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2012 Potpourri XXXIX

By December 21, 2012Commentary

A study reported in Health Affairs examined results in a medical home pilot.  The practices were working with the UPMC Health Plan and the study period ran from 2008 to 2010.  While both participating and non-participating providers had cost increases, they were lower for the medical home group, largely because of lower utilization in almost all classes of service.  The medical homes also had better quality scores, although this difference did not reach the level of statistical significance.  The health plan claimed that the return on investment was 160%, that is for every $1 invested in creating and supporting the medical homes, $1.60 was saved in avoided medical spending.   (HA Article)

A recent Gallup Poll asked about delaying medical care due to cost reasons.  Gallup has been tracking this since 2001 and found that now 32% say someone in their family has put off getting care for cost reasons, the highest percent ever recorded.  Fifty-five percent of people with no insurance report delays, compared with 30% who have private health insurance and 21% of Medicare and Medicaid beneficiaries.  Nineteen percent said they delayed care for a serious condition, which is particularly alarming.     (Gallup Poll)

Benefits consultant Buck, which is part of Xerox, released results from its survey of anticipated costs for the first part of 2013, based on a survey of 123 health insurers and coverage administrators.  For all of the types of plans–PPOs, POS, HMO and HDHP, the expected cost increase was between 9.3% and 9.7%, down from the 9.9% expected in the 2012 survey.  Drug trend was at 10.1%, which is up from the prior survey period.  It should be noted that expected cost increases don’t always translate to premium increases of the same size because benefits can be changed as well.  But these increases are running far above inflation and suggest continued lack of meaningful control on health spending.    (Buck Consultants Survey)

Another study reported in Health Affairs looked at the relative costs of physicians depending on years of experience.   The researchers actually were trying to find physician characteristics that seemed correlated with higher or lower spending and years of experience was the only one that reached statistical significance.  Doctors with ten years or less of experience had costs 13% higher.  Why is unclear, it could be that recently trained physicians are learning more costly practice styles or perhaps they are less confident in their diagnoses and treatment or maybe they need more income to pay off student loans or for other reasons.  Unlike some other research there is no suggestion that practice size affects cost.  (HA Article)

A study in the Journal of Medical Internet Research compared use of the internet or print to deliver the same health related content to various demographic groups.  Those who accessed the intervention via the web had much higher dropout rates and lower initial participation rates.  Those using the web were much younger, more likely to be male and not very physically active.  The results indicate that especially for people over 50, print may be a more effective communication channel than the internet and also indicate that the hype over internet health apps is just that, hype.   (Internet Research Article)

Finally, yet more research published in Health Affairs addresses the connection between poor health behaviors and health spending.  The authors find that ten modifiable health risk factors are associated with more than 20% of employee health spending.   Among these conditions are depression, high blood glucose, high blood pressure, obesity, tobacco use, physical inactivity and high stress.  This suggests that wellness and prevention can help lower health spending in employment-based health insurance plans.   (HA Article)


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