Winter nears but our Potpourri will distract you from the cold breezes, providing compelling nuggets on prostate screening recommendations, consumer use of technology for health, insurer medical cost trends, what to do about Medicare’s physician payments, heart failure hospitalization and mortality rates and rates of non-filling of new prescriptions.
The world’s aflame with reporting on provider quality and cost performance. Making sure the information is complete, accurate and credible is no simple task, as a recent Agency for Healthcare Research and Quality report demonstrates.
From the Commonwealth Fund comes another in a series of reports bemoaning the woeful inadequacy of the American health system, especially compared to those in other developed countries. Whatever our faults, this type of analysis is filled with its own flaws and provides little useful guidance for addressing our issues.
Specialty drugs have gotten the attention of all payers, with multiple efforts underway to manage the exploding costs associated with this category. A new paper from URAC summarizes the issues and sets out the value of using an accredited specialty pharmacy.
Hospital readmissions are targeted as a quality metric and a reimbursement adjustment. The program used by CMS in particular appears flawed, and a recent study examining readmission-risk models supports that conclusion.
Another brilliant Potpourri, with scintillating health care gems, including revising the FDA’s 510(k) process, the essential benefits package for health exchanges, the future of Medicare Advantage, the lack of labor productivity in health care, variation in elective procedure rates and the OIG’s work plan.
As Medicaid enrollment continues to grow, and will likely surge in 2014, states are looking for ways to control costs. Pharmacy spending has been an area of focus and a new Kaiser report discusses how states are handling prescription drug issues.
Medicare/Medicaid dual eligibles are relatively poor, elderly or disabled persons who have very high health spending. A report from America’s Health Insurance Plans discusses how care coordination programs can achieve significant savings for the programs and better health outcomes for the patients.
An Urban Institute report looks at the seemingly unsolvable problem of US health care spending growth, identifying four key potential causes and several solutions which might in total reduce spending by an average of about 5% to 10% a year through 2023.
The Kaiser Foundation takes a look at the competitiveness of individual and small group health insurance markets on a state-by-state basis, finding that most are relatively concentrated. The report also examines the implications of this concentration for aspects of the reform law, particularly the exchanges and rate review.