Research Roundup: small practical benefits; Rx price growth; fixing Medicare claims review -
Each week, KHN compiles a selection of studies and health policy briefs published recently
GAO :. Medicare Integrity: increased surveillance and guidance could improve the effectiveness and efficiency of post-payment claims review
Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) has taken steps to prevent its contractors to carry out certain allegations redundant postpaid Notice; opinion on the same claims that are not permitted by AGENCY- but CMS has neither reliable, nor provides oversight and sufficient guidance to measure and prevent duplication. ... GAO recommends that CMS take steps to improve the efficiency and effectiveness of the review of postpaid entrepreneurial efforts, which include providing supervision and further guidance on data, duplicate examinations, and contractor correspondence. In his comments, the Department of Health and Human Services agreed with the recommendations and noted plans to improve CMS oversight and guidance (King et al, 8/13)
Health Affairs :. Small primary care physician practices have low rates of preventable hospitalizations
It is often assumed that larger practices provide better care, although there is little evidence for or against this hypothesis. ... We conducted a national survey of 1,045 practices based on primary care with nineteen or fewer physicians to determine the characteristics of the practice. ... Compared to practices with 10-19 doctors, practices with 1-2 doctors had 33 percent fewer avoidable admissions, and practices with 3-9 doctors were 27 percent less. ... At a time when the reform of health care seems to be the conduct of physicians in large organizations, it is important to measure the comparative performance practices of all sizes (Casalino, 8/13)
Altarum Institute :. moderate health care cost growth Price
health care in June 2014 was 1.7% compared to June 2013, a tenth lower than May of the year in reading yoy. ... The growth of hospital prices fell to 1.9% against 2.1% in May, which has contributed to pushing the lower overall HICP despite the rapid growth of prescription drug prices. A 4.1% (against 3.6% last month), it is the highest drug prices growth reading since March 2012, and the result is a negative growth recently, in July 2013. Price growth for other categories showed little movement (8/7).
Health Affairs: More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain difficult for most
national effort to promote the adoption and 'meaningful use of electronic health records (EHR) is on track. However, 2014 marks an important transition: In many hospitals, the penalties will be assessed during the 2015 financial year for failing to meet the meaningful-use federal criteria by the end of fiscal 2014. We used the recent data from the annual Survey of the American Hospital Hospital Association -; IT Supplement to assess progress and challenges. EHR adoption among US hospitals continues to rise strongly: 59 percent now have at least a basic EHR. Small rural hospitals are lagging behind their counterparts more resources. Most hospitals are able to satisfy most significant stage 2 criteria to use, but only 5.8 percent of hospitals are able to meet all
Health Affairs (Adler-Milstein et al, 8/7.) :. Despite substantial progress in EHR adoption, exchange of information on health and patient participation remain low in Office Settings
In 2013, 78 percent of office-based physicians have adopted some type of EHR, and 48 percent had the capacity for a basic EHR system. However, we also found persistent weaknesses in EHR adoption, with doctors in individual practices and non-primary care specialties other delay. the electronic exchange of information on physician health with other suppliers is limited, with only 14 percent of data sharing with suppliers outside their organization. Finally, we found that 30 percent of physicians regularly used capacity for secure messaging with patients, and 24 percent regularly provided patients with the ability to view online, download or transmit their health record (Furukawa, 8 / 7).
Rand Corp: Prescription 340B discount drug program
price program 340B drugs is a federal program that allows certain categories of safety net providers, including some hospitals, clinics, and Find a health center to get outpatient prescription drugs at reduced prices. ... The discussion surrounding 340B climbing debate and often disagreement provisions expanding eligibility for 340B were included in the Affordable Care Act 2010 (ACA). RAND This perspective describes the purpose, history, and the current implementation of the program 340B (Mulcahy, Armstrong, and Lewis Mattke, 8/12)
Employee Benefit Research Institute. Satisfaction with Health Insurance and Care: Findings on EBRI / Greenwald & Associates Consumer engagement In Health Care Survey 2013
the overall satisfaction rate between the health plan consumer-oriented (HRCP) registered increased in most years the / Greenwald & Associates Consumer EBRI commitment Poll on health care (CEHCS), while it decreased in most years among traditional enrolled. The differences in off-pocket costs may explain some of the differences .... In 2013, 44 percent of traditional plan participants were extremely or very satisfied with off-pocket costs (for health care services other than drugs to Ordinance), while 20 percent of high-deductible health plans (HDHP) and registered 31 percent of CDHP participants were extremely or very satisfied. Satisfaction was increasing trend among registered HRCP (Fronstin, 8/13)
Kaiser Family Foundation :. A year Duals Demo Registration: Early Expectations Meet Reality
July 2014 marks a year since the first beneficiaries Dually eligible for Medicare and Medicaid began receiving services from one of the new alignment of financial events. The demonstrations are designed to maintain or decrease the cost of health care while maintaining or improving health outcomes for this vulnerable population of elderly and disabled important non-seniors. ... At this early stage of implementation, some initial ideas on events begin to emerge [including] the necessary work before the protests were ready to begin enrollment and provide services to beneficiaries took more time than expected (Musumeci, 8/13)
This is a selection of news coverage of other recent searches :.
Medscape: Only 10% of Medicaid Enrollees ED use is unnecessary
enrolled Medicaid use the emergency department (ED) often privately insured and uninsured, but that use accounts for only 4% of total Medicaid spending, a review of the literature by the Medicaid and CHIP Payment and access Commission (MacPac) indicates. The review also revealed that only 10% of emergency department visits by non-elderly patients, for non-emergency reasons, which compares with the rate of use by privately insured patients. MacPac researchers reviewed recent studies on the use of ED and found no consistent relationship between Medicaid status and use of disproportionate ED for non-urgent situations (Frellick, 8/11)
MedPage Today :. Readmission high levels in lupus
One in six lupus patients discharged from hospital were readmitted within a month, with underserved minority populations are the most vulnerable, the researchers found. ... Compared to whites, the adjusted odds ratios for readmission were 1.18 for blacks and 1.12 for Hispanics, the researchers reported online in Arthritis & Rheumatology (Walsh, 8/11)
Medscape :. Racial disparity in CRC Screening Despite similar access
screening for colorectal cancer (CRC), especially colonoscopy, is lower in black despite similar access to care across races, according to a study of Veterans Affairs (VA) of health system published online March 25 and in the August issue of gastrointestinal endoscopy. "African Americans have the highest incidence and mortality [CRC]," write Folasade P. May, MD, MPhil, Department of Medicine, Division of Gastroenterology, VA Greater Los Angeles Healthcare System, California , and colleagues. "Despite guidelines to begin screening with colonoscopy at age 45 in African Americans, CRC incidence remains high in this group" (Barclay, 8/11)
Reuters :. Non-profit hospitals AA Tipping Point Mounting Challenges
small and autonomous non-profit hospitals are faced with increasing pressure to weak operating margins and lower volumes of patients with multiple signal stress on the way, according to a report released Wednesday by standard & Poor Rating services. The rating agency warned the health sector was "a point where the negative forces have begun to outweigh the capacity of many suppliers to implement sufficient measures against tipping." From 2013 and continuing into this year, credit downgrades exceeded upgrades at an accelerated pace (Respaut, 8/13)
Reuters :. Many Meds taken by the elderly can increase the risk of falls
half of the 20 drugs used by the elderly can increase the risk of the most commonly prescribed falls, according to new research. analgesics and antidepressants were most strongly associated with a greater likelihood of being hurt in fall, the study of 64,000 Swedes over 65 found. serious injuries were significantly more frequent with 11 of the 20 drugs studied (Kennedy, 8/12)
Medscape :. 2 in 5 US adults will develop diabetes
Approximately 40% of US adults will develop diabetes, mostly type 2, in their lives, and over 50% of ethnic minorities will be affected, according to a new study from the Centers for Disease Control and Prevention ( CDC) and Emory University, Atlanta, Georgia, published online Aug. 13 in the Lancet diabetes and endocrinology. This is significantly higher than previous estimates, which were based on the incidence and mortality of the 190s, researchers say (Hackethal, 8/13)
Medscape :. Physician assistants more than double in a decade
The number of certified physician assistants (PA) increased by 219% between 03 and 2013, only about 6% during the last year of this decade, according to 2013 statistical profile assistants certified physician published online by the national Commission on certification of physician assistants (NCCPA). The number of certified AP stood at 95,583 across the United States at the end of 2013, against 0,227 in 2012 and 43,500 in 03. AP practice in all 50 states and the District of Columbia, according to the NCCPA, the only body certification for AP in the country (hand, 8/12).
Reuters: Dentists Miss Chance To Urge patients to quit smoking
health care providers, particularly dentists, often miss opportunities to inform patients on how to quit smoking cigarettes, a new study shows. Since 1996, the Public Health Service of the United States urged all health workers to ask each of their patients if they smoke and advise smokers to quit, said lead author Amy Ferketich, professor at the College Ohio State University of Public Health in Columbus. But when she and her colleagues analyzed survey data from 2010, they found that less than 12 percent of smokers who visited a dental worker and only half of smokers who saw a doctor said he received advice on how to break the habit (Cohen, 8/8)
Medscape :. 'Vanished' in the US, sigmoidoscopy save lives in Norway
Screening with flexible sigmoidoscopy significantly reduces colorectal cancer (CRC) incidence and mortality compared with no screening, a large randomized trial found. The results of the study were published in issue 13 August JAMA. The results of the prevention of colorectal cancer first Norwegian instance are not surprising. Three previous randomized trials have reported similar results with sigmoidoscopy. The sum total of the evidence, however, is "ironic" for clinicians in the United States, according to an accompanying editorial. "Screening by sigmoidoscopy has almost disappeared" in the United States, writes columnist Allan Brett, MD, clinical professor of internal medicine at the University of South Carolina in Columbia (Mulcahy, 8/12).
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