Research Roundup: Reenrollment; Patients’ Understanding Of Risk; Coverage For HIV

Health Affairs: Health Policy Brief: Reenrollment
During the second round of open enrollment for the Affordable Care Act's insurance Marketplaces, insurers and policy makers have a new challenge: keeping last year's enrollees in the system. ... Open enrollment began November 15 and thus far has been going much more smoothly than the first open enrollment. ... Enrollees who do not shop around and are automatically renewed may be surprised with their new premium. ... In recognition of the price sensitivity of enrollees, HHS is rethinking the automatic re-enrollment process for future open enrollment periods. (Goodell, 12/22)

Commonwealth Fund: Analysis Finds No Nationwide Increase In Health Insurance Marketplace Premiums
A new analysis of the Affordable Care Act’s health insurance marketplace costs finds that, nationwide, marketplace premiums did not increase at all from 2014 to 2015, though there were substantial average premium increases in some states and declines in others. ... The 0 percent change in average premiums is unprecedented when compared with historic trends in both the individual insurance market and employer-based health insurance. Prior to the passage of the Affordable Care Act, from 2008 to 2010, premiums grew an average 10 percent or more per year in state individual insurance markets. (Gabel et al., 12/22)

UCLA Center For Health Policy Research: The State Of Health Insurance In California: Findings From The 2011/2012 California Health Interview Survey
This biennial report uses data from the 2011-12 California Health Interview Survey (CHIS) ... The report found that, despite continuing job growth, employer-provided health benefits continued to erode for many Californians. The data also show continued lack of health access to and use of medical services by adult Latinos in the state. ... Specifically, the authors found that nearly half (47.4 percent) the 6.9 million people still uninsured in 2011-2012 were in families with a full-time worker. Latinos had the highest levels of uninsurance, 28.4 percent, and lowest share of employer-based insurance, 33.9 percent. (Charles et al., 12/22)

Kaiser Family Foundation/ PerryUndem Research and Communication: Health Insurance Coverage For People With HIV Under The Affordable Care Act: Experiences In Five States
[A]ntiretroviral therapy (ART) is not only critical for the health and longevity of people with HIV, it has also been shown to significantly reduce the risk of HIV transmission. However, the majority of people with HIV in the U.S. are not yet engaged in care and not on ART. Improving access to health coverage is one key component to addressing this gap. (Kates, Dawson, Undem and Perry, 12/19)

JAMA Internal Medicine: Patients’ Expectations Of The Benefits And Harms Of Treatments, Screening, And Tests
Reports of individuals’ (either patients or the general public) expectations about the likely benefit or harm of various interventions are fragmented across the literature. We aimed to systematically review all studies that had quantitatively measured patient or public expectations of the benefit and/or harm of any medical treatment, test, or screen. ... Participants rarely had accurate expectations of benefits and harms, and for many interventions, regardless of whether a treatment, test, or screen, they had a tendency to overestimate its benefits and underestimate its harms. (Hoffmann and Del Mar, 12/22)

American Journal of Managed Care/Rand Corp.: Paying For Telemedicine
[D]espite ... prospective advantages, telemedicine has been adopted in only limited circumstances, such as for reading radiology reports and remote phone or video visits for minor health issues. To promote adoption, some have advocated for telemedicine services to be reimbursed by health plans and many states have issued "parity laws" that force payers to reimburse some forms of telemedicine services at a level equal to in-person care. In this perspective, we explore why health plans are reluctant to cover most telemedicine services as part of current payment arrangements and explain why newer payment models offer greater potential for its expanded and more effective use. (Rudin, Auerbach, Zaydman and Mehrotra, 12/12)

Heritage Foundation: Measuring Choice And Competition In The Exchanges: Still Worse Than Before The ACA
This Heritage Foundation analysis reviews state-level insurer participation in the exchanges for 2015 in federally facilitated and state-based exchanges in all 50 states and compares those results with insurer participation in states in the pre-ACA individual market. ... The exchange market is 21.5 percent less competitive based on a comparison of the number of participating exchange insurers across all 50 states in 2015 with the number of carriers in the individual market in 2013. (Senger, 12/22)

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

The Wall Street Journal: Is Long-Term-Care Insurance for You?
According to researchers at Georgetown University and Pennsylvania State University, about 70% of individuals 65 and older will need some kind of long-term care—whether at home or in an assisted-living facility or nursing home. But how many of them should purchase a long-term-care insurance policy? That number, it turns out, is far lower—at 19% of men and 31% of women, according to a new study by researchers at Boston College’s Center for Retirement Research. (Women live longer on average, and so they’re statistically more likely to incur long-term-care costs.) Most “individuals should not buy insurance,” write the authors of the paper, which was published in November. (Tergesen, 12/23)

Bloomberg: More Contraception Means Fewer Abortions, Study Finds
More access to long-acting contraception methods resulted in fewer abortions, a study of Iowa women found, adding a new facet to the debate over abortion rights and political efforts to restrict them. According to a study of more than 500,000 Iowa medical records, from 2005 to 2012, the abortion rate in the state fell by 22 percent, according to research to be published in the medical journal Contraception. The fall in abortions coincided with two trends in the Midwestern state. While number of abortion facilities actually increased -- from 9 to at least 18 during the study period, the number of patients at family planning agencies using long-acting contraceptives, such as intrauterine devices, or IUDs, rose to 15 percent, from less than 1 percent. (Deprez, 12/23)

CQ Healthbeat: Study Finds E-Cigarettes Used More Than Tobacco Cigarettes By Teens
Teen use of e-cigarettes now surpasses use of tobacco cigarettes, according to a University of Michigan study that documents how quickly the products have made inroads in the lives of adolescents. The Monitoring the Future study, now in its 40th year, surveys 40,000 to 50,000 students in about 400 secondary schools across the country. It found 17 percent of 12th graders reported using e-cigarettes in the past 30 days, compared to 14 percent who reported use of a tobacco cigarette. (12/16)

The Wall Street Journal: Taking Measure Of Growth Charts
When it comes to measuring babies and young children, a growing body of research—controversial though it is—says one size fits all. Traditionally, nations have assessed children’s health by comparing weight and other measurements against growth charts generated from previous births. That’s fine if a country’s population is healthy. But if it isn’t, indicators of poor growth—such as lower birth weights—may be regarded as acceptable norms. (McGinty, 12/19)

Reuters: Cigarette Smoking Costs Weigh Heavily On Health Care System
Of every $10 spent on healthcare in the U.S., almost 90 cents is due to smoking, a new analysis says. Using recent health and medical spending surveys, researchers calculated that 8.7 percent of all healthcare spending, or $170 billion a year, is for illness caused by tobacco smoke, and public programs like Medicare and Medicaid paid for most of these costs. ... Over 18 percent of U.S. adults smoke cigarettes and about one in five deaths are caused by smoking, according to the CDC. (Kennedy, 12/19)