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Healthy Skeptic

Health care news and research

 

The Efficacy of Rehospitalization Interventions

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The Annals of Internal Medicine carries a study on the effectiveness of interventions to reduce the 30-day readmissions rate. This meta-review found little consistent evidence to support the value of any particular intervention, which should give further pause to the notion that most readmissions could be avoided or that hospitals should be penalized when they can’t be told how to reliably reduce readmissions.

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2011 Potpourri XXXXV

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No Potpourri next week due to the holiday, so enjoy this festive collection of health care nuggets, including pay-for-performance in large physician groups, employer views on the effect of the reform law, the effect of physician financial interest in cardiac testing, experience with high deductible plans, medical homes and quality improvement and for-profit and non-for-profit hospital treatment of the uninsured.

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Medicare Disease Management Pilots

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A final summary of Medicare’s disease management pilots gives a bleak picture of the value of the efforts. While there are design and methodological critiques of the Medicare program that may make the results not generalizable, the outcomes do suggest that if disease management is to show value, design and execution need to be improved.

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Massachusetts’ Cost Dilemma

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Massachusetts Special Commission on Provider Price Reform has released its momentous report on how to address the surging health care costs in the state, which appear to be largely caused by “excessive” provider prices and price increases. Someday regulators might learn that the more you regulate, the more you regulate.

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Drug Manufacturer Copay Assistance Programs

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Drug manufacturers have a new trick up their sleeve to get consumers to use their expensive branded products instead of cheaper alternatives–copay coupon programs. These programs significantly raise spending with no offsetting gain in quality or other benefits. Unfortunately, regulation is probably needed to ban the programs.

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2011 Potpourri XXXXIV

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The cold is approaching so curl up on the sofa and enjoy the warmth of our Potpourri, this week featuring results from a pay-for-performance program, the effect of the health insurance tax on premiums and employment, the evidence for a stroke treatment, collaborative care for heart disease and physicians views on their practices and health information tools.

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Hospital Transition Care

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It stands to reason that a care transition program will improve outcomes in regard to hospitalized stroke and heart attack patients, but an AHRQ research review finds little solid evidence that this is the case for most types of care transition interventions.

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Towers Watson Employer Survey

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The latest Towers Watson survey of employer intentions regarding health benefits indicates that significant changes may occur in the next two to three years, but the biggest danger may be firms’ willingness to play follow-the-leader when it comes to reactions to reform.

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Cost-Shifting and Care

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Research reported in Health Affairs examines the Mayo Clinic’s experience after increasing cost-sharing for its employees. Reductions in the use of many discretionary services seem to have been sustained over a multi-year period, leading to overall spending restraint.

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