Research Roundup: Medicaid Costs For Opioid Addiction Medication, Health Exits

The Commonwealth Fund: High-Need, High-Cost Patients: Who Are They And How Do They Use Health Care? 
High-need adults differed notably from adults with multiple chronic diseases but no functional limitations. They had annual health care expenditures that were nearly three times higher—and which were more likely to remain high over two years of observation—and out-of-pocket expenses that were more than a third higher, despite their lower incomes. On average, rates of hospital use for high-need adults were more than twice those for adults with multiple chronic conditions only; high-need adults also visited the doctor more frequently and used more home health care...Wide variation in costs and use of services within the high-need group suggests that interventions should be targeted and tailored to those individuals most likely to benefit. (Hayes et. al, 8/29)

The Commonwealth Fund: AHCA Economic And Employment Consequences For States 
The AHCA would raise employment and economic activity at first, but lower them in the long run. It initially raises the federal deficit when taxes are repealed, leading to 864,000 more jobs in 2018. In later years, reductions in support for health insurance cause negative economic effects. By 2026, 924,000 jobs would be lost, gross state products would be $93 billion lower, and business output would be $148 billion less. About three-quarters of jobs lost (725,000) would be in the health care sector. States which expanded Medicaid would experience faster and deeper economic losses. (Ku et al, 6/14)

JAMA: Quality Of Care After Health Plan Exit From Medicaid Managed Care
State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences...Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. (Ndumele et. al, 6/27)

New England Journal of Medicine: Implementation Of Medical Homes In Federally Qualified Health Centers
We examined the achievement of medical-home recognition and used Medicare claims and beneficiary surveys to measure utilization of services, quality of care, patients’ experiences, and Medicare expenditures in demonstration sites versus comparison sites. Using difference-in-differences analyses, we compared changes in outcomes in the two groups of sites during a 3-year period...Level 3 medical-home recognition was awarded to 70% of demonstration sites and to 11% of comparison sites. Although the number of visits to federally qualified health centers decreased in the two groups, smaller reductions among demonstration sites than among comparison sites led to a relative increase of 83 visits per 1000 beneficiaries per year at demonstration sites. (Timbie et. al, 6/21)

Urban Institute: Rapid Growth In Medicaid Spending On Medications To Treat Opioid Use Disorder And Overdose 
Between 2011 and 2016, spending on Medicaid-covered prescriptions used to treat opioid addiction and overdoses increased from $394 million to $930 million, an average annual increase of 19 percent. Spending grew faster in later years, with a 30 percent increase between 2015 and 2016. Certain states—including Kentucky, Maine, and Ohio—have seen particularly fast growth. These same states, and others, could be particularly hard hit by reductions in Medicaid spending growth under consideration in Congress because of their fast growth and high rates of fatal overdoses. (Clemans-Cope, Epstein and Kenney, 6/28)