Hospital readmissions are targeted as a quality metric and a reimbursement adjustment. The program used by CMS in particular appears flawed, and a recent study examining readmission-risk models supports that conclusion.
Another brilliant Potpourri, with scintillating health care gems, including revising the FDA’s 510(k) process, the essential benefits package for health exchanges, the future of Medicare Advantage, the lack of labor productivity in health care, variation in elective procedure rates and the OIG’s work plan.
As Medicaid enrollment continues to grow, and will likely surge in 2014, states are looking for ways to control costs. Pharmacy spending has been an area of focus and a new Kaiser report discusses how states are handling prescription drug issues.
Medicare/Medicaid dual eligibles are relatively poor, elderly or disabled persons who have very high health spending. A report from America’s Health Insurance Plans discusses how care coordination programs can achieve significant savings for the programs and better health outcomes for the patients.
An Urban Institute report looks at the seemingly unsolvable problem of US health care spending growth, identifying four key potential causes and several solutions which might in total reduce spending by an average of about 5% to 10% a year through 2023.
The Kaiser Foundation takes a look at the competitiveness of individual and small group health insurance markets on a state-by-state basis, finding that most are relatively concentrated. The report also examines the implications of this concentration for aspects of the reform law, particularly the exchanges and rate review.
Another Potpourri, with tidbits on the Medicare Star program results for 2012, pain management, blood pressure management, Massachusetts’ physicians’ views on work and health care, online error reporting and the FDA and CMS parallel medical device review process.
The Deloitte Center for Health Solutions releases the latest edition of its annual survey of consumers on health issues and health care use. Americans are anxious about the financial effects of health care and think our system is not good, but are generally happy with the care they actually receive.
The American Hospital Association weighs in on the hospital readmission reduction incentive program with a well-thought out program that identifies the complexities involved in identifying inappropriate readmissions and designing initiatives to reduce those readmissions.
A Journal of the American Medical Association article, based on work sponsored by AHRQ, reviews the off-label use of atypical antipsychotics, which are usually very expensive and have significant side effects. While there are occasional benefits to such use, adverse events are common, particularly in the elderly.
An EBRI survey reveals current attitudes by Americans regarding the health system, their health care coverage, how they access care and reflects serious concerns by many Americans about whether the reform law will make the system, better or worse.
The leaves fall but not the quality of our Potpourri, this week covering beneficiaries’ use of Medicare Star ratings, quality of care guidelines and older patients, compassionate care, asthma care guidelines and outcomes, infection control in hospitals and informal caregivers in California.
The effect of telehealth tools on the health spending of Medicare beneficiaries with chronic disease has been controversial, with a number of studies finding no or very limited savings. New research published in Health Affairs suggests that at least one such tool may contribute to savings in a care management program for common chronic diseases.
The Medicare Advantage plans’ latest ratings for 2012 will be released Wednesday. Top scoring plans will also win the ability to enroll new members year-round, rather than a few weeks each autumn.
End-of-life care is a significant contributor to overall health expenditures. New research in the Journal of the American Medical Association probes the effect of advance directives on end-of-life spending, with a particular focus on geographic variations both in the use of directives and care.
Increasingly hospitals are being judged on their “quality” based on process and outcome measures and on their cost. New research examines the characteristics of hospitals which fall in various quartiles based on quality and costs, finding that many hospitals serving poorer patients are judged low quality and high cost, but whether those hospitals are being fairly evaluated is an open question.
A new paper discusses the state of shared decision-making, illuminating progress and barriers to use by patients and providers. This approach results in higher-quality care, because it is consistent with patient values and with truly informed patient consent and it may also help reduce spending.
The Pharmacy Benefit Management Institute releases its most recent survey on prescription drug benefit design and cost issues. While drug spending growth has moderated, the size of the category means it still draws attention and employers and payers continue to refine their strategies for keeping utilization and cost under control.
October already!! Our 39th Potpourri of the year has many autumnal pleasures including selections on CMS’ Comprehensive Primary Care Initiative, a proposed guidance for FDA to use for mHealth regulation, end-of-life care discussions, CMS’ multi-payer database award, expected 2012 medical trend, and delivery of unnecessary care by doctors.
In another piece of research related to hospital readmissions, the Dartmouth Atlas project released a report on variations in readmission patterns across the country and among academic medical centers. Possible reasons for the variation are explored as is the longitudinal trend, which shows no improvement.
The final look at the Kaiser employer health benefit survey examines findings on prescription drug coverage, wellness programs, retiree health plans, funding mechanisms and the effect of health care reform.
The second part of our review of the Kaiser employer health benefits survey discusses employee contributions to premiums and employee cost-sharing trends, along with developments in high-deductible plans with savings accounts.
The annual Kaiser Foundation report on employment-based health coverage finds a rapid growth in per person and per family costs in 2009, but relative stability in the number of persons who have access to health insurance at the workplace. High-deductible plans continue to show rapid enrollment increases.