2010 Potpourri XXIII

The Urban Institute and the BCBS of Massachusetts Foundation issued an update on the state of reform in Massachusetts, as of the fall of 2009.  (Mass. Update) (For a more recent view on how things are going, see the other Massachusetts item below.)   The update finds that coverage levels have remained high, with over 95% of non-elderly adults covered.  There has been a slight drop in employer-based coverage, which may be due to the recession.  More people are using medical services, but one in five reported difficulty finding a provider who would see them.  Paying medical costs, however, is still a major and growing concern for patients, which make sense since costs in Massachusetts continue to rise very rapidly.

The Insurance Research Council has issued a report examining hospital cost-shifting to automobile liability claims.  The study compared costs in Maryland, which has an all-payer hospital rate system, with those in other states.   The study found a relationship between the number of uninsured and Medicaid-covered persons in a state and the average hospital charge in an auto liability claim.  It also found that that average charges were lower in Maryland than in the other states.   (IRC Council)

The American Hospital Association has released a report on the economic contribution of hospitals, probably at least partly in response to all the recent research suggesting that hospital price increases are the main driver of health spending rises.  The report says hospitals employ 5.3 million Americans and support over 10% of all jobs and create over $2 trillion of economic activity.  That’s wonderful, but all that activity from hospitals is basically sucking money out of other businesses and industries and government, money which otherwise would have gone to create more jobs and spending by those entities.  And health care may not be the segment that creates the most bang for the buck in terms of productivity and innovation and multiplier effects of investment.   (AHA Report)

Harris Interactive periodically surveys Americans on their use of information technology such as email and electronic records in health care.  The latest results indicate that very few people take advantage of these capabilities and many patients don’t even know if their provider has them.     (Harris Poll) People also continue to very concerned about who has access to their health information which might be stored in electronic form.  One interesting tidbit is that 89% of Americans report having a primary care physician.

Remote patient monitoring has entered a real growth phase at least in terms of the number of products and services offered.  Getting more widespread use is a different matter, needing reimbursement, which in turn requires more studies to show improved health and cost outcomes.  The Good Samaritan Society health system has received a grant to fund a three-year study of remote sensing technologies to monitor the health of seniors living at home or in assisted living.  This will be a randomized trial which should yield good data on the effects of such technology.  (Star Tribune Story)

And yet another item from Massachusetts.  The appeal board in the Division of Insurance reversed the department’s earlier refusal to accept Harvard Pilgrim health plan’s rate increase, largely on the basis that the increase was necessary to cover the increased costs of providers’ services.  The Duval administration howled, but the real problem is that the state passed a “reform” law that didn’t change anything in terms of the cost dynamics, in fact probably exacerbated the situation.  (Globe Story)

Interim results have been released from a trial of 139 patients regarding Vitality’s GlowCap technology.  The GlowCap is designed to alert patients when they haven’t taken their medication and can also send information through wireless networks to providers.  The study assigned some patients to nothing, some to GlowCap services and some to GlowCap plus a financial incentive for high adherence.  The GlowCap groups achieved close to 100% adherence, compared to 71% for the control group.  Another creative use of communication technology to solve a very significant health care problem.    (Adherence Study)