2011 Potpourri XII

The health plan company Highmark released results of a study looking at the impact of wellness programs on health care costs.  The study compared 10,000 employees in wellness programs with an equal number not in such programs, over a four year period.  It found that health care costs grew about 15% slower among the participants, saving about $332 per person.  The participants were also more likely to use preventive services, such as screenings.   (Highmark Release)

A study reported in the Annals of Internal Medicine continues the examination into the link between spending and health outcomes.  The Dartmouth studies have generally shown that higher spending areas have no better and often worse outcomes.  This study examined the link between higher spending and mortality for six common conditions treated at hospitals.  It divided hospitals into quintiles and the highest spending one cost more than the twice the lowest.   But mortality rates steadily declined for each higher spending quintile.  There could be a number of confounding factors, and keeping people from dying in the hospital may not be a good indicator of overall better outcomes or quality of life, but the study results do suggest that spending more might be associated with higher quality of care.   (Annals Article)

A bill has been introduced in Congress to require CMS to release and make available to the public and researchers data about the practice patterns and costs of individual physicians.  The AMA has successfully blocked this release for years on grounds of physician privacy, which is just silly because when you are being paid by taxpayer dollars for your services you have no expectation of privacy.  The release of this data would be immensely helpful in controlling spending and spending variation, as it would allow for very quick identification of those doctors who are high cost, but don’t have better outcomes or sicker patients.

Two studies from the University of Oregon look at ways to help smokers quit.  One used functional MRI to see reactions in various brain areas to anti-smoking messages to understand if it was possible to predict who was most likely to be successful in quitting and to help tailor messages to various patients.  The researchers believed they could show a connection between brain activity and success in stopping smoking.  The second study indicated that text messaging was a very inexpensive method of helping smokers deal with cravings and their response to them.  (Oregon Press Release)

The federal Department of Health and Human Services has granted Maine a reprieve from having to comply with the medical loss ratios for individual health insurance.  Maine demonstrated that it would likely see one or more major insurers withdraw from the individual market if the standard were enforced.  Other states have made similar requests.  As with mini-med and other waivers, it appears that HHS is doing what it can to cover up the increasingly obvious defects of the “reform” legislation.   (Maine Waiver Story)

HealthMedia, which is now a Johnson & Johnson subsidiary, released a study on the effects of its health coaching program.  According to the company, the program saved an average of about $350 per person per year.  The study tracked about 166,000 health plan members from 2002-2005.  It is unclear how the members were randomized or matched.  The company also claimed an ROI of over 2.83 in the first year of the study, but that dropped dramatically in the succeeding three years, as did the per person savings.   Still, if you could save $200 on 166,000 people that would be about a $33 million reduction in health care costs.   (HealthMedia Release)