Commentary Archives for June 2012
Oregon’s Early Experience With Insuring the Uninsured
The alleged primary spur for passage of the federal reform law was providing insurance for the uninsured, which supposedly would save money in the long run. An Oregon initiative has created an opportunity to see results from a similar effort and a report gives first year outcomes.
PPACA Survives, in a Perverse Way
A 5 to 4 majority of the Supreme Court has upheld the constitutionality of the individual mandate, but only as a tax, not as an exercise of the Commerce Clause, and has eviscerated the Medicaid expansion. This is likely the worst possible outcome for President Obama, his Administration and the party that supported this ill-advised stab at “reform”.
AHRQ on Improving Health Care Decision-Making
The Agency for Healthcare Research and Quality has issued a report looking at use of clinical decision support and knowledge management systems, finding some evidence for positive health and cost outcomes, but also large gaps in our understanding of how to maximize the value of these technologies.
ER Crowding
Use of emergency rooms is monitored as a potential indicator of access and quality problems. A recent study from the American College of Emergency Room Physicians analyses trends in both emergency room use and crowding.
2012 Potpourri XXI
It is officially the start of summer and our Potpourri is hot, hot, hot, but not steamy! This week we cover why health care IT doesn’t seem to create productivity gains, the use of whole-genome sequencing, the consequences on failure to comply with prescribed drug regimens and the rates of drug misuse and the potential savings for patients in CDHP plans.
AMA’s Report Card on Insurer Performance
The American Medical Association regularly assesses the administrative performance of the large health plans on issues relevant to physicians. This year’s report finds significant improvement in claims payment procedures and results.
What Will Medicare Really Cost?
When the Congressional Budget Office and the Board of Trustees of the Medicare trust funds make projections about future Medicare expenditures and revenues, they are required to utilize current law, even when everyone knows it doesn’t reflect likely reality. A memo from the Office of the Actuary presents an alternative, probably more accurate, set of Medicare projections.
EBRI Report on the CDHP Population
Our next report related to consumer-directed, high deductible health insurance plans comes from the Employee Benefit Research Institute and describes the characteristics of people in these plans over the years 2005-2011.
AHIP on CDHP
This week we will discuss several high deductible insurance plan reports. The first is from America’s Health Insurance Plans and gives information on details of enrolllment and plan types.
2012 Potpourri XX
Our Potpourri resumes, with information on consumer trust of insurers and providers, consumer use of online health information, price transparency in health care, imaging rates in integrated health care systems and effectiveness of telephonic depression therapy.
National Health Spending Projections
The latest projection on national health spending from the CMS Office of the Actuary is out and published in Health Affairs. It suggests that the very modest reduction in growth rate in the last couple of years is going to end and growth in spending will re-accelerate in the coming years.
Wellness Lessons From Germany
Germany has encouraged wellness programs in a manner similar to the US. A new report from the Commonwealth Fund discusses results from the country’s efforts and draws lessons that may be applicable to the United States.
E-Prescribing Status Report
The latest annual report on e-prescribing from SureScripts reveals continued rapid growth. The report also details benefits which appear to flow from greater use of electronic prescribing and opportunities to use the network created by SureScripts to address information sharing in other health care sectors.
PWC 2013 Cost Projections
PWC’s Health Research Institute is projecting that overall medical cost trend for employment-based health care coverage will be around 7.5% for 2013, which is identical to the number it currently estimates for 2012 and close to the 2011 and 2010 actuals.
Components of Hospital Cost Increases
A new Agency for HealthCare Research and Quality Statistical Brief decomposes the sources of inpatient hospital cost increases from 1997 to 2008, which is important to understand given that hospital spending is the single largest contributor to overall per capital health spending growth.
Express Scripts Drug Trend Report
The Express Scripts 2011 Drug Trend Report shows very low overall growth in drug spending, but continued sharp increases in the specialty sub-category. The firm presents interesting information and evidence on approaches to increasing medication adherence.
Medscape Survey on Physician Compensation
A Medscape survey of physicians gives statistics on compensation and compensation trend and reveals doctors’ attitudes regarding their pay. While “healthy”, physician compensation is not generally lavish and growth in physician spending is not nearly the problem that growth in hospital costs are.
2012 Potpourri XIX
Summer is heating up and our Potpourri is smoking too, with nuggets on a silly provision in the final MLR rule; research on causes of readmissions, some within hospital control, some not; why are some hospitals more costly in treating heart failure than others and an unintended consequence of a change in dialysis drug reimbursement.