spending, but not care quality.” See yesterday’s blog for the AHA study on effects of hospital mergers.
Cigna rolls out new plan to fully cover multi-million dollar gene therapies: “Health insurer Cigna Corp said on Thursday it had introduced a plan to fully cover costs for expensive gene therapies, eliminating any out-of-pocket payments for customers.” The therapies are so expensive that any patient contributions would not have any impact on cost reduction. A good move to increase financial accessibility and quality of care.
Medicare Advantage has little impact on traditional Medicare spending (Modern Healthcare- subscription required): “…MedPAC's study found that fee-for-service spending was just 2% lower in markets with high Advantage penetration compared to those with the lowest numbers. High Advantage penetration averaged 52.2% compared to 13% in low markets.” Check yesterday’s full presentation since the study has not yet been published.
Quality of Home Health Agencies Serving Traditional Medicare [TM] vs Medicare Advantage [MA] Beneficiaries: “Compared with TM beneficiaries, MA beneficiaries residing in the same zip code enrolled in either high- or low-quality MA plans may receive treatment from lower-quality HHAs. Policy makers may consider incentivizing MA plans to include higher-quality HHAs in their networks and improving patient education regarding HHA quality.”
About the public’s health
Lung illness tied to vaping has killed five people, may be a new ‘worrisome’ disease, officials say: The death toll from vaping is now five. The vitamin E reported yesterday as the cause of deaths appears to have been from black market marijuana cartridges. The cause for all the illness has yet to be identified.
Mortality Patterns Between Five States With Highest Death Rates and Five States With Lowest Death Rates: United States, 2017: This just-published report from the CDC details the dramatic health disparities among states. Overall, the “average age-adjusted death rate for the five states with the highest rates (926.8 per 100,000 standard population) was 49% higher than the rate for the five states with the lowest rates (624.0).”
Stronger focus on nutrition within health services could save 3.7 million lives by 2025: This WHO report illuminates how important improving nutrition is as a life-saving measure.
Kentucky hospitals sue drugmakers, distributors and retailers for opioid epidemic costs: Yesterday’s blog reported Texas hospitals are suing opioid manufacturers over the epidemic’s cost. Now Kentucky hospitals are following suit (pun intended). Expect a cascade of further such hospital actions.
The Dartmouth Atlas of Neonatal Intensive Care: This extensive report on national (and some local) neonatal care is a rich source for policy study and was done in cooperation with insurer Anthem. One important conclusion that reflects on inappropriate intensity of care is that “more than half of NICU [neonatal intensive care units] admissions and close to half of special care days are now for lower-risk newborns.” More appropriate use of services would not only lower costs but hopefully also reallocate resources to those locations in true need of this specialized care. (See page 41 for a full summary of this section of the research).
70 Million Flu Vaccines Delayed This Year, According to CDC: “Sanofi Pasteur, the largest company that exclusively produces vaccines, delayed delivery of the flu vaccine by three to four weeks.
The delay affects Fluzone Quadrivalent, Fluzone High-Dose, and Flublok Quadrivalent. According to CDC data, these products make up approximately 40 percent of the U.S. flu vaccine market.”
Civil rights groups sue Trump administration over immigrant medical care cases: The headline speaks for itself.
About medical devices
Humanitarian Device Exemption (HDE) Program: The FDA just finalized its guidance “to provide clarity to industry and FDA staff about the current review practices for the Humanitarian Device Exemption (HDE) Program.”
About healthcare IT
Feds turn over CONNECT messaging platform to private sector: “The Federal Health Architecture and the Office of the National Coordinator for Health IT are ending support for an open source software project that promotes healthcare interoperability.
CONNECT enables secure electronic health data exchange among providers, insurers, government agencies and consumer services. However, it’s been 10 years since federal agencies first co-developed the messaging platform, and the government now wants to transition the project to the private sector.”
See Chapter 9 of the text for more background information.