In this summary, you’ll find information on NYS’s Essential Health Benefits plan, the decline of prescription drug abuse, the increase number of knee replacement surgeries covered by Medicare and more!
Please let us know us what you think and if there is a particular topic you would like to see covered.
We hope you enjoy your “Weekly Dose of Health News.”
Affordable Care Act
The Affordable Care Act has proven to be a boon for companies that specialize in reducing health care spending. USA Today examines the methods these companies are employing to help providers reduce costs (Kennedy, 9/24).
Beginning in 2014, the Affordable Care Act (ACA) provides for a significant Medicaid expansion uninsured, low-income adults. Kaiser Family Foundation has released a new report on how homeless individuals might benefit from the Medicaid expansion under the Affordable Care Act.
The New York State Department of Health (DOH) continues to move forward with implementation of the Affordable Care Act and the start up of the Health Benefit Exchange. This week, the DOH released a final report on the issues surrounding the selection of the essential health benefits (EHB) benchmark plan. The report discusses the implications that the EHB choice will have on consumers, businesses, and the state. The DOH is required to submit New York’s decision on the selection of a benchmark plan to the federal department of Health and Human Services by September 28th, 2012. The identification of the benchmark plan will form the basis of essential health benefits for New York’s individual and small group markets both inside and outside of the Exchange.
Prescription Drug Abuse
According to the National Survey on Drug Use and Health , prescription drug abuse in the United States fell to its lowest level since 2002. The sharpest reduction in prescription drug abuse was seen among young adults between the ages of 18-25. The survey, sponsored by the Substance Abuse and Mental Health Services Administration, collects data from interviews with 67,500 people age 12 and older. Some experts attribute the decrease in abuse to the rise in prescription-drug monitoring programs implemented by various states (USA Today, Leger, 9/25).
On a related note, the Wall Street Journal writes about some unintended consequence of new state laws that are cracking down on prescription drug abuse. The article describes some of the obstacles these laws have created for individuals with a legitimate need for prescription painkillers. Some patients have had to travel long distances to fill prescriptions or go without pain medication for lengthy periods of time. These circumstances have put drug-enforcement and public-health officials at odds with some doctors and patients legitimately prescribed the pills (Martin, 9/26).
The field of addiction treatment is undergoing transformation as providers are moving away from 12-step programs and a medication-free approach. The Los Angeles Times profiles how doctors and the National Institute on Drug Abuse are pushing for mainstream recognition of addiction as a disease and the use of medical treatments in therapy (Roan, 9/22).
The Wall Street Journal writes about the growing popularity of consumer-directed health insurance plans among individuals seeking more affordable insurance options. These plans typically involve lower premiums but higher deductibles and are considered an attractive option for healthy individuals. Data from the Kaiser Family Foundation show that in 2012, high-deductible plans had premiums that averaged just under $5,000 for single coverage, about 15% lower than preferred provider organization (PPO) plans, the most common kind of coverage (Marte, 9/24).
The Wall Street Journal reports that two major American employers are changing how they provide health insurance to employees. Both Sears and Darden Restaurants will be giving their employees a lump sum of money to purchase insurance from an online marketplace. If successful this change could spark a national trend in how employers provide health care to workers. Some health care advocates worry that this model leaves employees exposed to the increasing costs of health insurance (Mathews, 9/26).
The New York Times reports that the Obama administration is developing a pilot project to encourage consumers to report medical mistakes and unsafe practices by health care providers. Currently there is no mechanism for consumers to report such information and federal officials say that medical mistakes often go unreported (Pear, 9/22).
Extending office hours at primary care physicians’ offices may reduce health care costs. According to a new study published in the Annals of Family Medicine, when a patient seeks care at an urgent care center or emergency room because their doctor’s office is closed the cost of that care rises. The study was based on data collected from 2000 to 2008 regarding more than 30,000 patients between 18 and 90 years old, all of whom had a usual source of health care. The researchers found that when physicians expanded their office hours, patients’ health care costs were reduced by more than 10 percent.
Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) released a new brief which highlights data from a survey of Medicaid coverage of recommended preventive services for adults in Medicaid fee-for-service programs. The survey, fielded by KCMU and Health Management Associates, found that preventive services were generally well-covered by state Medicaid programs in 2010. Although there was some variation in which services were covered, each preventive service was covered by at least half if not two-thirds of states.
A new study published in Health Affairs proposes that the use of observation units in hospitals to provide care to certain patients may be more efficient than admitting them to the hospital and can reduce costs. However, such units are present in only about one-third of US hospitals. The study’s authors created a simulation model and estimated that if a hospital added an observation unit, it would save $4.6 million per year, and the national annual savings would be $3.1 billion.
New research published in the Journal of American Medical Association (JAMA) this week shows that the number of knee replacements paid for by Medicare has more than doubled over the past two decades. Researchers examining Medicare insurance claims found that in 2010, people over 65 underwent 243,802 operations for knee replacement, up from 93,230 in 1991. The study’s authors theorized that the increase in volume is likely due to a number of factors, including the growing population of older people and an increase in obesity that increases wear on knees.
-Jaime Venditti, 9/28/12