Research Roundup: Surprise Billing; Medicaid Work Requirements; And Decision-Making After Cancer Diagnosis

Georgetown University’s Center on Health Insurance Reforms/Robert Wood Johnson Foundation: New York’s 2014 Law To Protect Consumers From Surprise Out-Of-Network Bills Mostly Working As Intended: Results Of A Case Study.
[New York’s Surprise Billing law] has been a success. Consumer complaints have declined dramatically. For the most part, insurers and providers appear to be working out their differences without resorting to arbitration. Further, there is not yet clear evidence that the law’s use of [usual and customary payment rates] as a benchmark price has had broadly inflationary effects. However, it can take time for a policy change to change behavior, including the billing practices of a diverse array of specialty physicians.The law also contains some significant gaps, particularly with respect to surprise balance bills that occur when patients are misinformed about their providers’ network status and when patients are taken to out-of-network facilities in an emergency. (Corlette and Hoppe, 5/13)

Commonwealth Fund: How A Medicaid Work Requirement Could Affect New Hampshire’s Economy
New Hampshire has now joined Kentucky, Arkansas, and six other states in gaining approval from the Trump administration to add a work requirement to its Medicaid program. (In some states, including New Hampshire, this requirement is limited to beneficiaries covered through the Affordable Care Act’s Medicaid expansion). In prior blog posts, we examined the economic implications of adding Medicaid work requirements in Kentucky and Arkansas. Work requirements drive down Medicaid enrollment, by making it harder for people to qualify for and keep their coverage. (Glied, 5/9)

Pediatrics: Adolescent And Young Adult Cancer Patients’ Experiences With Treatment Decision-Making 
Adolescents and young adults (AYAs) with cancer generally want to engage in decision-making but are not always able to do so. We evaluated cancer treatment decision-making among AYAs, including decisional engagement and regret. (Mack, Fasciano and Block, 5/1)

Health Affairs: The Culture Of Health In Early Care And Education: Workers’ Wages, Health, And Job Characteristics
Little is known about the health of the 2.2 million early care and education (ECE) workers responsible for the care, well-being, and success of the approximately ten million children younger than age six enrolled in ECE, or the extent to which ECE environments and employers play a role in workers’ health. The purpose of this analysis was to describe the health of an ECE worker sample by wage and by job and center characteristics and to begin to explore the relationships between these factors and workers’ health. (Otten et al, 5/1)

JAMA Internal Medicine: Estimated Quality Of Life And Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies: A Cost-Effectiveness Analysis
Of 12 strategies evaluated in a cost-effectiveness model, cytologic testing every 3 years for women aged 21 to 29 years with either continued triennial cytologic testing or switching to a low-cost high-risk human papillomavirus test every 5 years from age 30 to 65 years conferred a reasonable balance of benefits, harms, and costs from both a societal and health care sector perspective. (Sawaya, Sanstead, Alarid-Escudero, et al, 5/13)

The Henry J. Kaiser Family Foundation: Do People Who Sign Up For Medicare Advantage Plans Have Lower Medicare Spending?
People on Medicare can choose coverage from either traditional Medicare or Medicare Advantage plans, typically trading off broad access to providers for potentially lower premiums and out-of-pocket costs. Beneficiaries who choose Medicare Advantage may differ from those in traditional Medicare in both measurable and unmeasurable ways, which may influence their use of services and spending. Yet, Medicare payments to Medicare Advantage plans per enrollee are based on average spending among beneficiaries in traditional Medicare. This analysis looks at whether beneficiaries who choose to enroll in Medicare Advantage plans have lower spending, on average – before they enroll in Medicare Advantage plans – than similar people who remain in traditional Medicare. (Jacobson, Neuman and Damico, 5/7)

The Philadelphia Inquirer/Philly.com: Students Who Are Bullied Use More Pain Medication, Raising Concerns Of Future Drug Use
Students who are bullied are twice as likely to use pain medication for issues like headaches, backaches, and stomach aches, even when controlling for the amount of pain they feel, a new study found. ... According to the International Research Network, 11 percent of children between age 11 and 15 say they’re bullied at least twice per month. Previous research has shown bullied children are more likely to experience migraines, headaches, and backaches. They’re also more likely to use alcohol and and other drugs. (Pattani, 5/15)

The Philadelphia Inquirer/Philly.com: Medicare Fraud More Common Among Doctors Treating Minorities, Low-Income Seniors
Minorities and some of the most vulnerable Medicare beneficiaries — including people with a disability and low-income seniors — are more likely than others to be treated by providers who were later banned for fraud or abuse, according to a new study from the Johns Hopkins Bloomberg School of Public Health. The research appeared in the May edition of Health Affairs. (Gantz, 5/15)