Commentary Archives for November 2010
New Evidence on Wellness Value
Doubt continues to exist about whether wellness and prevention have net short or long-term cost savings. A new study indicates that a well-designed, comprehensive health program can save money, at least in the near term, and may lower longer term cost trajectories.
MedPAC on Retainer Medicine
Retainer-based medicine, in which patients pay physicians a flat periodic fee to cover a package of basic medical services, often referred to as a “concierge” practice, is reviewed in a MedPac report, to ascertain if has or might have a deleterious effect on access or costs for Medicare patients.
Turkey of a Potpourri
There you are, relaxing on a holiday and holiday weekend and for some reason you feel compelled to browse the internet and come across our Thanksgiving potpourri, hopefully not a turkey, but stuffed with edible data, including HHS’ final rule on MLRs; the AMAs survey on prior authorization; principles for ACOs, how to use research studies, Humana’s acquisition of Concentra and an explanation of why health care costs keep going up. Happy Thanksgiving!
Cancer Care Variation
The Dartmouth Atlas project has issued numerous reports on variation in health spending across the United States. The most recent report focuses on cancer care for terminal patients and once again finds substantial difference in resource use both across and within geographic regions.
GAO on Integrated Delivery Systems
The Government Accounting Office interviewed representatives of a number of integrated provider systems to ascertain features, purported benefits in assisting underserved populations and challenges to the success of the organizations.
Does Telemonitoring of Health Failure Improve Outcomes?
New research reported in the NEJM finds that telemonitoring of recently discharged heart failure patients did not result in better outcomes than did usual care, but characteristics of the study and analysis mean that the results should not be over-interpreted.
2010 Potpourri XLII
Thanksgiving approaches and we are thankful for the continuing stream of news to fill our Potpourri, including the effect of malpractice liability on Illinois’ ability to retain physicians; the role of prices in health spending increases; comparative health and death rates in the US and England; employer health insurance costs; CBO review of a plan to reshape to Medicare; and end-of-life decision making.
More on Hospital Pricing Power
Another study, this time from the Center for Studying Health System Change, suggests that hospital market power plays a substantial role in health care cost increases and discusses some possible options to address the problem.
Philips Index of Global Well-being
Phillips releases its first in a projected series of reports on a global health and well-being index. The trans-country survey reflects commonalities and divergence around the world on levels of satisfaction and concern regarding a number of health and life issues.
Care Management for the Elderly Patient
Older Americans have a high rate of chronic disease and those patients are responsible for much of overall health spending. An article in JAMA explores programs designed to manage care better for these patients.
Characteristics of the Uninsured
Concern about the growing number of uninsured Americans was one of the primary drivers of the health reform bill enacted earlier this year. Looking at the characteristics of the uninsured provides some interesting insights.
TowersWatson Employee Survey
A Towers Watson survey examined employees perspectives on their health plans. High cost sharing appears to be a major concern, but many employees are not taking proactive steps to help reduce those costs.
2010 Potpourri XLI
The holidays approach, the Potpourri rolls on, this week unveiling information on potential savings for Medicare and Medicaid dual eligibles; EHR use’s effect on physician revenue; likely physician reaction to the SGR cuts, if implemented; characteristics of California health plan enrollees; CBO’s view of the impact of the reform law on drug prices and a health plan allowing nurse practitioners to be primary care providers.
Cigna’s Report on High-Deductible Plans
Cigna releases the latest of its annual reports on the experience of members in its high-deductible health insurance plans, finding that their medical costs continue to be lower in the first and following years, and they appear to receive as good or better medical care.
Telecare for Arthritis
Studies continue to show the value of telecommunications technology in lowering the cost of managing chronic disease while improving outcomes. A study in the Annals of Internal Medicine reports on telephonic support for self-management of osteoarthritis.
Reimbursement’s Impact on Medical Practice
A New England Journal of Medicine article further solidifies the susceptibility of physicians to financial incentives to overuse care when it assists them economically. Removing those incentives does not seem to prevent continued delivery of the same care when it is needed.
State of the Medical Device Industry
Although health care products like drugs and medical devices get blamed for much of the cost in our system, they also often provide better care for patients and the companies making these products are an important part of our economy. A new report summarizes the state of the medical device industry.
End-of-Life Care
New research covering aspects of end-of-life care in Canada and the US reveals that costs continue to be high, even though the use of palliative care in the United States has increased significantly.
What Now After the Election?
There was a big change in the balance of power between the parties in this week’s midterm election but that change may or may not have a significant effect on the health reform law. Changes in government at the state level may have more of a near-term effect.
Obesity Costs
A new report from the National Bureau of Economics adds to the evidence that obesity is related to substantial health expenditures, but primarily concentrated in a few individuals.
Pharmacy Benefit Report
The annual survey of employers in regard to their prescription drug benefits conducted by the PBMI is out. It reveals lots of interesting information about design and cost trends.
The Prevalence and Cost of Mandated Benefits
The Council for Affordable Health Insurance puts out the latest in its series of reports on mandated benefits, looking at not just the number and type of mandates, but the incremental cost they add to insurance premiums; a cost which is ultimately borne by consumers.
Pew Mobile Health Survey
The Pew Internet project puts out its latest survey on mobile technology being used for health purposes. The survey indicates growing use of health apps and health information search capabilities, but with variable presence among demographic groups.
The Most Costly Hospital Stays
AHRQ released a report on high-cost hospitalizations, demonstrating the concentration of spending on a relatively few cases. The diagnoses are what would be expected and it is unclear how these hospitalizations might be avoided.