Research Roundup: Mental Health Parity; Kids’ Food Ads; Medicare Part B Premiums

Health Affairs: Enforcing Mental Health Parity
[N]early all insured Americans are now entitled to receive their mental health and substance use benefits at the same level as their benefits for other medical care. Enforcing those rights, however, has not been consistent .... Patients, providers, and consumer advocates allege that health plans ... are using more subtle ways to make mental health and substance use treatment less available ... including more frequent utilization review, "fail first" requirements, and applying stricter medical necessity criteria. In addition, patients report having trouble getting timely access to network providers .... regulations for Medicaid and CHIP plans have lagged. ... As the single largest payer for mental health services, HHS is under pressure from advocates to quickly finalize the regulations and extend parity protections to millions of beneficiaries covered by Medicaid. (Goodell, 11/9)

Urban Institute/Robert Wood Johnson Foundation: Marketplace Antidepressant Coverage And Transparency
This paper examines marketplace and insurer web sites in five states -- Alabama, California, Florida, Maryland, and Minnesota -- to determine transparency, coverage, and out-of-pocket costs of antidepressant medications. Antidepressants are commonly used in the United States, making them an important marker of the ability of patients with prescription drug needs to choose an appropriate, cost-effective plan. While insurers tend to provide broad coverage of the array of antidepressants, there is variation by state and insurer. Plus, there is considerable room for improvement in transparency of coverage, limits, and cost-sharing requirements. (Blumberg, Skopec and Wengle, 11/10)

Pediatrics: Children’s Food And Beverage Promotion On Television To Parents
Nutritionally poor foods are heavily advertised to children on television. Whether those same products are also advertised to parents on television has not been systematically examined. ... This study is a content analysis of advertisements for children’s packaged foods and beverages aired over US network, cable, and syndicated television for 1 year (2012 to 2013). ... Fifty-one children’s food or beverage products were advertised over the study year, 25 (49%) of which were advertised directly to parents. ... Over all products, 42.4% of total airtime was devoted to advertisements that targeted parents. The products with the most amount of airtime over the study year were ready-to-eat cereals, sugar-sweetened beverages, and children’s yogurt. (Emond et al., 11/9)

Health Affairs: Food Insecurity And Health Outcomes
Almost fifty million people are food insecure in the United States .... We examine recent research evidence of the health consequences of food insecurity for children, nonsenior adults, and seniors in the United States. ... We show that the literature has consistently found food insecurity to be negatively associated with health. For example, after confounding risk factors were controlled for, studies found that food-insecure children are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children; and food-insecure seniors have limitations in activities of daily living comparable to those of food-secure seniors fourteen years older. (Gundersen and Ziliak, 11/2)

The Kaiser Family Foundation: What's In Store For Medicare's Part B Premiums And Deductible In 2016, And Why?
The Bipartisan Budget Act of 2015 averted an unprecedented increase in the 2016 Medicare Part B premium for the 30 percent of Part B enrollees who would have otherwise have faced a 52 percent increase in their premiums. It also reduced the level of increase in the Part B deductible that would have affected virtually all beneficiaries in traditional Medicare. ... some beneficiaries could see an actual reduction in their Social Security benefits in 2016 due to rising Part D drug plan premiums—which are increasing by 13 percent on average between 2015 and 2016 .... And the absence of a [cost of living adjustment] for 2016 in and of itself has direct financial implications for roughly 60 million Social Security recipients, many of whom ... rely on Social Security benefits as their primary source of income. Thus ... many people on Medicare could have greater difficulty affording their medical care costs in the coming year. (Cubanski and Neuman, 11/11)

Here is a selection of news coverage of other recent research:

Philadelphia Inquirer: Penn Study: Pay Patients To Take Their Pills
Statins are proven to reduce the risk of heart attack and stroke, yet as many as half of patients with prescriptions eventually stop taking the pills. A possible solution, says a team of University of Pennsylvania researchers: Pay the patients. And for those whose good pill-taking habits lead to lower levels of LDL ("bad") cholesterol, give their physicians a bonus as well. (Avril, 11/8)

NBC News: Study Details Confirm Lower Blood Pressure Is Better
Last September, a government-led team of experts created an uproar among heart disease experts when they stopped an ongoing study of blood pressure treatment to announce that patients who got more drugs to force their blood pressure lower were living longer .... But they didn't have all the details yet. Now, they've released them at a meeting of the American Heart Association. ... For blood pressure patients 50 and older, going for a reading of 120 millimeters of mercury (mm Hg) cuts events such as heart attack, stroke and heart failure by 25 percent. And people whose blood pressure was forced this low were 27 percent less likely to die over the three-year study than people whose blood pressures were at the current target of 140. (Fox, 11/10)

The Associated Press: Big Study Suggests Steep Drop In Needless Heart Procedures
Fewer heart patients are getting inappropriate angioplasties, a new study suggests. The analysis showed overuse of the common procedure to open clogged heart arteries has declined dramatically since 2009 guidelines, which were aimed at curbing inappropriate use. The study examined nearly 3 million angioplasties done nationwide. In these procedures, doctors guide a narrow tube into an artery, inflate a tiny balloon to flatten blockages, and often insert a stent to keep arteries propped open. (Tanner, 11/9)

The New York Times: Uterus Transplants May Soon Help Some Infertile Women In The U.S. Become Pregnant
Within the next few months, surgeons at the Cleveland Clinic expect to become the first in the United States to transplant a uterus into a woman who lacks one, so that she can become pregnant and give birth. The recipients will be women who were born without a uterus, had it removed or have uterine damage. The transplants will be temporary: The uterus would be removed after the recipient has had one or two babies, so she can stop taking transplant anti-rejection drugs. (Grady, 11/12)

MedPage Today: Diabetes Screening Underused In Mental Illness
The majority of California Medicaid patients with severe mental illness aren't screened for diabetes, despite this group's elevated risk of cardiovascular mortality, researchers found. Only 30% of patients in the state's Medi-Cal program with severe mental illness were screened for diabetes with a standard procedure such as fasting plasma glucose or HbA1c, Christina Mangurian, MD, of the University of California San Francisco, and colleagues reported in a research letter in JAMA Internal Medicine. (Fiore, 11/9)

The Connecticut Mirror: Study: Black Women Twice As Likely To Be Re-Hospitalized After Childbirth
Black women in Connecticut were twice as likely as white women to be readmitted to the hospital within 30 days of childbirth, and Hispanic women were nearly 50 percent more likely than whites to be readmitted, according to a study published this month in the journal Obstetrics and Gynecology. (Levin Becker, 11/11)

Stat: Getting A Flu Shot Every Year? More May Not Be Better
If you’ve been diligent about getting your flu shot every year, you may not want to read this. But a growing body of evidence indicates that more may not always be better.The evidence, which is confounding some researchers, suggests that getting flu shots repeatedly can gradually reduce the effectiveness of the vaccines under some circumstances. (Branswell, 11/11)

Bloomberg: U.S. Smoking Hints At Rare Comeback After Decades-Long Decline
For the first time more than a decade, Americans appear to be smoking more. A confluence of factors -- from a better jobs market to cheaper gasoline to reductions in government anti-smoking programs -- are driving a months-long pickup in cigarette sales, analysts say. If current trends hold, 2015 could mark the first year since 2002 that sales volumes increase. (Kaplan, 11/9)

The Associated Press: Wealth May Give Advantage For Getting Organ Transplants
You can't buy hearts, kidneys or other organs but money can still help you get one. Wealthy people are more likely to get on multiple waiting lists and score a transplant, and less likely to die while waiting for one, a new study finds. The work confirms what many have long suspected — the rich have advantages even in a system designed to steer organs to the sickest patients and those who have waited longest. Wealthier people can better afford the tests and travel to get on more than one transplant center's waiting list, and the new study shows how much this pays off. (Marchione, 11/9)

Reuters: Superbugs Mean More Infections And Deaths After Surgery, Chemotherapy
The declining effectiveness of antibiotics may make tens of thousands more U.S. patients vulnerable to potentially fatal infections after surgery or chemotherapy, researchers estimate. Up to half of pathogens causing surgical site infections and more than a quarter of bugs leading to infections after chemotherapy are already resistant to antibiotics commonly used in the U.S., the researchers calculate based on an analysis of previously published studies. (Rapaport, 11/6)

The Philadelphia Inquirer: Virtua Team: Pricey New Drug No Better Than Old One For Knee Surgery Pain
A relatively new, brand-name drug was about as effective as a long-available generic at relieving pain after knee replacement despite costing 25 times as much, a team of Virtua Health orthopedists reported, winning a national research award for their small study. Orthopedic surgeon Rajesh K. Jain and colleagues from the Virtua Joint Replacement Institute in Voorhees measured post-operative pain earlier this year among 207 consecutive patients who were randomly assigned to three groups in advance. (Sapatkin, 11/11)

Reuters: High-Spending Doctors Less Likely To Be Sued
Providing more care than necessary may work to lower a doctor's risk of being accused of malpractice, suggests a new U.S. study. Although the results can't prove extra expenditures are due to so-called defensive medicine, the researchers found that doctors in Florida who provided the most costly care between 2000 and 2009 were also least likely to be sued between 2001 and 2010. (Seaman, 11/6)