The Origins of the Opioid Epidemic
A state prescription drug policy first adopted in 1939, and last ended in 2004, appears to have influenced where Purdue Pharma chose to market its opioid drug OxyContin upon launch in 1996. The consequences of that decision reverberate to this day, according to a new NBER paper by LDI Senior Fellow Abby Alpert and colleagues, who estimate that states with the prescription policy had 11.4 fewer overdose deaths per 100,000 people in 2017. Let that sink in for a moment. In 2017.
Medicare Coverage, With a Catch
There’s good news and bad news. The good news is Medicare drug plans are increasing coverage of newer, better drugs to prevent blood clots in people at risk. The bad news is that coverage comes with significant strings attached, including higher patient copayments that could prevent access to the newer, better drugs.
No Safe Dose for That First Opioid Prescription
Lower Cardiovascular Mortality Linked to Medicaid Expansion
Add this to the expanding list of the benefits of the ACA’s Medicaid expansion. In JAMA Cardiology, a new study by LDI Associate Fellow Sameed Khatana and colleagues finds that Medicaid expansion was associated with lower cardiovascular mortality in adults aged 45-64.
Do Cardiac Centers of Excellence Really Excel?
If I needed a cardiac procedure, I might look for a hospital designated as a cardiac “center of excellence” (COE) by my insurer. I might assume that the hospital delivers higher quality care and achieves better outcomes than other hospitals. But that assumption might be wrong, according to a new study by LDI Associate Fellow Sameed Khatana and colleagues in JAMA Internal Medicine.
Selling Naloxone Over the Counter Likely to Boost Sales
In a new study in Health Services Research, our colleagues at CHERISH (Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV) use pharmaceutical claims data to predict the effect of converting naloxone to OTC status on retail pharmacy sales.
Prompt Primary Care Linked to Fewer Rehospitalizations in Medicaid Patients
The Camden Coalition of Healthcare Providers (of hotspotting fame) has published some intriguing findings from a city-wide program to reduce rehospitalizations by linking hospitalized Medicaid patients to primary care follow-up within seven days of discharge.
Penn LDI’s Top 10 Reads of 2018
2018 was a year that defies easy categorization. In health policy, deep cynicism and hyperpartisanship often made evidence seem almost passé, a quaint paean to a time when research and data might contribute to thoughtful national debate. But if you listened closely, you also heard not-so-faint rumblings of a desire to get past slogans and bitter divides, to find areas of common ground, and to use evidence to improve health and health care, even if only incrementally. In 2018, people flocked to LDI in record numbers, with more than 550,000 page views on our web site.
Physician-Hospital Relationships: Integration ≠ Alignment
Inside the Black Box of Patient-Centered Medical Homes
The concept of a patient-centered medical home (PCMH) holds intuitive appeal, with its emphasis on coordination of care, improved patient-provider communication and patient engagement, use of health information technology, and expanded practice hours.
Addressing Kidney Transplant Waiting List Disparities Through Medicaid Expansion
The evidence on the positive effects of Medicaid expansion on coverage, access, utilization, and financial security is substantial and growing.
Julie Fairman Makes History
Policy Changes to Improve Care for Older Adults with Chronic Illness
On May 2 and 3, the School of Nursing sponsored a multidisciplinary “Think Tank” devoted to improving care for older adults with chronic illness. Led by Mary Naylor and Nancy Hodgson, it drew more than 40 external thought leaders, who joined Penn experts from across the University.
Where Patients Go After Hospital Discharge: Trends in Post-Acute Care
As the largest single source of health care spending, hospitals have drawn considerable attention from policymakers. Efforts to reduce costs have led to decreased lengths of hospital stays, but far less attention has been paid to where those patients go immediately after discharge. Medicare payment reforms implemented in the wake of the Affordable Care Act, such as hospital readmissions penalties and bundled payments, have made hospitals accountable for care beyond their walls, including institutional post-acute care.