Moving into the first home you own is filled with meaning and emotion. There is that sense of promise, and a passion to make everything just the way you want it. There is some fear—so much can go wrong with a house. The overall experience is both empowering and daunting. People moving into rentals typically don’t have the same highs or lows. After all, it’s just a rental.
What if health systems provided rides for elderly patients with limited transportation options or poor patients unable to access public transportation? We might applaud them for a creative strategy to improve access for vulnerable populations. However, their actions might be illegal.
Penn’s third annual Martin Luther King Jr. Health Equity Symposium featured a keynote address by Antonia Novello, 14th Surgeon General of the United States, who had a hopeful, yet challenging message: “Had Martin Luther King been here today, he would see that we are doing much better, but he would he would still be fighting. He would feel pride, disappointment, sadness, and he would be appalled that blacks and whites are still segregated.”[content_elements:element:0]
Despite major components of the Affordable Care Act on the chopping block, value-based care reforms largely have bipartisan support and are likely here to stay. And while the majority of providers and politicians support efforts to incentivize value over volume, fewer providers have realized success achieving higher value care.
It seems self-evident: one way to address the epidemic of opioid deaths is to make prescription opioids harder to misuse. OxyContin, for example, is especially dangerous when it is crushed for ingestion, inhalation, or injection. In 2010, the FDA approved a reformulated, abuse-deterrent version of OxyContin that made the pill difficult to crush or dissolve. The new version immediately replaced the old one, marking a substantial reduction in the supply of abusable prescription pain relievers.
Our colleagues at the Wharton Public Policy Initiative have released a new Issue Brief, The Economic Realities of Replacing the Affordable Care Act, by LDI Senior Fellow Hanming Fang, PhD. In it, Dr. Fang uses a new model of labor and health insurance market dynamics to simulate the long-run effects of the ACA's mechanisms, thus shedding some much-needed light on the repeal-and-replace debate.
Mental health continues to live on the fringes of the health care delivery system. According to the former Surgeon General, “even more than other areas of health and medicine, the mental health field is plagued by disparities in the availability of and access to its services,” with significant barriers related to patients’ socioeconomic background.
[This post originally appeared on the PolicyLab at Children’s Hospital of Philadelphia blog.]
“Pay more for drugs that do more.” Although few would argue with the concept of paying for value, the mechanism for doing so has thus far eluded our multi-payer, market-based system. The Gant Precision Cancer Medicine Consortium at the University of Pennsylvania looked past US borders to learn about mechanisms in other countries, in its quest to recommend sustainable frameworks for valuing precision cancer drugs.
House Speaker Ryan recently claimed that “[t]he problem that we’re seeing in Medicaid is more and more doctors just won’t take Medicaid, because they lose money on Medicaid.” Our new paper in JAMA Internal Medicine, “Changes in Primary Care Between 2012 and 2016 for New Patients with Medicaid and Private Coverage,” suggests otherwise.
We recently convened an expert roundtable to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable. This got us thinking - while the process by which ineffective practices or technologies are abandoned is neither simple nor automatic, even the language used to describe it is not clear. And language matters. It often reflects an unstated focus on one mechanism or one level of decision-making. Here we review, and potentially clarify, the terminology.
Should a patient’s level of cognitive function be considered when allocating scarce organs for transplantation? In a recent perspective in the New England Journal of Medicine (NEJM), LDI Senior Fellows Scott Halpern and David Goldberg weigh in on the highly charged debate about organ allocation to cognitively disabled people.