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Health Affairs

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https://read.qxmd.com/read/30856021/new-year-brings-new-aca-developments
#1
Katie Keith
A new year ushers in new Affordable Care Act regulations, court decisions, and hearings in the US House of Representatives.
March 11, 2019: Health Affairs
https://read.qxmd.com/read/30785832/national-health-expenditure-projections-2018-27-economic-and-demographic-trends-drive-spending-and-enrollment-growth
#2
Andrea M Sisko, Sean P Keehan, John A Poisal, Gigi A Cuckler, Sheila D Smith, Andrew J Madison, Kathryn E Rennie, James C Hardesty
National health expenditures are projected to grow at an average annual rate of 5.5 percent for 2018-27 and represent 19.4 percent of gross domestic product in 2027. Following a ten-year period largely influenced by the Great Recession and major health reform, national health spending growth during 2018-27 is expected to be driven primarily by long-observed demographic and economic factors fundamental to the health sector. Prices for health care goods and services are projected to grow 2.5 percent per year, on average, for 2018-27-faster than the average price growth experienced over the last decade-and to account for nearly half of projected personal health care spending growth...
February 20, 2019: Health Affairs
https://read.qxmd.com/read/30933606/adjusted-mortality-rates-are-lower-for-medicare-advantage-than-traditional-medicare-but-the-rates-converge-over-time
#3
Joseph P Newhouse, Mary Price, J Michael McWilliams, John Hsu, Jeffrey Souza, Bruce E Landon
Overall mortality rates, adjusted for age, sex, and Medicaid status, in Medicare Advantage have been below those in traditional Medicare for many years. Much attention has been paid to the resulting issue of favorable selection in Medicare Advantage. The common study design used to estimate causal effects of Medicare Advantage on utilization and outcomes compares new Medicare Advantage beneficiaries immediately before and after enrollment in Medicare Advantage with beneficiaries who choose to remain in traditional Medicare...
April 2019: Health Affairs
https://read.qxmd.com/read/30933605/physicians-medicare-and-more
#4
Alan R Weil
No abstract text is available yet for this article.
April 2019: Health Affairs
https://read.qxmd.com/read/30933604/an-education-in-meeting-patients-where-they-live
#5
T R Goldman
In Richmond, Virginia, an interprofessional group of health care students and faculty members is helping seniors solve problems early.
April 2019: Health Affairs
https://read.qxmd.com/read/30933603/patient-safety-as-a-priority-the-authors-reply
#6
David W Bates, Hardeep Singh
No abstract text is available yet for this article.
April 2019: Health Affairs
https://read.qxmd.com/read/30933602/patient-safety-and-other-priorities
#7
Zhike Lei, Eitan Naveh
No abstract text is available yet for this article.
April 2019: Health Affairs
https://read.qxmd.com/read/30933601/abuse-deterrent-oxycontin-and-hepatitis-c
#8
Marcelo E Bigal
No abstract text is available yet for this article.
April 2019: Health Affairs
https://read.qxmd.com/read/30933600/us-spending-on-health-care
#9
Cyprian M Mostert
No abstract text is available yet for this article.
April 2019: Health Affairs
https://read.qxmd.com/read/30933599/effects-of-alternative-food-voucher-delivery-strategies-on-nutrition-among-low-income-adults
#10
Sanjay Basu, Christopher D Gardner, Justin S White, Joseph Rigdon, Mandy M Carroll, Melissa Akers, Hilary K Seligman
Nutrition assistance programs are the subject of ongoing policy debates. Two proposals remain uninformed by existing evidence: whether restricting benefits to allow only fruit and vegetable purchases improves overall dietary intake, and whether more frequent distribution of benefits (weekly versus monthly) induces more fruit and vegetable consumption and less purchasing of calorie-dense foods. In a community-based trial, we randomly assigned participants to receive food vouchers that differed in what foods could be purchased (fruit and vegetables only or any foods) and in distribution schedule (in weekly or monthly installments, holding total monthly value constant)...
April 2019: Health Affairs
https://read.qxmd.com/read/30933598/measuring-the-lifetime-costs-of-serious-mental-illness-and-the-mitigating-effects-of-educational-attainment
#11
Seth A Seabury, Sarah Axeen, Gwyn Pauley, Bryan Tysinger, Danielle Schlosser, John B Hernandez, Hanke Heun-Johnson, Henu Zhao, Dana P Goldman
Serious mental illness (SMI) is a disabling condition that develops early in life and imposes substantial economic burden. There is a growing belief that early intervention for SMI has lifelong benefits for patients. However, assessing the cost-effectiveness of early intervention efforts is hampered by a lack of evidence on the long-term benefits. We addressed this by using a dynamic microsimulation model to estimate the lifetime burden of SMI for those diagnosed by age twenty-five. We estimated that the per patient lifetime burden of SMI is $1...
April 2019: Health Affairs
https://read.qxmd.com/read/30933597/maryland-s-experiment-with-capitated-payments-for-rural-hospitals-large-reductions-in-hospital-based-care
#12
Jesse M Pines, Sonal Vats, Mark S Zocchi, Bernard Black
In 2010 Maryland replaced fee-for-service payment for some rural hospitals with "global budgets" for hospital-provided services called Total Patient Revenue (TPR). A principal goal was to incentivize hospitals to manage resources efficiently. Using a difference-in-differences design, we compared eight TPR hospitals to seven similar non-TPR Maryland hospitals to estimate how TPR affected hospital-provided services. We also compared health care use by "treated" patients in TPR counties to that of patients in counties containing control hospitals...
April 2019: Health Affairs
https://read.qxmd.com/read/30933596/medicare-s-bundled-payments-for-care-improvement-initiative-maintained-quality-of-care-for-vulnerable-patients
#13
Brandon C Maughan, Daver C Kahvecioglu, Grecia Marrufo, Gina M Gerding, Syvart Dennen, Jaclyn K Marshall, Daniel M Cooper, Colleen M Kummet, Laura A Dummit
The Bundled Payments for Care Improvement (BPCI) initiative established four models to test whether linking payments for an episode of care could reduce Medicare payments while maintaining or improving quality. Evaluations concluded that model 2, the largest, generally lowered payments without reducing quality for the average beneficiary, but these global results could mask adverse findings among vulnerable subpopulations. We analyzed changes in emergency department visits, unplanned hospital readmissions, and all-cause mortality within ninety days of hospital discharge among beneficiaries with one or more of three vulnerable characteristics-dementia, dual eligibility for Medicare and Medicaid, and recent institutional care-in 105,458 beneficiary episodes in the period October 2013-December 2016...
April 2019: Health Affairs
https://read.qxmd.com/read/30933595/primary-care-physician-networks-in-medicare-advantage
#14
Yevgeniy Feyman, José F Figueroa, Daniel E Polsky, Michael Adelberg, Austin Frakt
Medicare Advantage (MA) plans often establish restrictive networks of covered providers. Some policy makers have raised concerns that networks may have become excessively restrictive over time, potentially interfering with patients' access to providers. Because of data limitations, little is known about the breadth of MA networks. Taking a novel approach, we used Medicare Part D claims data for 2011-15 to examine how primary care physician networks have changed over time and what demographic and plan characteristics are associated with varying levels of network breadth...
April 2019: Health Affairs
https://read.qxmd.com/read/30933594/medication-and-substance-abuse-the-authors-reply
#15
Ramin Mojtabai, Colleen Barry, Mark Olfson
No abstract text is available yet for this article.
April 2019: Health Affairs
https://read.qxmd.com/read/30933593/plan-choice-and-affordability-in-the-individual-and-small-group-markets-policy-and-performance-past-and-present
#16
Jean M Abraham, Anne B Royalty, Coleman Drake
The individual and small-group health insurance markets have experienced considerable changes since the passage of the Affordable Care Act in 2010, affecting access, choice, and affordability for enrollees in these markets. We examined how health plan access, choice, and affordability varied between the individual on-Marketplace, individual off-Marketplace, and small-group markets in 2018. We found relatively similar outcomes across the three markets with respect to deductibles and out-of-pocket spending maximums...
April 2019: Health Affairs
https://read.qxmd.com/read/30933592/the-affordable-care-act-in-the-heart-of-the-opioid-crisis-evidence-from-west-virginia
#17
Brendan Saloner, Rachel Landis, Bradley D Stein, Colleen L Barry
West Virginia is at the epicenter of a national opioid crisis, with a 2016 fatal opioid overdose rate of 43.4 per 100,000 population-more than triple the US average. We used claims data for 2014-16 to examine trends in treatment for opioid use disorder (OUD) among people enrolled in the West Virginia Medicaid expansion program under the Affordable Care Act. Expanding Medicaid could provide services to populations that may previously have had limited access to OUD treatment. We thus sought to understand trends over time in OUD diagnosis and treatment, especially with medications...
April 2019: Health Affairs
https://read.qxmd.com/read/30933591/medical-cannabis-and-pain-the-authors-reply
#18
Kevin F Boehnke, Daniel J Clauw, Rebecca L Haffajee
No abstract text is available yet for this article.
April 2019: Health Affairs
https://read.qxmd.com/read/30933590/knowledge-of-practicing-physicians-about-their-legal-obligations-when-caring-for-patients-with-disability
#19
Nicole D Agaronnik, Elizabeth Pendo, Eric G Campbell, Julie Ressalam, Lisa I Iezzoni
Disability civil rights laws require equitable treatment of the approximately sixty-one million Americans with disability. However, federal reports and numerous research studies indicate that this diverse and growing population often experiences health care disparities. To examine one possible contributing factor, we interviewed practicing physicians to explore their knowledge of their obligations to accommodate patients with disability under federal civil rights law. Interviewees reported having had little formal training about, and demonstrated superficial or incorrect understanding of, their obligations in three potentially problematic areas: deciding which accommodations their practices should implement, refusing patients with disability, and holding patients accountable for costs of accommodations...
April 2019: Health Affairs
https://read.qxmd.com/read/30933589/us-spending-on-health-care-the-authors-reply
#20
Gerard F Anderson, Peter Hussey, Varduhi Petrosyan
No abstract text is available yet for this article.
April 2019: Health Affairs
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