Research Roundup: Adult Vaccine Use; Safety-Net Hospital Readmissions; State Abortion Policy

Health Affairs: Modeling The Economic Burden Of Adult Vaccine-Preventable Diseases In The United States
[W]e calculated the current economic burden that is attributable to vaccine-preventable diseases among US adults. We estimated the total remaining economic burden at approximately $9 billion (plausibility range: $4.7–$15.2 billion) in a single year, 2015, from vaccine-preventable diseases related to ten vaccines recommended for adults ages nineteen and older. Unvaccinated individuals are responsible for almost 80 percent, or $7.1 billion, of the financial burden. (Ozawa et al., 10/12)

Health Affairs: Hospital Readmissions Reduction Program: Safety-Net Hospitals Show Improvement, Modifications To Penalty Formula Still Needed
Many observers are calling for modification of Medicare’s Hospital Readmissions Reduction Program (HRRP) to relieve an unfair burden on safety-net hospitals, which serve low-income populations and consequently have relatively high readmission rates. To broaden the perspective on this issue, we addressed the fundamental question of whether the HRRP has been an effective tool for reducing thirty-day readmissions in safety-net hospitals. In the first three years of the program, these hospitals reduced readmissions for heart attack by 2.86 percentage points, heart failure by 2.78 percentage points, and pneumonia by 1.77 percentage points, and they also reduced the disparity between their readmission rates and those of other hospitals. (Carey and Lin, 10/4)

JAMA: Association Between The 2014 Medicaid Expansion And US Hospital Finances
The sample included between 1200 and 1400 hospitals per fiscal year in 19 states with Medicaid expansion and between 2200 and 2400 hospitals per fiscal year in 25 states without Medicaid expansion .... Expansion of Medicaid was associated with a decline of $2.8 million ... in mean annual uncompensated care costs per hospital. Hospitals in states with Medicaid expansion experienced a $3.2 million increase ... in mean annual Medicaid revenue per hospital, relative to hospitals in states without Medicaid expansion. Medicaid expansion was also significantly associated with improved excess margins ... but not improved operating margins. (Blavin, 10/10)

JAMA/The Kaiser Family Foundation: Intersection Of State Abortion Policy And Clinical Practice
This Visualizing Health Policy infographic examines state policies related to abortion and their intersection with clinical practice. Nine of 10 reported abortions in the United States are in the first trimester. Between 2003 and 2012, the abortion rate decreased 18% among women aged 15 to 44 years. Twenty-five states have laws that restrict insurance coverage of abortion in private plans. Twenty-seven states require women seeking abortion to wait 18 hours or more before obtaining an abortion, and several require women to be counseled on topics unsupported by medical consensus or evidence, such as abortion raising the risk of breast cancer. Many states have specific requirements for clinics and physicians who provide medication abortions. (Gomez et al., 10/11)

Avalere: Health Insurance Is A Good Buy To Protect Against Significant Financial Risk For A Range Of Common Health Conditions
Avalere finds that consumers with a range of common health conditions could reduce their spending between $8,800 and $90,020 by purchasing insurance through the Affordable Care Act (ACA). Avalere examined the potential financial benefits for consumers with a range of ages, incomes, and family size who have diabetes, a broken leg, breast cancer, and stroke. The findings indicate that even after paying premiums, deductibles, and cost-sharing, these consumers could reduce their spending significantly by purchasing insurance compared to remaining uninsured. (10/13)