In this week’s summary, the state of New York once again finds itself facing federal scrutiny over its Medicaid billing, more and more companies are incentivizing personal health, we highlight details on the latest advancements in prostate screening and much, much more!
Affordable Care Act
A new report from the Society of Actuaries finds that the Affordable Care Act will increase health insurance premium costs. USA Today writes that while some states will see medical claims costs per person decline, the report concluded that the overwhelming majority will see double-digit increases in their individual health insurance markets, where people purchase coverage directly from insurers. The report attributes the increased claim costs to the fact that sicker individuals will be joining the insurance risk pool (Kennedy, 3/26).
The Wall Street Journal has a story about the changing views of some business owners regarding the costs of the Affordable Care Act. Restaurant owners have been fierce critics of the health-care overhaul law, fearing that its mandate for employers to offer insurance more broadly will drive up costs and deter hiring. Now, some operators say the law may not be that costly after all. They say many employees won’t qualify for coverage, and many of those who do qualify will decline company-offered insurance (Thurm, 3/27).
The Washington Post profiles the efforts by the American Association of Nurse Practitioners to increase the number of states that allow nurse practitioners to practice without physician supervision. The effort is getting a boost from consumer advocates and state officials concerned about the Affordable Care Act’s looming impact on the availability of doctors. Beginning in January, about 27 million uninsured Americans are expected to get coverage under the law, contributing to a projected shortage of about 45,000 primary-care physicians by 2020, according to the Association of American Medical Colleges. (Aizenman, 3/24).
New York State is facing more scrutiny from the Centers for Medicaid and Medicare Services (CMS) for its Medicaid billing practices. The Times Union reports that a new audit from the U.S. Department of Health and Human Services Office of Inspector General found billing errors for services provided in New York’s network of residential centers for mentally ill youths. As a result of the audit New York State is directed to return $27.4 million dollars to CMS. Officials from the Cuomo administration assert that the program is being closed down and they will work with CMS officials to address the audit findings (Odato, 3/26).
Despite growing warnings from pediatricians about feeding newborns anything other than breast milk or formula, many mothers appear to be introducing solid food well before their babies’ bodies can handle it, says a study published this week in the journal Pediatrics. In a national survey of 1,334 mothers, conducted by the Centers for Disease Control and Prevention, 40 percent said they gave their baby solid food before they were 4 months old, with 9 percent starting as early as 4 weeks. Doctors now recommend waiting until a baby is at least 6 months old.
The New York Times writes that a number of companies have been increasing the use of incentives to persuade workers to improve their health in an effort to reduce health care costs. A recent survey by the human-services consultant Aon Hewitt has found that the majority of companies, or 79 percent, use rewards like lower insurance premiums to try to nudge employees to improve their health. But increasingly, the survey found, employers are taking the programs a step further, by penalizing employees who do not make healthy choices and linking incentives to measurable results (Thomas, 3/25).
How often patients land in the hospital—and how long they stay—were better indicators of which patients would return to the hospital unnecessarily than types of illnesses, number of prescriptions and other factors, a study found. The research, published in JAMA Internal Medicine, seeks to identify patients at high risk for avoidable hospital stays by sorting through patient data in search of flags that predict who will make a repeat hospital visit. Policymakers have targeted hospital readmissions as a source of potential waste.
The New York Times reports that sophisticated new prostate cancer tests are coming to market that might supplement the unreliable P.S.A. test, potentially saving tens of thousands of men each year from unnecessary biopsies, operations and radiation treatments. Some of the tests are aimed at reducing the false alarms caused by elevated P.S.A. readings. Others, intended for use after a definitive diagnosis, examine the genetic workings of the cancer to distinguish dangerous tumors that need treatment from slow-growing ones that might be left alone (Pollack, 3/26).