Archive for the ‘Health Affairs’ Category

International Survey Of Older Adults Finds Shortcomings In Access, Coordination, And Patient-Centered Care

November 20, 2014 Comments off

International Survey Of Older Adults Finds Shortcomings In Access, Coordination, And Patient-Centered Care
Source: Health Affairs

Industrialized nations face the common challenge of caring for aging populations, with rising rates of chronic disease and disability. Our 2014 computer-assisted telephone survey of the health and care experiences among 15,617 adults age sixty-five or older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States has found that US older adults were sicker than their counterparts abroad. Out-of-pocket expenses posed greater problems in the United States than elsewhere. Accessing primary care and avoiding the emergency department tended to be more difficult in the United States, Canada, and Sweden than in other surveyed countries. One-fifth or more of older adults reported receiving uncoordinated care in all countries except France. US respondents were among the most likely to have discussed health-promoting behaviors with a clinician, to have a chronic care plan tailored to their daily life, and to have engaged in end-of-life care planning. Finally, in half of the countries, one-fifth or more of chronically ill adults were caregivers themselves.

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ACA — The Family Glitch

November 14, 2014 Comments off

The Family Glitch
Source: Health Affairs

The Affordable Care Act’s (ACA’s) “family glitch” bears no relationship to the early technology deficiencies that dominated the news and plagued the rollout of and the state-based Marketplaces. Instead, it refers to how some low-to-moderate-income families may be locked out of receiving financial assistance to purchase health coverage through the new health insurance Marketplaces.

Eligibility is not solely determined by income. It is also subject to whether a family has access to affordable employer-sponsored insurance. The problem is that the definition of “affordable”–for both an individual employee and a family–is based only on the cost of individual-only coverage and does not take into consideration the often significantly higher cost of a family plan.

This shortcoming is a trouble spot in how the ACA is being implemented. As its name clearly conveys, the law was intended to make coverage more affordable, and for millions of Americans, it has. Families caught up in this glitch, however, cannot qualify for premium tax credits to reduce the cost of a Marketplace plan or for cost-sharing reductions to lower their out-of-pocket payments for health services, even if the family cannot afford coverage otherwise.

While a large number of children in these families are eligible for coverage through Medicaid or the Children’s Health Insurance Program (CHIP), spouses and some children will remain uninsured without a path to affordable insurance if the family glitch is not fixed. However, many more children could be affected if Congress does not act to extend funding for CHIP after the current appropriation ends in September 2015.

National Health Expenditure Projections, 2013–23: Faster Growth Expected With Expanded Coverage And Improving Economy

September 4, 2014 Comments off

National Health Expenditure Projections, 2013–23: Faster Growth Expected With Expanded Coverage And Improving Economy
Source: Health Affairs

In 2013 health spending growth is expected to have remained slow, at 3.6 percent, as a result of the sluggish economic recovery, the effects of sequestration, and continued increases in private health insurance cost-sharing requirements. The combined effects of the Affordable Care Act’s coverage expansions, faster economic growth, and population aging are expected to fuel health spending growth this year and thereafter (5.6 percent in 2014 and 6.0 percent per year for 2015–23). However, the average rate of increase through 2023 is projected to be slower than the 7.2 percent average growth experienced during 1990–2008. Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013–23, the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023.

E-Cigarettes and Federal Regulation (Updated)

August 7, 2014 Comments off

E-Cigarettes and Federal Regulation (Updated)
Source: Health Affairs

Policy makers have begun developing rules for how popular alternatives to traditional cigarettes can be marketed and sold.

What’s the issue?
E-cigarettes, virtually nonexistent 10 years ago, have skyrocketed in popularity. Though often shaped like a traditional cigarette, they are fundamentally different in both design and ingredients and are widely believed by supporters and critics to be a safer alternative and a potentially valuable tool in weaning people off tobacco cigarettes. How much safer, however, and how well they function as a smoking cessation device are key questions subject to a fierce debate.

Translating Research For Health Policy: Researchers’ Perceptions And Use Of Social Media

June 13, 2014 Comments off

Translating Research For Health Policy: Researchers’ Perceptions And Use Of Social Media
Source: Health Affairs

As the United States moves forward with health reform, the communication gap between researchers and policy makers will need to be narrowed to promote policies informed by evidence. Social media represent an expanding channel for communication. Academic journals, public health agencies, and health care organizations are increasingly using social media to communicate health information. For example, the Centers for Disease Control and Prevention now regularly tweets to 290,000 followers. We conducted a survey of health policy researchers about using social media and two traditional channels (traditional media and direct outreach) to disseminate research findings to policy makers. Researchers rated the efficacy of the three dissemination methods similarly but rated social media lower than the other two in three domains: researchers’ confidence in their ability to use the method, peers’ respect for its use, and how it is perceived in academic promotion. Just 14 percent of our participants reported tweeting, and 21 percent reported blogging about their research or related health policy in the past year. Researchers described social media as being incompatible with research, of high risk professionally, of uncertain efficacy, and an unfamiliar technology that they did not know how to use. Researchers will need evidence-based strategies, training, and institutional resources to use social media to communicate evidence.

Understanding Differences Between High- And Low-Price Hospitals: Implications For Efforts To Rein In Costs

February 4, 2014 Comments off

Understanding Differences Between High- And Low-Price Hospitals: Implications For Efforts To Rein In Costs
Source: Health Affairs

Private insurers pay widely varying prices for inpatient care across hospitals. Previous research indicates that certain hospitals use market clout to obtain higher payment rates, but there have been few in-depth examinations of the relationship between hospital characteristics and pricing power. This study used private insurance claims data to identify hospitals receiving inpatient prices significantly higher or lower than the median in their market. High-price hospitals, compared to other hospitals, tend to be larger; be major teaching hospitals; belong to systems with large market shares; and provide specialized services, such as heart transplants and Level I trauma care. High-price hospitals also receive significant revenues from nonpatient sources, such as state Medicaid disproportionate-share hospital funds, and they enjoy healthy total financial margins. Quality indicators for high-price hospitals were mixed: High-price hospitals fared much better than low-price hospitals did in U.S. News & World Report rankings, which are largely based on reputation, while generally scoring worse on objective measures of quality, such as postsurgical mortality rates. Thus, insurers may face resistance if they attempt to steer patients away from high-price hospitals because these facilities have good reputations and offer specialized services that may be unique in their markets.

How Will Federal Medicaid Payments To States In 2015 Be Affected By New Personal Income Data?

October 10, 2013 Comments off

How Will Federal Medicaid Payments To States In 2015 Be Affected By New Personal Income Data?
Source: Health Affairs

The release of per capita state personal income data by the Bureau of Economic Analysis (BEA) on September 30, 2013, permits the calculation of Federal Medical Assistance Percentages (FMAPs) for federal fiscal year (FY) 2015. These income data are the first state-level data from BEA reflecting its recent comprehensive revisions (“benchmarking”)—adjusting concepts, statistical techniques and presentations—in the National Income and Product Accounts (NIPAs). Such revisions serve BEA’s mandate to track gross domestic product (GDP) and income (GDI). Though the income data revisions have little direct relevance for Medicaid and state government finance, they will drive changes in FMAPs and therefore Medicaid grants to states, both in FY 2015 and beyond.

Twenty-one states will see their FMAPs increase in FY 2015 and seventeen will see them decline. The biggest increases will be for Missouri (+1.42), Nevada (+1.26), Arizona (+1.23), and Colorado and Georgia (each +1.01). The biggest declines will be experienced by Iowa (-2.39), South Dakota (-1.90), Oklahoma (-1.72), Pennsylvania (-1.70) and Delaware (-1.68). These changes reflect the combined impacts of actual economic shifts, annual data adjustments and the comprehensive revisions.


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