2011 Potpourri XVI

One of the health information technology advances in the last decade has been the creation of personal health records which consumers can access and use to compile data about their health and health care.  A recent survey published in the Archives of Internal Medicine compared users and non-users of PHRs among about 75,000 patients at one large northeastern health system.  Whites were more likely to adopt use than minorities, as were higher-income persons and patients who had more disease.  (Archives Story)

Research published in Health Affairs describes findings regarding the effect of hospital pay-for-performance programs.  The researchers compared 260 hospitals that participated in a Medicare demonstration with 780 hospitals that did not.  The hospitals in the demo initially improved their performance on the quality metrics, largely process measures for certain diseases, more than did the control hospitals, but after five years there was no difference in performance.  Higher incentives, less competition in a market and being a hospital in better financial condition were associated with greater improvement.   (HA Article)

According to a survey conducted by Suffolk University, 49% of Massachusetts residents don’t think the state’s 2006 health reform plan is working, while 38% think it is.  So after five years of experiencing the reform plan, more residents think it didn’t accomplish its goals than do.  Not surprising, given that health insurance and health care costs continue to rise rapidly in the state and are among the highest in the country.  The state is floundering trying to address the cost issue and whatever the solution is will undoubtedly have unintended negative consequences, as government-imposed answers usually do.  (Globe Story)

The American Association of Retired Persons tracks data on drug prices.  Its most recently released report indicates that the prices of brand drugs continue to go up rapidly, particularly in the period just before generic competition can begin.  While brand name drug prices increased overall 8.3% in 2009, prices for those drugs which would face generic competition in 2010 increased 13.7%.  In the five years prior to generic competition, brand names averaged a cumulative 51% retail price increase.  Since 6 of the 10 top selling drugs go off patent in the next couple of years, this pricing behavior has accelerated recently.  This is economically rational behavior, but not particularly attractive and certainly exacerbates our health cost problem.   (AARP Report)

The individual mandate is a cornerstone of the reform law, but is under challenge on constitutional and other grounds.  Congress asked the Government Accounting Office to report on what other avenues might be available to encourage the purchase of health insurance by individuals if the mandate were not upheld.  GAO talked to 41 experts who gave them a variety of ideas, with four key points, including creating financial incentives, making the plans affordable, strong marketing and education programs, and easy access to help in finding and selecting a plan.  Of course, the report ignores the fact that the reform law makes it impossible to actually create a desirable, inexpensive insurance package that might be attractive, especially to the young people who make up most of the uninsured.   (GAO Report)

A survey taken by Capstrat and Public Policy Polling reveals consumers perceptions of social media and health care.   Eighty percent of the phone survey respondents said they were very involved in their health care; 88% of women and 70% of men; 89% of Hispanics; 60% of caucasians and 42% of Afro-Americans.  If email were made available by their doctor, 60% said they would use it; 67% of women and 53% of men.   But if social media were available, only 11% said they would take advantage of it.  Another interesting tidbit–the most common reasons to switch doctors are insurance coverage network restrictions, and just as common, doctor demeanor or service attitude.  (Poll Results)