Featured Post
Health care “affordability” is a top concern for most Americans, but it means different things to different people. Affordability can be examined as an economic concept, a policy threshold, or through the decisions made by individuals and families. As part of Penn LDI's research partnership with United States of Care, we have developed a brief that explores the concept of affordability through these different lenses, and outlines key issues for policymakers to consider as they try to tackle this pressing problem. It is the first in a series that will examine the cost burden of health care in the United States.
[This post originally appeared on Center for Injury Research and Prevention (CIRP) at Children's Hospital of Philadelphia Research in Action blog.]
July 18, 2018
When we think about distracted driving much of the focus is, appropriately, placed on teen drivers and cell phones. But what about child passengers driving with a distracted parent or caregiver? This is a group we wanted to identify and explore in new research published today in The Journal of Pediatrics.
July 11, 2018
Under the federal Sunshine Act, drug and device companies must disclose payments to doctors and teaching hospitals, but do not have to report payments to patient advocacy organizations (PAOs). In a recent commentary in the American Journal of Public Health, LDI Senior Fellow Matthew McCoy points out that this lack of disclosure raises serious ethical concerns, and argues that relationships between industry and PAOs demand greater transparency and accountability. McCoy calls for the extension of the Sunshine Act to require public reporting of industry payments to PAOs. In a responding editorial in AJPH, LDI Senior Fellow Genevieve Kanter notes that expanding the scope of the Sunshine Act to industry-PAO relationships may be more complicated than McCoy suggests. Kanter outlines practical challenges to extending the law and considerations for next steps.
July 9, 2018
The adequacy of “narrow network” plans offered on the Affordable Care Act Marketplaces continues to be a concern in the wake of exclusions of some high-cost providers and the incidence of “surprise medical bills” even in facilities that are in-network. Increasingly, federal and state policymakers are adopting quantitative standards for network adequacy, but a new Health Affairs study by Jeffrey Colvin, LDI Senior Fellow Evan Fieldston, and colleagues questions whether these standards ensure access to pediatric specialty care provided by children’s hospitals.
July 6, 2018
Nearly 20 years after the Surgeon General’s Report on Oral Health in America characterized oral diseases as a silent epidemic “affecting our most vulnerable citizens,” poor oral health still receives relatively little attention from researchers and policymakers. But at the recent 2018 AcademyHealth conference, I was pleasantly surprised to see several scheduled talks and a poster session centered on oral health. I attended this leading national conference for health services research as part of the Penn LDI SUMR Scholars Program.
June 21, 2018
In a New England Journal of Medicine Perspective, LDI Senior Fellow Linda Aiken and colleagues present a compelling case for funding a new consortium model that trains nurse practitioners in the community settings where they are a crucial source of primary care.
June 18, 2018
The evidence on the positive effects of Medicaid expansion on coverage, access, utilization, and financial security is substantial and growing. A new study by Meera Harhay, her spouse and LDI Senior Fellow Michael Harhay, and colleagues suggests yet another benefit: Medicaid expansion helped low-income and minority patients with chronic kidney disease (CKD) gain access to the kidney transplant waiting list.
June 14, 2018
A new study in Health Affairs by Hilary Barnes, Matthew McHugh, and colleagues, demonstrates the increasingly important role nurse practitioners (NPs) have in primary care in the United States.
June 11, 2018
[Reposted: Jalpa A. Doshi, Justin Puckett, Michael S. Parmacek, and Daniel J. Rader. Balancing Affordability And Access: Lessons From New Cholesterol-Lowering Drugs, Health Affairs Blog, June 5, 2018. https://www.healthaffairs.org/do/10.1377/hblog20180604.549026/full: Copyright ©2018 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.]
PCSK9Is offer a fascinating case study in the intersections between pharmaceutical innovation, specialty drug pricing, real world budget concerns, and patient access. This is not the first time PCSK9Is have been the focus of media attention. They reignited national debate about the high cost of medications and the need to rein in prescription drug spending in the wake of their approval by the Food and Drug Administration (FDA) in the summer of 2015. Their efficacy in lowering stubbornly high LDL cholesterol was impressive; however, payers were concerned with their list price (approximately $14,000), as well as the absence of data at launch showing that the cholesterol reductions were accompanied by lower rates of cardiovascular events such as heart attacks and strokes.
June 7, 2018
Scott Halpern, Kevin Volpp Michael Harhay, and colleagues recently published results of a large smoking cessation trial in the New England Journal of Medicine. They tested the real-world effectiveness of offering five strategies for quitting smoking among all known smokers at 54 U.S. companies (over 6,000 employees). The results reflect what employers, insurers, or others offering similar programs might expect to see. Here, Scott Halpern shares some thoughts on the trial, including what we can and cannot conclude.
June 4, 2018
New research shows that young citizen children were more likely to receive important social services when their undocumented mothers became eligible for the Deferred Action for Childhood Arrivals (DACA) program. Providing evidence of the multi-generational spillover effects of immigration policy, this new analysis comes as the U.S. House of Representatives is on the brink of forcing a vote on a permanent solution for recipients of the DACA Program.
May 29, 2018
Medicaid’s federal-state partnership structure has long permitted states to adopt modifications to coverage design, including benefits and cost-sharing. That structure, combined with an Administration signaling its support for greater state flexibility and funding constraints, could produce substantial shifts in state Medicaid policy.
May 17, 2018
Several states, including some that reluctantly implemented Medicaid expansion and some contemplating it, have asked for federal permission to link Medicaid eligibility to labor force participation—working or looking for work. As with everything in health policy these days, this idea is controversial, with disagreement even about the facts but more fundamentally about subjective social values.