Research Roundup - June 2015

State News

Nurse-Led Clinic Opens in Minnesota

By Adam Rubenfire, Modern Healthcare | April 2, 2015

The University of Minnesota launched a new nurse-led outpatient clinic, which was made possible through the recent change in state scope-of-practice laws. The clinic is one of approximately 250 clinics nationwide that operates without physician oversight and will be used as a training facility for University of Minnesota nursing, pharmacy and other primary-care students. Minnesota is one of twenty states and the District of Columbia that allow nurse practitioners to practice independent of a physician.

Expensive ER fees perplex, exasperate unknowing patients

By Marlene Harris Taylor, Toledo Blade| May 25, 2015

As part of a Toledo Blade series of articles on the cost of medical care in the Toledo area, this article describes the anger and confusion of consumers who have received high bills as a result of emergency department care. Patients are frustrated with the hidden costs they are responsible for paying and are angered that there is not one standardized pricing menu for care costs.

University of Iowa launches state's first virtual health clinic

By Vanessa Miller, The Iowa Gazette| May 28, 2015

The University of Iowa launched the first virtual health clinic in the state. This internet-based clinic is designed to provide care for patients with minor illnesses and injuries and can be used by anyone in Iowa, regardless of their location, as long as they are in the state at the time of their “call.” The virtual clinic enables patients to discuss their symptoms with a University of Iowa-credentialed healthcare provider. The program could help residents living in rural parts of the state that would otherwise have to travel long distances for care.

Accountable Care Organizations Taking Hold and Improving Healthcare In California

By Stephen Shortell and Richard Scheffler, Health Affairs Blog | June 2, 2015

California’s healthcare leaders set an aspirational goal of 60 percent of the population receiving integrated care by 2022. This survey of ACO activity in the state finds that Accountable Care Organizations (ACOs) - a form of integrated care - are growing in size and number, serving more patients, and improving quality of care.  Enrollment in (ACOs) is projected to grow by approximately 48 percent in in California over the next two years.

Recent Reports

Extreme Markup: The Fifty U.S. Hospitals with the Highest Charge-to-Cost Ratios

Ge Bai and Gerard F. Anderson | Health Affairs | June 2015

This study identifies U.S. hospitals with the largest charge-to-cost ratios--approximately 10 times their Medicare-allowable costs--compared to the national average of 3.4 percent. While high markups have long generated consumer outrage, as outlined in a Consumers Union study. Maryland and West Virginia are currently the only states that regulate hospital markups to maintain low charge-to-cost ratios. This study received significant news coverage and commentary including this Washington Post story which included a great graphic.

Patient-Satisfaction Surveys on a Scale of 0 to 10: Improving Healthcare, or Leading It Astray?

Alexandra Junewicz and Stuart J. Youngner | Hastings Center Report | May-June 2015

This report discusses the connections that patient-satisfaction surveys have with the quality of care provided to patients. According to the authors, though patient satisfaction is an important aspect of good healthcare, there are some uses in which patient satisfaction surveys may not be indicative of quality care.. They point to three ways patients may be “satisfied.” First, they receive care that is medically necessary and improves their outcomes. Second, they receive care they want, but the care is unnecessary, costly and may may negatively affect health outcomes. The third category includes “humanistic” aspects of care that are less likely to affect health outcomes, but contribute to a sense of dignity and well being, such as good office staff communication, treating patients with respect, convenient parking, etc.  

Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Healthcare

Lydia Mitts and Cheryl Fish-Parcham, Families USA,| May 2015

The Affordable Care Act has increased access to health insurance and financial assistance for millions of Americans. However, consumers are still responsible for paying premiums and out-of-pocket healthcare costs, such as copays. This report examines the portion of adults who went without needed medical care because they could not afford these out-of-pocket costs and premiums, and the possible contributing factors to these affordability issues.

Do Patient-Centered Medical Homes Reduce Emergency Department Visits?

By Guy David, et al., Health Services Research | April 2015

This study assesses whether patient-centered medical homes reduce the number of visits to emergency departments (EDs). The findings show a 5 to 8 percent reduction in ED use among patients with chronic conditions, but no significant reduction among patients without chronic conditions. Researchers find that the reduction in ED utilization stems from better chronic illness management rather than increased access to primary care clinics.

CDC Launches Community Health Improvement Navigator

Centers for Disease Control and Prevention| May 2015

The CDC has launched  a new website that includes tools and resources for advocates and other stakeholders working on community health improvement issues. These tools include maps and infographics for data visualization.


Medicare Vies to keep ACOs on board with More Flexible Rules

CMS released the final rules for Medicare accountable care organizations (ACOs). In these revised rules, the medicare share savings program will offer a new track to take on more financial risk of patient care and will allow Medicare ACOs to avoid penalties beyond the initial three-year term.

More Health-care Insurers Seek Big Premium Increases

By Louise Radnofsky and Stephanie Armour, The Wall Street Journal| June 1, 2015

Major insurance carriers from around the country are proposing large premium rate increases for consumers who purchase individual plans. Insurers have said their rates for the year ahead reflect the impact of the law’s sweeping changes to the way health insurance is sold and priced. According to many insurers,  there are still many unknowns,  including how many people will enroll in coverage and the mix of healthy and unhealthy enrollees.

Free Market Ideology Doesn’t Work for Healthcare

Wendell Potter, The Center for Public Integrity| June 8, 2015

In this opinion piece, Wendell Potter argues that blind acceptance of price increases are the main cause of continuing price increases in healthcare. Although many would argue that the free market requires prices to increase, Potter instead points to the “medical industrial complex” and the negotiating power of large provider groups as reasons for the constant price jumps in care.

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