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2011 Potpourri XXXVIII

By September 30, 2011Commentary

Another excellent National Bureau of Economics paper uses Medicare Part D drug plans to examine “comparison friction”.  A competitive market assumes that buyers have easy access to good information about choices and will use that information.  Comparison friction is the difference between access to information and actual use of it.  The researchers sent personalized letters explaining Part D choices and the impact on the beneficiary to one group of Part D enrollees and not to another.  They found that 28% of these people switched plans compared to only 17% in the control group.  The net savings were $100 per person for the intervention group.  Very useful results.   (NBER Paper)

The latest Harris poll on health-related uses of the internet shows a leveling off in the percent of people using the internet for various health needs, largely because the rates are now very high.  Almost 90% of adults have looked for health information at least once and almost 40% do so frequently.  Search engines and medical websites are the primary sources of information and a very high 90% of people say they found what they were looking for.  Almost all users report believing the information they found was reliable and 57% have discussed what they found with their doctors.  (Harris Poll)

Researchers in Canada studied the effect of an aging population on health care costs.  The aging of populations is often cited as a factor in health spending growth.  Using the population of British Columbia, the researchers created a model to understand the effects of aging, mortality and non-demographic factors on health spending between 1996 and 2006.  Population aging contributed less than 1% a year to to spending and the study found little effect of people living longer creating higher spending.  The primary factors in spending growth were drug costs and outpatient visits.  Canada’s universal health insurance plan may mean results would be different for the US.   (Aging Study)

Several major insurers have started a Health Care Cost Institute, to which they will contribute ten years worth of de-identified claims covering over a trillion dollars in health care costs.  The insurers include Aetna, Humana, Kaiser and UnitedHealth and they hope other insurers will also contribute.  The board is primarily health economists and researchers.  The Institute hopes to also combine data from Medicare and Medicaid.  The data will be available to researchers who can use it to spot trends and problem areas.  But unfortunately, specific providers will not be identified so the usefulness of the data is greatly reduced, as the best way to help control spending is to identify providers who appear to be providing expensive and/or excessive care.   (NY Times Story)

Preliminary results from Mercer’s annual survey of employers on expected health costs and reactions to those costs in the next year have been released.  In 2012 employers expect to see health benefit costs increase about 5.4%.  Before making benefit changes, the cost rise would have been 7.1%, still below the average for the last five years of 9%.  The two primary reasons cited for the lower trend were wellness programs and the increased share employees bear deterring utilization.  To keep costs lower, employers plan to continue shifting more costs to employees, including higher premium share and higher deductibles, coinsurance and copays.  (Mercer Survey)

Although it is somewhat humorous given all the praise for EHRs, AHRQ has a very valuable portion of its site dedicated to unintended consequences of those wonderful systems which will ultimately transform health care (for good or ill).  The site helps providers consider what kinds of problems they might encounter, provides ideas on how to avoid those or fix them when they occur and links to other resources on the issue.  Among common unintended consequences are conflicts in paper and electronic systems, the need for never-ending system changes, unanticipated workflow problems and negative user emotions.   (AHRQ Guide)

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