About healthcare quality
2018 Quality Payment Program (QPP) Performance Results: This statement is from CMS. In summary, 84 percent of eligible clinicians will receive an additional adjustment for exceptional performance, 13 percent will receive a positive payment adjustment and 2 percent will receive a negative payment adjustment.
Association of Powder Use in the Genital Area With Risk of Ovarian Cancer: “Among women from 4 prospective cohorts, there was not a statistically significant association between use of powder in the genital area and ovarian cancer, but the study may have been underpowered to identify a small increase in risk.” It is not certain what impact this study will have on the pending lawsuits against Johnson & Johnson.
Roughly 10% of U.S. children get unneeded medical care: “…11 percent of publicly insured children and 9 percent of privately insured children received "low-value" care, or care that offered little benefit to their health, at least once. In addition, 4 percent and 3 percent of each group received similar low-value care at least twice during the same period.” Studies show that evidence-based medicine that suggests underutilization results in physicians doing more; however studies like this one that show unnecessary care do not get as much traction. Think it has to do with reimbursements?
Spending And Quality After Three Years Of Medicare’s Voluntary Bundled Payment For Joint Replacement Surgery: We found that over three years, compared to no participation, participation in BPCI [Bundled Payments for Care Improvement] associated with a 1.6 percent differential decrease in average LEJR [lower extremity joint replacement] spending with no differential changes in quality, driven by early participants. Patient selection accounted for 27 percent of episode savings.”
The Impact Of Bundled Payment On Health Care Spending, Utilization, And Quality: A Systematic Review: Do not generalize from the above research. These researchers “performed a systematic review of the impact of three CMS bundled payment programs on spending, utilization, and quality outcomes. The three programs were the Acute Care Episode Demonstration, the voluntary Bundled Payments for Care Improvement initiative, and the mandatory Comprehensive Care for Joint Replacement model. Twenty studies that we identified through search and screening processes showed that bundled payment maintains or improves quality while lowering costs for lower extremity joint replacement, but not for other conditions or procedures [emphasis added].”
Seniors Still Wary of Online Reviews When Picking Doctors: “ Most older Americans don't fully rely on or trust online ratings of doctors, a new study finds.
Among men and women between the ages of 50 and 80, only 43% have looked online to see how patients rated a doctor…”
About health insurance
CMS wants to use more encounter data for Medicare Advantage payments: “The CMS on Monday proposed changes to Medicare Advantage payments for 2021, including an increase in the percentage of patient ‘encounter data’ used to calculate payments.” Insurers say the data is inaccurate and incomplete, but they are the ones using that data to submit higher intensity payment requests to CMS.
Supreme Court sets Friday deadline for responses in ObamaCare case: ”The Supreme Court on Monday told the Trump administration and a group of [red] states to respond by the end of the week to an effort by Democrats to expedite a challenge to a lower court ruling that struck down a key tenet of ObamaCare.”
Combining medical, pharmacy and behavioral benefits delivers annual savings of more than $850 per customer with an identified health improvement opportunity: Benefits are often fragmented because of expertise in individual functional areas. But this study shows their integration for patients with chronic conditions can save money.
New Fast PATH Initiative Aims to Improve Prior Authorization for Patients and Doctors:”America’s Health Insurance Plans (AHIP), along with several of our member insurance providers, is launching the Fast Prior Authorization Technology Highway (Fast PATH) initiative to improve the prior authorization process…This new initiative will rely upon the proven automated technologies of both Availity and Surescripts to speed prior authorization requests, responses, and information exchange.”
Individual Insurance Market Performance in Late 2019: The main fear this year was that elimination of the penalty for not having insurance would cause healthy people to drop coverage and result in increased insurance premiums. This study found that: “Going into 2019, insurers reported that the reduction of the penalty to $0 drove premiums up by about 5 percentage points. Nonetheless, premiums were largely steady in 2019, on average, in part because insurers had priced too high in 2018. Despite concerns about the continuing impact of the loss of the mandate penalty, the individual market has remained fairly stable through 2019. Enrollment among those not eligible for subsidies declined by 10% in early 2019, but individual market enrollment overall appears to be stabilizing, with total market enrollment falling by just 5%.”
About the public’s health
The downstream air pollution impacts of the transition from coal to natural gas in the United States: Does reducing coal emissions really help improve health? Yes! And crop production as well.
“Between 2005 and 2016 in the continental United States, decommissioning of a coal-fired unit was associated with reduced nearby pollution concentrations and subsequent reductions in mortality and increases in crop yield. In total during this period, the shutdown of coal-fired units saved an estimated 26,610 (5%–95% confidence intervals (CI), 2,725–49,680) lives and 570 million (249–878 million) bushels of corn, soybeans and wheat in their immediate vicinities; these estimates increase when pollution transport-related spillovers are included.”
About healthcare professionals
Nurses Continue to Rate Highest in Honesty, Ethics: “For the 18th year in a row, Americans rate the honesty and ethics of nurses highest among a list of professions that Gallup asks U.S. adults to assess annually. Currently, 85% of Americans say nurses' honesty and ethical standards are ‘very high’ or ‘high’…” Engineers are in second with 66% and physicians are third with 65%.
Best Paying Jobs: The U.S. News report says that the top 11 highest paying jobs are in healthcare professions. #1 is anesthesiology.