In the Journal of Adolescent Health, Alexander Bain and colleagues, including Charlene Wong, Daniel Polsky, Raina Merchant, and David Rubinm, identify the most prevalent and costly inpatient hospitalizations in a national cohort of privately insured young adults since the implementation of the Affordable Care Act. The researchers analyzed 158,777 hospitalizations among 4.7 million young adults from January 2012 to June 2013. They find that the top diagnoses for young adult female hospitalizations were pregnancy related (71.9%) and mental illness (8.9%). The top diagnoses for young...
Price transparency—the ability to know the price of something before buying—is a mainstay of most markets. It has been touted as a way to reduce health care spending by enabling a new breed of cost-conscious consumers to comparison shop for care. A new JAMA study suggests that it might not be that simple.
The cost of private health insurance, the main mechanism by which people access and pay for health care, is high and rising. In fact, the average family spends more than $17,000 annually on health insurance premiums (KFF). That is, even when a family consumes no health care, they are buying the equivalent of a base-model Toyota Corolla in health insurance every year.
In Health Affairs, Charlene Wong and colleagues go shopping on the most recent iteration of ACA marketplaces. They find added features to help consumers browse and pick a health plan, including total cost estimators and provider look-up tools. Marketplaces differ in how they estimate out-of-pocket costs and how they display plan choices, although most continue to present plans in premium order.
High Cost Sharing and Specialty Drug Initiation Under Medicare Part D: A Case Study in Patients With Newly Diagnosed Chronic Myeloid Leukemia
Does high cost sharing in Medicare Part D drug plans affect whether and how quickly patients initiate a recommended and life-extending drug treatment? In American Journal of Managed Care, LDI Senior Fellows Jalpa Doshi, Pengxiang Li and colleagues assess whether Medicare patients newly diagnosed with chronic myeloid leukemia (CML) and subject to significant coinsurance, take longer to initiate tyrosine kinase inhibitors (TKI) treatment than low-income (subsidized) Medicare patients subject to a nominal copayment.
Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population
In the Journal of the American Academy of Dermatology, Jalpa Doshi and colleagues, including Penxiang Li and Preethi Rao, investigate real-world utilization patterns of biologic therapy in Medicare beneficiaries with psoriasis. Studies indicate low adherence to biologics among patients with psoriasis, yet little is known about the adherence level in the Medicare population. Using data from the Medicare Chronic Condition Data Warehouse Part A, B, and D files with 12-month follow-up after index prescription, Doshi and colleagues conducted a retrospective claims analysis on 2707...
h/t Paul Houchens
An interesting chart by Milliman caught my eye today. Here it is:
Nurse staffing and the work environment linked to readmissions among older adults following elective total hip and knee replacement
In the International Journal for Quality in Health Care, Karen Lasater and Matthew McHugh examine the effect of nurse staffing and the work environment on 10- and 30-day unplanned readmissions for Medicare patients following elective total hip and knee replacement. The authors conducted a cross-sectional secondary data analysis using patient administrative data, nurse survey data, and hospital organizational data from acute care hospitals in California, Florida, New Jersey and Pennsylvania. Nurse survey responses were aggregated to construct hospital measures of nurse staffing and...
Many physician and consumer groups cheered when the Obama administration proposed network adequacy standards for health insurance plans sold on state and federal marketplaces. They will be disappointed that many of these standards did not make it into the Final Rule published yesterday in the Federal Register.
Much of what we hear about Accountable Care Organizations (ACOs) has to do with how well, or poorly, they’re serving the Medicare population. Medicare ACOs have received a great deal of attention, but less discussed is the application of this new health care delivery model to the Medicaid population.