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Health Affairs

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https://www.readbyqxmd.com/read/28100464/six-month-market-exclusivity-extensions-to-promote-research-offer-substantial-returns-for-many-drug-makers
#1
Aaron S Kesselheim, Benjamin N Rome, Ameet Sarpatwari, Jerry Avorn
To incentivize pharmaceutical manufacturers to invest in areas of unmet medical need, policy makers frequently propose extending the market exclusivity period of desired drugs. Some such proposals are modeled after the pediatric exclusivity patent extension program, which since 1997 has provided six additional months of market exclusivity for drugs studied in children. The most recent proposal would encourage rare disease research by providing six months of extended exclusivity for any existing drug that is granted subsequent FDA approval for a new rare disease indication...
January 18, 2017: Health Affairs
https://www.readbyqxmd.com/read/27974361/one-in-five-inpatient-emergency-department-cases-may-lead-to-surprise-bills
#2
Christopher Garmon, Benjamin Chartock
A surprise medical bill is a bill from an out-of-network provider that was not expected by the patient or that came from an out-of-network provider not chosen by the patient. In 2014, 20 percent of hospital inpatient admissions that originated in the emergency department (ED), 14 percent of outpatient visits to the ED, and 9 percent of elective inpatient admissions likely led to a surprise medical bill.
December 14, 2016: Health Affairs
https://www.readbyqxmd.com/read/27913569/national-health-spending-faster-growth-in-2015-as-coverage-expands-and-utilization-increases
#3
Anne B Martin, Micah Hartman, Benjamin Washington, Aaron Catlin
Total nominal US health care spending increased 5.8 percent and reached $3.2 trillion in 2015. On a per person basis, spending on health care increased 5.0 percent, reaching $9,990. The share of gross domestic product devoted to health care spending was 17.8 percent in 2015, up from 17.4 percent in 2014. Coverage expansions that began in 2014 as a result of the Affordable Care Act continued to affect health spending growth in 2015. In that year, the faster growth in total health care spending was primarily due to accelerated growth in spending for private health insurance (growth of 7...
December 2, 2016: Health Affairs
https://www.readbyqxmd.com/read/27784722/employer-sponsored-insurance-offers-largely-stable-in-2014-following-aca-implementation
#4
Jean Abraham, Anne B Royalty, Coleman Drake
Affordable Care Act provisions implemented in 2014 could have influenced employers' decisions to offer health insurance. Using data for 2014 from the Medical Expenditure Panel Survey-Insurance Component, we found little change in employer-sponsored health insurance offerings: More than 95 percent of employers either continued offering coverage or continued not offering it between 2013 and 2014. Fewer than 3.5 percent of employers dropped coverage, and 1.1 percent added coverage.
October 26, 2016: Health Affairs
https://www.readbyqxmd.com/read/28069862/health-professions-workforce-recent-grants-awarded
#5
(no author information available yet)
No abstract text is available yet for this article.
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069861/the-fine-line-between-doctoring-and-dealing
#6
Pooja Lagisetty
To treat a patient with addiction, a physician must overcome feelings of frustration and betrayal.
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069860/in-opioid-withdrawal-with-no-help-in-sight
#7
Travis N Rieder
A patient receives prescription opioids after an accident-and no support from his physicians as he weans himself off.
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069859/global-health-a-pivotal-moment-of-opportunity-and-peril
#8
Lawrence O Gostin, Eric A Friedman
A growing tide of populism in Europe and the United States, combined with other factors, threatens the solidarity upon which the global health movement is based. The highest-profile example of the turn toward populism is US president-elect Donald Trump, whose proposals would redefine US engagement in global health, development, and environmental efforts. In this challenging landscape, three influential global institutions-the United Nations, the World Health Organization, and the World Bank-are undergoing leadership transitions...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069858/large-reductions-in-amenable-mortality-associated-with-brazil-s-primary-care-expansion-and-strong-health-governance
#9
Thomas Hone, Davide Rasella, Mauricio Barreto, Rifat Atun, Azeem Majeed, Christopher Millett
Strong health governance is key to universal health coverage. However, the relationship between governance and health system performance is underexplored. We investigated whether expansion of the Brazilian Estratégia de Saúde da Família (ESF; family health strategy), a community-based primary care program, reduced amenable mortality (mortality avoidable with timely and effective health care) and whether this association varied by municipal health governance. Fixed-effects longitudinal regression models were used to identify the relationship between ESF coverage and amenable mortality rates in 1,622 municipalities in Brazil over the period 2000-12...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069857/market-share-matters-evidence-of-insurer-and-provider-bargaining-over-prices
#10
Eric T Roberts, Michael E Chernew, J Michael McWilliams
Proposed mergers among large US health insurers and growing consolidation among providers have renewed concerns about the effects of market concentration on commercial health care prices. Using multipayer claims for physician services provided in office settings, we estimated that-within the same provider groups-insurers with market shares of 15 percent or more (average: 24.5 percent), for example, negotiated prices for office visits that were 21 percent lower than prices negotiated by insurers with shares of less than 5 percent...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069856/patient-hospital-experience-improved-modestly-but-no-evidence-medicare-incentives-promoted-meaningful-gains
#11
Irene Papanicolas, José F Figueroa, E John Orav, Ashish K Jha
The Centers for Medicare and Medicaid Services (CMS) has played a leading role in efforts to improve patients' experiences with hospital care. Yet little is known about how much patient experience has changed over the past decade, and even less is known about the impact of CMS's most recent strategy: tying payments to performance under the Value-Based Purchasing (VBP) program. We examined trends in multiple measures of patient satisfaction in the period 2008-14. We found that patient experience has improved modestly at US hospitals-both those participating in the VBP program and others-with the majority of improvement concentrated in the period before the program was implemented...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069855/prevalence-and-spending-associated-with-patients-who-have-a-behavioral-health-disorder-and-other-conditions
#12
Ken Thorpe, Sanjula Jain, Peter Joski
: People with multiple medical conditions are a growing and increasingly costly segment of the U.S. POPULATION: Despite the co-occurrence of physical and behavioral health comorbidities, the US health care system tends to treat these conditions separately rather than holistically. To identify opportunities for population health improvement, we examined the treated prevalence of and health care spending on behavioral health disorders, by the number of coexisting physical disorders, among noninstitutionalized adults...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069854/for-many-served-by-the-ryan-white-hiv-aids-program-disparities-in-viral-suppression-decreased-2010-14
#13
Rupali K Doshi, John Milberg, Theresa Jumento, Tracy Matthews, Antigone Dempsey, Laura W Cheever
For twenty-five years, the Ryan White HIV/AIDS Program has supported a comprehensive system of health services for vulnerable and under- or uninsured people living with HIV. Using data from the Health Resources and Services Administration about people living with HIV and served by the Ryan White HIV/AIDS Program, we found reductions in disparities in viral suppression rates between 2010 and 2014-with rates for Blacks/African Americans, adolescents and young adults, and people living in the South becoming more similar to rates for Whites, older adults, and people in other regions of the United States, respectively...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069853/sharp-decline-in-prostate-cancer-treatment-among-men-in-the-general-population-but-not-among-diagnosed-men
#14
Tudor Borza, Samuel R Kaufman, Vahakn B Shahinian, Phyllis Yan, David C Miller, Ted A Skolarus, Brent K Hollenbeck
The indolent nature of many prostate cancers has heightened concerns that harms from treatment may outweigh those from the disease and has resulted in a growing consensus in favor of less aggressive screening and treatment. We sought to understand the population-level impact of this consensus on the treatment of prostate cancer. Using national Medicare data for the period 2007-12, we assessed treatment rates among men with newly diagnosed prostate cancer. We identified both population-based rates (which are sensitive to changes in diagnosis and treatment patterns) and rates among diagnosed men (which are sensitive only to changes in treatment patterns)...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069852/affordable-care-act-changes-to-medicare-led-to-increased-diagnoses-of-early-stage-colorectal-cancer-among-seniors
#15
Brett Lissenden, Nengliang Aaron Yao
The Affordable Care Act (ACA) helped make preventive care, including recommended cancer screening, more affordable and accessible for millions of Americans. Using population-based data from the Surveillance, Epidemiology, and End Results (SEER) Program, we estimated the impact of ACA policy changes to facilitate the diagnosis of cancer at an earlier and more treatable stage. We estimated that the ACA resulted in an increase of 8,400 (8 percent) diagnoses of early-stage colorectal cancer among US seniors in the period 2011-13...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#16
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069850/spending-on-care-after-surgery-driven-by-choice-of-care-settings-instead-of-intensity-of-services
#17
Lena M Chen, Edward C Norton, Mousumi Banerjee, Scott E Regenbogen, Anne H Cain-Nielsen, John D Birkmeyer
The rising popularity of episode-based payment models for surgery underscores the need to better understand the drivers of variability in spending on postacute care. Examining postacute care spending for fee-for-service Medicare beneficiaries after three common surgical procedures in the period 2009-12, we found that it varied widely between hospitals in the lowest versus highest spending quintiles for postacute care, with differences of 129 percent for total hip replacement, 103 percent for coronary artery bypass grafting (CABG), and 82 percent for colectomy...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069849/lower-versus-higher-income-populations-in-the-alternative-quality-contract-improved-quality-and-similar-spending
#18
Zirui Song, Sherri Rose, Michael E Chernew, Dana Gelb Safran
As population-based payment models become increasingly common, it is crucial to understand how such payment models affect health disparities. We evaluated health care quality and spending among enrollees in areas with lower versus higher socioeconomic status in Massachusetts before and after providers entered into the Alternative Quality Contract, a two-sided population-based payment model with substantial incentives tied to quality. We compared changes in process measures, outcome measures, and spending between enrollees in areas with lower and higher socioeconomic status from 2006 to 2012 (outcome measures were measured after the intervention only)...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069848/aco-affiliated-hospitals-reduced-rehospitalizations-from-skilled-nursing-facilities-faster-than-other-hospitals
#19
Ulrika Winblad, Vincent Mor, John P McHugh, Momotazur Rahman
Medicare's more than 420 accountable care organizations (ACOs) provide care for a considerable percentage of the elderly in the United States. One goal of ACOs is to improve care coordination and thereby decrease rates of rehospitalization. We examined whether ACO-affiliated hospitals were more effective than other hospitals in reducing rehospitalizations from skilled nursing facilities. We found a general reduction in rehospitalizations from 2007 to 2013, which suggests that all hospitals made efforts to reduce rehospitalizations...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069847/acos-serving-high-proportions-of-racial-and-ethnic-minorities-lag-in-quality-performance
#20
Valerie A Lewis, Taressa Fraze, Elliott S Fisher, Stephen M Shortell, Carrie H Colla
Accountable care organizations (ACOs) are intended, in part, to improve health care quality. However, little is known about how ACOs may affect disparities or how providers serving disadvantaged patients perform under Medicare ACO contracts. We analyzed racial and ethnic disparities in health care outcomes among ACOs to investigate the association between the share of an ACO's patients who are members of racial or ethnic minority groups and the ACO's performance on quality measures. Using data from Medicare and a national survey of ACOs, we found that having a higher proportion of minority patients was associated with worse scores on twenty-five of thirty-three Medicare quality performance measures, two disease composite measures, and an overall quality composite measure...
January 1, 2017: Health Affairs
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