Research Roundup - November 2015

Colorado

Coloradans’ Spending on Healthcare Quadruples in Two Decades

By David Olinger, The Denver Post | Nov. 16, 2015

Consumer spending on healthcare in Colorado has quadrupled in the past two decades, according to a report issued by the newly-formed Colorado Commission on Affordable Healthcare. The Commission forecasts continued cost increases "without changes in the health system as a whole," but there’s disagreement on the form that the changes should take.

Maryland

Budget Switch For Maryland Hospitals Is Starting To Pay Off

By Andrea Hsu, National Public Radio | Nov. 11, 2015

Results are in from the first year of a bold change to the way hospitals get paid in Maryland, and so far the experiment to rein in healthcare costs seems to be working. Maryland phased out fee-for-service payments to hospitals in favor of a fixed pot of money each year. A report on Maryland’s global budgeting program in the latest New England Journal of Medicine says the experiment saved an estimated $116 million in 2014, the first year it was in operation.

Maryland’s Maverick Healthcare Overhaul: A Physician Perspective

By Martin Makary and Seth Goldstein, Health Affairs Blog | July 20, 2015

The change of incentives has the potential to positively alter hospital workplace culture by halting the current revenue-based push to do more — an effort that invariably trickles down to doctors. Maryland’s framework has the potential to break these vicious cycles and replace them with virtuous ones leading to greater quality and health.

Oregon

Young Oregon Latinos Face Healthcare Barriers

By Julie Cooper, The Daily Barometer | Oct. 26, 2015

Research from the Oregon State University found that discrimination by healthcare providers may be preventing young Latinos from seeking access to health services. The findings show that 40 percent of participants said they experience discrimination when obtaining healthcare services. The study also showed experiences of discrimination were found to be significantly higher for foreign-born Latinos than for US-born Latinos. If someone feels discriminated against, they are less likely to access healthcare services in a timely manner, delaying easily treatable health issues until the situation is too urgent to ignore. This delay in receiving treatment can lead to the development of chronic illnesses, which are more costly to treat.

Washington

The Healthier Washington Initiative Promotes Accountable Communities of Health Statewide

By Taylor Kniffin, State Reforum | Nov. 13, 2015

This blog post discusses work currently underway as part of the state’s Healthier Washington initiative - in particular the Accountable Communities of Health (ACH) regions that bring together public and private entities to improve health and health systems, improve population health and drive physical and behavioral health integration.

Go here for more background information on: surprise medical bills, healthcare costs and public health

Recent Reports

Models of Care for High-Need, High-Cost Patients: An Evidence Synthesis

The Commonwealth Fund | Oct. 29, 2015

This brief highlights promising models for treating high-need, high-cost patients and discusses ways to address barriers to successful implementation, including the lack of financial incentives in fee-for service reimbursement. In addition, a separate blog post  offers guidance on how to improve outcomes and lower costs for “high-need, high-cost” patients -- laying out six principles for improving care for this population.

New IOM Report Calls for Change in Healthcare Diagnosis

Nurse.com | Nov 17, 2015

According to a report from the Institute of Medicine, most consumers will experience at least one diagnostic error in their lifetime, sometimes with devastating medical harm. In an effort to improve diagnosis and reduce errors, the authors calls for more effective teamwork among healthcare professionals, patients and families. The report also suggests enhanced training for healthcare professionals; more emphasis on identifying and learning from diagnostic errors and near misses in clinical practice; a payment and care delivery environment that supports the diagnostic process and a dedicated focus on new research.

Companies Continue Chipping away at Health Insurance Benefits

By Jayne O’Donnell, USA Today | Nov. 11, 2015

Although companies’ healthcare costs in 2015 rose at the lowest rate in at least 20 years, a report released by consulting firm Aon found that workers’ share of costs continues to skyrocket. The average amount workers have to contribute toward their healthcare is up more than 134% over the past decade and that trend will accelerate. According to the researchers at Aon a lot of this increase in out-of-pocket costs stem from the impending Cadillac tax, which penalizes companies for having generous health plans. Higher levels of cost sharing and high-deductible plans are seen as one way to avoid the tax.

Commentary/ News

Value-Driven Innovations Critical Healthcare Quality and Progress

By Kenneth Thorpe, The Huffington Post | Oct. 23, 2015

This commentary examines the shift to value-based healthcare, but offers a cautionary tale. Using a recent Institute of Clinical and Economic Review (ICER) evaluation of a medical device as an example, the author argues we can't afford to focus on just short-term cost savings while ignoring quality - in particular,  value that can improve lives and save dollars in the long run.

How Government Policy Promotes High Drug Prices

By Alfred Engelberg, Health Affairs Blog | Oct. 29, 2015

According to the Pharmaceutical Manufacturers Association, it takes at least 10 years to develop a new drug. It is no surprise that the typical monopoly period for new drugs is also 10-12 years. Yet, the pharmaceutical industry is becoming more and more dependent on the U.S. to conduct and pay for the basic biomedical research as the starting point the development of new drugs. The author argues that the government must stop the practice of giving away patents resulting from that research and manage those rights in a manner that assures that drugs developed with public support produce public economic benefit and not just company profits.

Anger Over Healthcare Costs is at a Breaking Point

By Ron Shinkman, FierceHealthFinance | Nov. 16, 2015

The real anger about healthcare costs--the kind that could actually reshape healthcare delivery--is beginning. Those grumblings are coming from Americans have been rudely slapped around in recent years paying more for premiums and in cost-sharing. Polling shows most people want to see a lot of different actions taken to contain healthcare costs, including government price controls of providers, drugs and devices.

Epic Fail:  Digitizing America’s Medical Records was Supposed to Help Patients and Save Money. Why hasn’t that Happened

By Patrick Caldwell, Mother Jones | November 2015

Epic is the leading vendor of software in the $9.3 billion electronic health records (EHR) sector. The company earned $1.8 billion in 2014 and is expanding at a rate of about 1,000 new employees a year. However, Epic has helped create a fragmented system that leaves doctors unable to share information across practices and hospitals. This lack of integration is especially worrisome for patients with lengthy and complicated health histories and slows efforts to improve care coordination.

New Math on Drug Cost-Effectiveness

Peter Bach, The New England Journal of Medicine | Nov. 5, 2015

This commentary explores the rising cost of drugs, including new drugs coming to market that, while highly effective, are also very expensive. The prices of these new drugs, and the rising prices of some already on the market are hurting many consumers and limiting their access to drugs. Many patients have to pay large sums out of pocket, and research shows that when that happens, some patients will stop taking medications even if they are very effective. “The reality of exorbitant drug pricing overshadows even the most exceptional stories of drug efficacy," the author said. “Hand clapping for science is now inextricably linked to hand-wringing over affordability.”

The Power of States as Public Purchasers in Healthcare

Ian Morrison, Hospitals and Health Network | Nov. 4, 2015

Private employers are becoming even more aggressive in their attempts to  to control healthcare costs, but their influence is limited. However, states are large employers, they run large Medicaid programs and some have their own health insurance exchanges. Increasingly, states including Washington and Arkansas are using this combined purchasing power to transform the healthcare marketplace and coordinate their payment reform efforts with private purchasers. Public purchasers (acting in concert with willing private purchasers) can have a powerful influence on healthcare transformation.

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