Another luminescent Potpourri, focusing on the ACA’s high-risk pool plan; controlling health spending in Massachusetts; what components of EHRs and HIEs may control costs; another survey of employers and dealing with hospital pricing power.
An Agency for Healthcare Research & Quality report looks at the evidence for the effectiveness of public reporting of providers’ performance on various quality measures in actually creating quality improvements at those providers.
The Employee Benefit Research Institute releases a report looking at private health insurance exchanges and defined contribution plans, putting them in historical perspective and suggesting that adoption of these initiatives may not meet the objectives employers hope they will attain.
An interesting paper from the National Bureau of Economics focuses on moral hazard in health insurance and more specifically the extent to which consumers anticipation of future spending affects utilization, given the complicated nature of insurance cost-sharing, with a deductible, copays and an out-of-pocket maximum.
Medication adherence is a widespread problem in health care, ranging from failure to even pick up a prescription to failure to follow instructions on when and how to use the drug. A number of interventions have been tried to improve adherence and an Agency for Healthcare Research and Quality review seeks to ascertain what evidence there is for effectiveness for these interventions.
Our first Potpourri in a while is as diverse and flamboyant as the fall colors, including items on the effectiveness of telemonitoring, the history of health “reform” in the United States, mortality and Medicaid eligibility expansions, continued issues with cost affecting access in Massachusetts and methods to help control imaging use.
Physicians still largely control the levers of the health care system. Their perceptions of the system and their role in it therefore carry outsized importance. A detail survey by The Physicians Foundation reveals deep dissatisfaction among many doctors.
The Physician Group Practice Demonstration conducted by Medicare has largely wrapped up , to be supplanted by the accountable care organization programs. The PGP demo appears to have led to slightly improved quality and has led to slightly lower cost savings over traditional fee-for-service Medicare.
The Health Care Cost Institute releases a report on spending and utilization in the employer-based health care coverage market for 2011. Spending continues to rise faster than inflation or economic growth and is largely driven by higher prices charged by providers, not by increases in utilization.
The Center for Public Integrity has pointed out what was an obvious unintended consequence of greater use of electronic health records–providers will use the additional clinical information to feed billing systems that use the data to maximize coding for reimbursement. Medicare is already feeling the effects and other payers are likely to do so also.
Yet another report on hospital readmission work, this one from the Northeast Business Group on Health. Basically a puff piece full of obvious recommendations and bland nostrums, it purports to provide recommendations to addressing the readmissions “crisis”.
Bundled payments are designed to change the incentives for providers so that they manage patient care in a more cost-effective manner, hopefully without negatively affecting quality. A report from the Agency for Healthcare Research and Quality examines the research evidence to date on the effect of bundled payment approaches, finding that spending and utilization are probably lower, with an uncertain effect on quality.
The Government Accounting Office weighs in on the ongoing controversy over the effects of the Affordable Care Act on employment-based health insurance, reviewing a number of microsimulation models and employer surveys, finding that there is a wide range of estimates of a decrease or increase in the number of covered persons and substantial uncertainty in the accuracy of the predictions.
Yet another survey of the employer market, this one from Aon Hewitt, which also reflects views of employees covered under their companies’ health plans. Aon Hewitt finds that employers are stepping up their level of action in regard to designing and operating health plans and other programs to encourage better health.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
© 2024 Healthy Skeptic.
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