May 17th, 2013
In the May Health Affairs Narrative Matters essay, two graduate students describe their fight with the bureaucracy to gain coverage for their son under the Children’s Health Insurance Program, and they express the hope that provisions of the Affordable Care Act will cut the red tape. The article, “To Cover Their Child, One Couple Navigates A Health Insurance Maze In Pennsylvania, is by Ari Friedman, a fifth-year medical-doctoral student in health economics at the University of Pennsylvania’s Perelman School of Medicine and Wharton School, and Tara Mendola is a sixth-year graduate student in comparative literature at New York University. Read the rest of this entry »
May 15th, 2013
A new study, released today as a Web First by Health Affairs, reports that cancer patients in Washington state were 2.65 times more likely to file for bankruptcy than people without cancer. Of 197,840 cancer patients age 18 or older in the western district of Washington between 1995 and 2009, 4,408 (2.2 percent) filed for bankruptcy protection after being diagnosed with cancer. Among a control group of 197,840 people from that same region who did not have cancer, only 2,291 (1.1 percent) filed for bankruptcy.
“Although the risk of bankruptcy for cancer patients is relatively low in absolute terms, bankruptcy represents an extreme manifestation of what is probably a larger picture of economic hardship for cancer patients,” conclude Scott Ramsey of the Fred Hutchinson Cancer Research Center and coauthors. “As a policy issue, there may be a role for employers and governments in creating programs or incentives to reduce the likelihood of financial insolvency, given that bankruptcies are ‘lose-lose’ events for debtors and creditors alike.” Read the rest of this entry »
May 15th, 2013
The list of most-read Health Affairs Blog posts for April includes four posts in Tim Jost’s ongoing series on implementing the Affordable Care Act; number one on the top-ten list is Tim’s post about proposed regulations on health insurance exchange navigators. The list also includes posts on accountable care organizations, patient-centered care, controlling health care costs. and more.
The full list is below: Read the rest of this entry »
May 13th, 2013
If you missed last week’s Health Affairs briefing on our May issue, “Tackling The Cost Conundrum,” or if you just want to see it again, video and speaker materials are now available on the Health Affairs website. You can watch the whole briefing or select particular panels or speakers. Read the rest of this entry »
May 10th, 2013
At Managed Care Matters, Joe Paduda presents highlights of recent health policy blogging in a new Health Wonk Review. Among the pieces Joe highlights are Health Affairs Blog posts by John Holahan & Stacey McMorrow and Charles Roehrig on the causes and likely longevity of the recent slowdown in health spending growth. Read the rest of this entry »
May 6th, 2013
Health Affairs’ May issue, released today, analyzes the recent slowing in the growth of health care expenditures and explores whether the trend will last. The issue also addresses major cost drivers in Medicare and presents proposals for putting the program on a more sustainable path. Another article tracks federal spending on mental health during severe state budget constraints throughout the recession.
As Health Affairs Founding Editor John Iglehart notes on his “From The Founding Editor” page (quoted at length below), the new thematic volume, “Tackling The Cost Conundrum,” continues the journal’s coverage of a topic that has been a “driving theme” of the journal since its inception. The May issue will be discussed at a National Press Club briefing tomorrow morning, Tuesday, May 7. The issue and briefing are supported by a grant from the Robert Wood Johnson Foundation.
Researchers writing in the new issue are cautiously optimistic that the slowdown in health care spending is here to stay. A study by Michael Chernew, Alexander Ryu, and colleagues at Harvard Medical School looks at two factors potentially contributing to the record slowdown in growth to 3.1 percent during 2007-11: job loss and benefit changes shifting costs to the insured. Analyzing National Health Expenditure Accounts and large-employer data, the authors found that benefit design changes that increased enrollees’ out-of-pocket costs were responsible for about one-fifth of the observed decrease in the rate of growth. However, the slowdown occurred even when benefit generosity at large firms was held constant. The authors suggest that other factors are largely responsible and that major events, such as health reform, shifts in payment methodology, and the transformation of the delivery system’s organization may contribute to a longer-term trend of slower spending growth.
In a related article, David Cutler and Nikhil Sahni of Harvard University conclude that fundamental changes, including less-rapid development of imaging technology and new pharmaceuticals, increased patient cost-sharing, and greater provider efficiency, led to the majority of the slowdown in health care spending growth; if this path continues for the next ten years, public-sector health care spending could wind up $770 billion under projections, they write. Read the rest of this entry »
May 2nd, 2013
US presidents and policymakers have for decades struggled with the issue of ballooning health care costs and were unsuccessful, or unmotivated, in finding a path to lasting cost containment. Recently, though, there has been progress. The forthcoming issue of Health Affairs, “Tackling the Cost Conundrum,” explores the slowing growth of health care expenditures of late and examines whether it is a temporary or lasting phenomenon; the issue also examines major cost drivers and presents proposals for putting Medicare on a more sustainable path.
Please join Health Affairs Founding Editor John Iglehart on Tuesday, May 7, at the National Press Club in Washington, DC, for a Health Affairs briefing at which we unveil the May 2013 thematic issue, “Tackling the Cost Conundrum.” The thematic issue and briefing are supported by a grant from the Robert Wood Johnson Foundation.
WHEN & WHERE:
Tuesday, May 7, 2013
9:00 a.m. – 12:30 p.m.
National Press Club
529 14th Street NW (Metro Center)
Follow live Tweets from the event @HA_Events, and join in the conversation with the hashtag #HA_Costs.
Read the rest of this entry »
May 2nd, 2013
Yesterday, Senator Orrin Hatch (R-Utah) and Representative Fred Upton (R-Mich.) released their plan for “Making Medicaid Work.” One of the blueprint’s key proposals is to implement per capita caps, which would impose a cap on the funds that the federal government contributes to states for each Medicaid beneficiary. In April Health Affairs released a Health Policy Brief that explains how a per capita cap would work and looks at the arguments for and against the approach:
Supporters contend that instituting a system of per capita caps would moderate the growth of federal spending on Medicaid. They describe the approach as a middle ground between the program as it currently operates and other proposals such as block grants, which would more dramatically change the way federal Medicaid funding is calculated.
Critics contend that a per capita cap approach would not necessarily slow the rate of growth of Medicaid spending. If it did, they say, it would do so by shifting the costs to the states, which would face even greater pressures to cut services or limit eligibility, ultimately limiting many poor Americans’ access to care. What’s more, they contend that setting up a system of per capita caps would be very complex and difficult to administer.
Read the rest of this entry »
April 26th, 2013
Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the association’s comprehensive guide that sets the classification, diagnosis, and treatment of mental disorders across the United States and the world. In an April 24 Health Affairs Web First analysis and commentary, Helena Hansen of New York University and coauthors argue that the revision process for the DSM-5 missed crucial population-level and social determinants of mental health disorders and their diagnoses.
Some of these include environmental factors triggering biological responses that manifest in behavior; differing cultural perceptions in defining normal and abnormal behaviors; and institutional pressures, such as insurance reimbursements, disability benefits, and pharmaceutical marketing. At stake, the authors believe, are billions of dollars in insurance payments and the accurate diagnoses and treatment of patients.
To address future DSM revisions, the Hansen and her colleagues propose the formation of an independent, multidisciplinary task force; the commentary outlines how this task force would operate. Read the rest of this entry »
April 26th, 2013
Over at InsureBlog, Hank Stern hosts a “Money Tree” edition of the Health Wonk Review. Hank highlights a number of great posts, including a Health Affairs Blog post by Paul Ellwood — known as the father of managed care — proposing a framework for holding health spending constant as a percentage of GDP. Read the rest of this entry »