Week of May 2-6, 2016

HEALTH POLICY RESEARCH REPORTS AND KEY TAKEAWAYS

Health Care Leadership and Management 
New York-Presbyterian CEO Steven Corwin delves into his system’s culture, the future of academic medical centers, and why his background as a physician helps him lead. Why New York Presbyterian’s CEO isn’t a ‘big believer’ in starting a health plan,

After a few complaints from grieving families, Beth Israel Deaconess Medical Center is now taking a closer look at how it handles the aftermath of a patient’s death.  Hospital takes on taboo subject, mistakes made after people die,

Experts say patient portals can offer financial benefits that improve collections, reduce staff workload and better engage patients.  Patient portals saving medical practices in overhead, improving collections, managers say,

The Commonwealth Fund post on how a “digital health advisor”—a comprehensive personalized set of digital health services—might help people with their health-related needs and provide guidance through the maze of the American health care system. Envisioning a Digital Health Advisor,

Ms. Whitfield is a participant in Independence at Home, a congressionally authorized pilot program. The program gives the sickest Medicare patients primary care right where they live. Since launching in 2012, it has been a tremendous success, delivering high-quality care at a lower cost than traditional Medicare. Ezekiel J. Emanuel: Elderly, Ailing – and Treated at Home,

A retired banker and former city manager, he had no healthcare experience when he got the job as CEO of Miami-based Jackson Health System in May 2011. But what he did have — a track record of turning organizations around — proved to be enough. Now, five years later, Mr. Migoya has led the system through a complete 180. On brink of disaster, Jackson turns profitable thanks to visionary CEO,

Patients who use Google search or WebMD to self-diagnose tend to assume the worst or end up with the wrong diagnosis.  Another challenge is that patients often expect treatments that clash with evidence-based quality measures.  Bridging the Expectation Gap in the ED,

In 2007, Mayo Clinic launched an initiative to better understand and address physician burnout by leveraging its expertise in internal medicine, psychiatry, psychology, and other specialties.  Clinic researchers have found several factors that correlate with physician burnout, including poor leadership. At Mayo Clinic, there is such a thing as a free lunch, 

ACA Implementation
On April 29, 2016, the Centers for Medicare and Medicaid Services posted in the Federal Register and at its Paperwork Reduction Act (PRA) website its final proposal for Transparency in Coverage Reporting for Qualified Health Plans (QHPs).  CMS Releases Revised Transparency Proposal For QHPs, 

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses how the debate between Hillary Clinton and Bernie Sanders about how to get to universal coverage has generated more support among Democrats for expanding the Affordable Care Act (and less support for the law as is).  Clinton-Sanders Contest Fuels Democratic Support for Expanding Obamacare,  

The federal government paid bonuses to 231 hospitals with subpar quality because their patients tend to be less expensive for Medicare, new research shows.  Medicare Pays Bonuses To 231 Hospitals With Lower Quality Because Of Cheaper Costs,

This Visualizing Health Policy infographic looks at eligibility and coverage trends in employer-sponsored health insurance. Since 2000, the share of workers covered by employers’ health benefits at both offering and non-offering firms has dropped to 56%, with the biggest decrease among employees working for small firms (3-199 workers). Eligibility and Coverage Trends in Employer-Sponsored Insurance,

While consolidation may generate less competitive prices for consumers, the health care law gives states a powerful bargaining chip: the ability to design their marketplaces.  Differing Impacts of Market Concentration on Affordable Care Act Marketplace Premiums,

The Treasury Inspector General for Tax Administration’s (TIGTA) analysis of more than 2.6 million returns with PTC claims filed between January 20 and May 28, 2015 found that the IRS accurately determined premium tax credits on 93 percent of the returns.  ACA Implementation Round-Up: Insurer Quality Ratings And More, 

As insurers around the country begin requesting rate changes for plans in 2017 Affordable Care Act marketplaces, this new policy insight from Kaiser Family Foundation insurance experts explains the key factors that will influence proposed premiums in the exchanges’ fourth year.  What to Look for in 2017 ACA Marketplace Premium Changes,

Insurers have begun to propose big premium increases for coverage next year as some struggle to make money in a market where their costs have soared.  On Wednesday, Humana Inc. said it made a slim profit on individual plans in the first quarter, not including some administrative costs, but still expects a loss for the full year.  Health Insurers Struggle to Offset New Costs,

Moms have another reason to smile this Mother’s Day: the uninsurance rate among mothers living with dependent children under the age of 19 fell 3.8 percentage points between 2013 and 2014.  How Are Moms Faring under the Affordable Care Act? Evidence through 2014, 

The authors from Health Affairs examined the impact of market concentration on the growth of health insurance premiums between 2014 and 2015 in two ACA state-based Marketplaces: Covered California and NY State of Health.  They found that more concentrated health plan markets were associated with lower premium growth in California but higher premium growth in New York. Differing Impacts of Market Concentration on Affordable Care Act Marketplace Premiums (abstract),

ELSEWHERE IN THE NEWS

Drugmakers assert that promoting their products makes patients aware of conditions they can then flag for their doctor.  In November 2015 the American Medical Association asked for a ban on these ads, saying that they are partially responsible for the skyrocketing costs of drugs.  Scientific American,

Simple math errors at a tiny Massachusetts hospital have created big problems for other hospitals in the state, contributing to a potential $160 million drop in federal Medicare payments over the next year.  Boston Globe,

New York’s governor is seeking federal approval to extend Medicaid coverage to inmates who face serious health challenges immediately before they’re released from prison. The governor says that too many inmates leave prison with serious mental health and addiction challenges.  NY Times,

A study analyzing data from the Mount Sinai emergency department in New York found that patients with limited English are likely to make a return visit to the ER within 72 hours. Annals of Emergency Medicine (abstract), 

Seven of the 10 U.S. hospitals with the biggest surpluses from patient care services in 2013 were not-for-profits, according to a new study based on Medicare cost reports.  Health Affairs (abstract), 

Gundersen Health has called a Health Affairs study published this week that dubbed Gundersen the most profitable hospital in the United States misleading and “simply not true.  Healthcare Finance,

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller abuse. Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.  Kaiser, 

Johnson & Johnson must pay $55 million to a 62-year-old South Dakota woman who blamed her ovarian cancer on the company’s talcum powder in the second such trial loss this year. Bloomberg,

Some of the most expensive drugs are covered under Medicare’s medical benefit, Part B, because they are administered by a physician. To help change these incentives and control costs, CMS has proposed a new demonstration program, which offers a few different reimbursement methods for Part B drugs.  Health Affairs Blog, 

Despite improvements in both care access and care quality, a new report from the Agency for Healthcare Research and Quality (AHRQ) finds racial and economic disparities persist in healthcare.  AHRQ, 

A new study published in The BMJ confirms that medical errors are the third leading cause of death in United States, behind only heart disease and cancer.  Medical error—the third leading cause of death in the US,  BMJ, 

Health care professionals, professional societies, large employer groups, patient advocacy organizations, and researchers voiced the need to reduce the estimated high toll of medical errors and adverse events, Donald M. Berwick, MD, MPP, JAMA Viewpoint,

Patients taking the antipsychotic drug Abilify, one of the country’s top-selling prescription medications, have reported uncontrollable urges to gamble, binge eat, shop, and have sex, the US Food and Drug Administration said in a warning Tuesday.  FDA,

New York City agreed to pay the U.S. government $4.3 million to settle a civil fraud lawsuit accusing the city’s fire department of accepting tens of thousands of improper Medicare reimbursements for emergency ambulance services.  NY Times,

Whether people have a reliable place to seek medical care varies widely by state, show new data out from the CDC. Also of note: The percentage of people who hadn’t seen a doctor in the past year was lower in states that have expanded Medicaid under Obamacare.  CDC,

Deaths from hepatitis C in the United States continued climbing in 2014, the Centers for Disease Control and Prevention reported on Wednesday, but experts hope the trend will reverse over the next few years as more people with the virus receive highly effective new treatments.  NY Times, 

Since 2012, the Center for Medicare and Medicaid Services (CMS) has introduced more than a dozen new Medicare payment models. Most of them emanate from the Center for Medicare and Medicaid Innovation (CMMI), whose strategy is to launch various initiatives, evaluate them rapidly, and expand those that reduce spending without harming quality of care.  NEJM Perspective,

Although spending rates on health care and social services vary substantially across the states, little is known about the possible association between variation in state-level health outcomes and the allocation of state spending between health care and social services. Health Affairs,

 

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