Morning Briefing
Summaries of health policy coverage from major news organizations
Research Roundup: Employer-Sponsored Health Care; Cost Of Care; And Medicaid
Health Affairs: Health Care Spending Under Employer-Sponsored Insurance: A 10-Year Retrospective
Using a national sample of health care claims data from the Health Care Cost Institute, we found that total spending per capita (not including premiums) on health services for enrollees in employer-sponsored insurance plans increased by 44 percent from 2007 through 2016 (average annual growth of 4.1 percent). Spending increased across all major categories of health services, although the increases were not uniform across years or categories. Growth rates for total per capita spending generally slowed after 2009 but increased between 2014 and 2016. Spending on outpatient services grew more quickly (average annual growth of 5.7 percent) compared to spending on the other types of services. However, the overall distribution of spending across categories remained largely unchanged. In the context of the dramatic economic and policy events that have taken place since 2007—including the Great Recession, the Affordable Care Act, and numerous medical innovations—this assessment of ten-year spending trends provides insights into how the largest insured population in the US contributes to health care spending growth. (Frost et al, 9/19)
JAMA Internal Medicine: Association Between Patient Cognitive And Functional Status And Medicare Total Annual Cost Of Care: Implications For Value-Based Payment
This observational study of data from the Medicare Current Beneficiary Survey and Area Health Resources File found that patient depression, dementia, limitations in activities of daily living, and residence in areas of mental health care shortage or high unemployment were associated with substantially higher TACC, after applying standard Medicare risk adjustment methods. In a model adding these factors to risk adjustment, the TACC performance of safety-net clinicians was improved. (Johnston et al, 9/17)
Commonwealth Fund: Kansas Medicaid: New Evidence On Expansion, Work Requirements
The uninsured rate among low-income Kansans ages 19 to 64 is 20 percent, significantly higher than rates in Ohio and Indiana. Low-income Kansans also reported comparatively more frequent delays in care because of cost, greater difficulty affording medical bills, and worse health care quality. Survey data show Medicaid expansion is favored by 77 percent of low-income Kansans, and state policymakers have expressed interest in using a Section 1115 waiver for expansion, which would include a work requirement. Our data suggest such a provision would likely have little impact on employment in Kansas, where most potential Medicaid enrollees are disabled or already employed. (Goldman and Sommers, 9/17)
JAMA Internal Medicine: Association Of Medical Scribes In Primary Care With Physician Workflow And Patient Experience
In this crossover study of 18 primary care physicians, use of scribes was associated with significant reductions in electronic health record documentation time and significant improvements in productivity and job satisfaction. (Mishra et al, 9/17)
The Henry J. Kaiser Family Foundation: The Recovery Of Community Health Centers In Puerto Rico And The US Virgin Islands One Year After Hurricanes Maria And Irma
One year after hurricanes Maria and Irma struck Puerto Rico and the U.S. Virgin Islands (USVI), recovery has progressed but remains slow. This issue brief presents findings from the Geiger Gibson/Kaiser Family Foundation survey of community health centers in Puerto Rico and USVI one year after the hurricanes. It describes the current state of health center recovery and examines shifts in need and capacity, which have potential longer-term implications. (Sharac et al, 9/19)
