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Health Affairs

Pinar Karaca-Mandic, Andrew Wilcock, Laura Baum, Colleen L Barry, Erika Franklin Fowler, Jeff Niederdeppe, Sarah E Gollust
The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau's American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics...
March 15, 2017: Health Affairs
Timothy Stoltzfus Jost
The effort to repeal, replace, and repair the ACA faces myriad policy and political challenges.
March 13, 2017: Health Affairs
M Arantxa Cochero, Juan Rivera-Dommarco, Barry M Popkin, Shu Wen Ng
Mexico implemented a 1 peso per liter excise tax on sugar-sweetened beverages on January 1, 2014, and a previous study found a 6 percent reduction in purchases of taxed beverages in 2014. In this study we estimated changes in beverage purchases for 2014 and 2015. We used store purchase data for 6,645 households from January 2012 to December 2015. Changes in purchases of taxed and untaxed beverages in the study period were estimated using two models, which compared 2014 and 2015 purchases with predicted (counterfactual) purchases based on trends in 2012-13...
February 22, 2017: Health Affairs
Sean P Keehan, Devin A Stone, John A Poisal, Gigi A Cuckler, Andrea M Sisko, Sheila D Smith, Andrew J Madison, Christian J Wolfe, Joseph M Lizonitz
Under current law, national health expenditures are projected to grow at an average annual rate of 5.6 percent for 2016-25 and represent 19.9 percent of gross domestic product by 2025. For 2016, national health expenditure growth is anticipated to have slowed 1.1 percentage points to 4.8 percent, as a result of slower Medicaid and prescription drug spending growth. For the rest of the projection period, faster projected growth in medical prices is partly offset by slower projected growth in the use and intensity of medical goods and services, relative to that observed in 2014-16 associated with the Affordable Care Act coverage expansions...
February 15, 2017: Health Affairs
Timothy Stoltzfus Jost
The United States has never experienced a sea change in national health policy like that which occurred in early 2017.
February 13, 2017: Health Affairs
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
Tom Kenyon
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
Nancy Lutwak, Curt Dill
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
Julia Adler-Milstein, Sunny C Lin, Ashish K Jha
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
John P Kansky
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
Kathleen M Haddad
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
Pooja Lagisetty
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
(no author information available yet)
No abstract text is available yet for this article.
March 1, 2017: Health Affairs
Aroonsiri Sangarlangkarn
A physician reconnects with the patient who mentored her as a medical student and helps him make a final care decision.
March 1, 2017: Health Affairs
Judy H Ng, Faye Ye, Lauren M Ward, Samuel C Chris Haffer, Sarah Hudson Scholle
The Affordable Care Act requires the federal government to collect and report population data on race, ethnicity, and language needs to help reduce health and health care disparities. We assessed data availability in commercial, Medicaid, and Medicare managed care plans using the Healthcare Effectiveness Data and Information Set. Data availability varied but remained largely incomplete.
March 1, 2017: Health Affairs
Garret Johnson, Zoe M Lyon, Austin Frakt
Hospitals and health systems are increasingly offering their own insurance products, a type of consolidation known as "vertical integration." The relationship between plan-provider vertical integration and quality of care has not been examined extensively or over time. We created a new data set of all vertically integrated Medicare Advantage contracts operating in the period 2011-15 and tracked their characteristics and quality over time. While the percentage of vertically integrated contracts increased slightly between 2011 and 2015, the percentage of all Medicare Advantage enrollees in them declined from 24...
March 1, 2017: Health Affairs
Madeline Pesec, Hannah L Ratcliffe, Ami Karlage, Lisa R Hirschhorn, Atul Gawande, Asaf Bitton
Long considered a paragon among low- and middle-income countries in its provision of primary health care, Costa Rica reformed its primary health care system in 1994 using a model that, despite its success, has been generally understudied: basic integrated health care teams. This case study provides a detailed description of Costa Rica's innovative implementation of four critical service delivery reforms and explains how those reforms supported the provision of the four essential functions of primary health care: first-contact access, coordination, continuity, and comprehensiveness...
March 1, 2017: Health Affairs
James C Robinson, Timothy T Brown, Christopher Whaley
Reference pricing in health insurance creates incentives for patients to select for nonemergency services providers that charge relatively low prices and still offer high quality of care. It changes the "choice architecture" by offering standard coverage if the patient chooses cost-effective providers but requires considerable consumer cost sharing if more expensive alternatives are selected. The short-term impact of reference pricing has been to shift patient volumes from hospital-based to freestanding surgical, diagnostic, imaging, and laboratory facilities...
March 1, 2017: Health Affairs
Mary E Reed, E Margaret Warton, Eileen Kim, Matthew D Solomon, Andrew J Karter
Enrollment in high-deductible health plans is increasing out-of-pocket spending. But innovative plans that pair deductibles with value-based insurance designs can help preserve low-cost access to high-value treatments for patients by aligning coverage with clinical value. Among adults in high-deductible health plans who were prescribed medications for chronic conditions, we examined what impact a value-based pharmacy benefit that offered free chronic disease medications had on medication adherence. Overall, we found that the value-based plan offset reductions in medication adherence associated with switching to a deductible plan...
March 1, 2017: Health Affairs
Kevin W Smith, Anupa Bir, Nikki L B Freeman, Benjamin C Koethe, Julia Cohen, Timothy J Day
Using delivery system innovations to advance health care reform continues to be of widespread interest. However, it is difficult to generalize about the success of specific types of innovations, since they have been examined in only a few studies. To gain a broader perspective, we analyzed the results of forty-three ambulatory care programs funded by the first round of the Center for Medicare and Medicaid Innovation's Health Care Innovations Awards. The innovations' impacts on total cost of care were estimated by independent evaluators using multivariable difference-in-differences models...
March 1, 2017: Health Affairs
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