Late last year, the Centers for Disease Control and Prevention (CDC) announced that more than 70,000 people died from drug overdoses in 2017, a 9.6% increase from 2016. Deaths continue to soar, even as states and health systems implement policies to curb the overprescribing of opioids that led to the epidemic in the first place. It’s hard not to be discouraged by these numbers and our failure to reduce overdose deaths. To fully appreciate the shifting dynamics of the opioid crisis, we need to understand both the nature of the policies we are implementing as well as their likely short- and long-term effects.
A new study in BMJ Open led by LDI Senior Fellow Genevieve Kanter, in collaboration with colleagues Michelle Mello at Stanford, Daniel Carpenter at Harvard, and Lisa Lehmann at the Veterans Health Administration, finds that the Open Payments program has had little success in improving public awareness and knowledge of industry payments.
Every day, we hear about the staggering toll of the opioid overdose crisis. Despite effective medications for opioid use disorder, such as buprenorphine and methadone, few people receive treatment. The ongoing challenge is to expand access to these lifesaving treatments to people who need them the most. Emergency departments, which treat patients 24/7 and provide an entry point into the health system, are a promising place to start. With my colleagues Kit Delgado, Austin Kilaru, Jeanmarie Perrone, Zack Meisel, Jessica Hemmons, and Dina Abdel Rahman, I surveyed emergency medicine physicians in two Penn Medicine hospitals to understand the barriers and facilitators to starting buprenorphine in the emergency department.
It’s a policy decision with direct life-and-death consequences. Should naloxone, the prescription rescue medication that reverses the effects of an opioid overdose, be sold over the counter? As deaths from opioid overdoses continue to increase, consensus is building on the need to make life-saving naloxone more readily available. The question is, will selling naloxone over the counter (OTC) improve access, even if the out-of-pocket price for consumers goes up because some insurers will no longer cover it?
Although the phenomenon of “surprise billing” has become common, no research has examined how consumers respond to surprise bills and alter their health-seeking behavior. In our new study in Health Affairs, we investigate how mothers respond to receiving a surprise medical bill after delivering their first child. Those who received a surprise out-of-network bill for their first delivery had 13% greater odds of switching hospitals for their second delivery compared to those who did not get a surprise bill.
After delivering a keynote at the recent Wharton Health Care Business conference, Centers for Medicare and Medicaid Services Administrator (CMS) Seema Verma sat down with a group of LDI Senior Fellows to discuss current federal initiatives, understand relevant research and research gaps, and exchange ideas.
As the use of artificial intelligence (AI) in the form of machine learning and algorithms in health care increases, an unanswered question looms large: How should policymakers regulate AI? A new article from LDI Associate Fellow Ravi Parikh, Ziad Obermeyer, and LDI Senior Fellow Amol Navathe is a useful place to start. Writing in Science, they demystify and de-mythologize machine learning and AI and suggest some practical guidelines for regulating the rise of machine learning.
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. Patients who had a primary care appointment within seven days had reduced readmissions at both 30 and 90 days.
The durability and vulnerability of the Affordable Care Act (ACA) was on full display last year amidst the Administration’s efforts to undermine it, according to LDI Senior Fellow and law professor Allison Hoffman. In the Journal of Law, Medicine, and Ethics, she makes the case that recent experience demonstrates the shortcomings of market-based health policy and draws insights for future health reforms
With the ongoing measles outbreak in Washington, there has been increasing national attention to real-life consequences of vaccine-preventable diseases and vaccine hesitancy. Most of cases in this recent outbreak have been among unvaccinated individuals and children between the ages of 1 and 10 years. In the first month of 2019, the US has already seen 101 measles cases, on pace to exceed the 372 cases in 2018 and 120 cases in 2017. Studies have shown that states that have more lenient immunization laws generally have higher nonmedical exemption and disease rates compared to states with stricter exemption laws.
A new study from LDI Senior Fellow Abby Alpert (Wharton), David Powell (RAND), and Rosalie Pacula (RAND) links OxyContin reformulation to a national epidemic of hepatitis C, which kills more than 20,000 Americans a year and infects tens of thousands more.
Should providers participating in accountable care organizations (ACOs) be exempt from existing regulations that prevent financial conflicts of interest in physician referrals? On the one hand, these regulations, collectively known as the Stark Law, can impede efforts to coordinate care across providers and facilities. On the other hand, ACOs and other alternative payment and delivery models do not necessarily obviate the need for regulations that prohibit physician kickbacks or self-referrals. In a New England Journal of Medicine Perspective, Genevieve Kanter and Mark Pauly argue that exemptions are not the answer to the tension between ACOs and conflict-of-interest laws. Instead, they call for a reevaluation of both care coordination efforts and the Stark law.