Research Roundup: Teens And Nighttime Car Crashes; Self-Insured Plans; Virtual Violence

Centers for Disease Control and Prevention/Mobidity and Mortality Report: Graduated Driver Licensing Night Driving Restrictions And Drivers Aged 16 Or 17 Years Involved In Fatal Night Crashes — United States, 2009–2014
To help address the increased crash risk for beginner teen drivers, 49 states and the District of Columbia include a night driving restriction (NDR) in their Graduated Driver Licensing (GDL) system. ... in 23 states and the District of Columbia, NDRs begin at 12:00 a.m. or later .... CDC analyzed 2009–2014 national and state-level data from the Fatality Analysis Reporting System (FARS) to determine the proportion of drivers aged 16 or 17 years involved in fatal crashes who crashed at night .... Nationwide, among 6,104 drivers aged 16 or 17 years involved in fatal crashes ..., 1,865 (31%) were involved in night crashes. Among drivers involved in night crashes, 1,054 (57%) crashed before 12:00 a.m. ... Because nearly all of the night driving trips taken by drivers aged 16 or 17 years end before 12:00 a.m., NDRs beginning at 12:00 a.m. or later provide minimal protection. (Shults and Williams, 7/28)

Health and Human Services Office of Inspector General: Adverse Events In Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries
This report is part of a series on adverse events in health care settings .... An estimated 29 percent of Medicare beneficiaries experienced adverse or temporary harm events during their rehab hospital stays, resulting in temporary harm; prolonged stays or transfers to other hospitals; permanent harm; life-sustaining intervention; or death. This harm rate is in line with what we found in hospitals (27 percent) and in SNFs (33 percent). Physician reviewers determined that 46 percent of these adverse and temporary harm events were clearly or likely preventable. Physicians attributed much of the preventable harm to substandard treatment, inadequate patient monitoring, and failure to provide needed treatment. (7/19)

Pediatrics: Virtual Violence
In the United States, exposure to media violence is becoming an inescapable component of children’s lives. With the rise in new technologies, such as tablets and new gaming platforms, children and adolescents increasingly are exposed to what is known as “virtual violence.” This form of violence is not experienced physically; rather, it is experienced in realistic ways via new technology and ever more intense and realistic games. The American Academy of Pediatrics continues to be concerned about children’s exposure to virtual violence and the effect it has on their overall health and well-being. This policy statement aims to summarize the current state of scientific knowledge regarding the effects of virtual violence on children’s attitudes and behaviors and to make specific recommendations for pediatricians, parents, industry, and policy makers. (Christakis, 7/18)

Employee Benefits Research Institute: Self-Insured Health Plans: Recent Trends By Firm Size, 1996-2015
This Notes article examines 1996‒2015 trends in self-insured health plans among private-sector establishments .... The data come from the Medical Expenditure Panel Survey Insurance Component (MEPS-IC). ... The percentage of private-sector establishments offering health plans at least one of which is self-insured has increased from 28.5 percent in 1996 to 39 percent in 2015 (36.8 percent increase). Between 2013 and 2015, the percentages of establishments offering health plans with at least one self-insured plan has increased for midsized establishments from 25.3 percent to 30.1 percent (a 19 percent increase); for small establishments from 13.3 percent to 14.2 percent (a 7 percent increase); and has decreased from 83.9 percent to 80.4 percent for large establishments (a 4 percent decrease). (Fronstin, 7/27)

Health Affairs: Off-Label Drug Promotion
In recent years there has been renewed debate over whether and how the FDA should regulate the pharmaceutical industry's communication to physicians around off-label uses .... The FDA has released multiple guidance documents detailing its current thinking about manufacturer communication and promotion, including updates -- in 2011 and 2014, respectively .... Nevertheless, it is not always clear what behavior falls into one of these safe harbors, and manufacturers have substantial incentives to push the boundaries of the law. The FDA also has limited capacity to review and monitor all forms and avenues of communication. Violations are common, and many of these violations have led to serious and costly patient harm. (Richardson, 6/30)

The Kaiser Family Foundation: Turning Medicare Into A Premium Support System: Frequently Asked Questions
Premium support is a general term used to describe an approach ... to reduce the growth in Medicare spending by increasing competition among health plans and providing a stronger incentive for beneficiaries to be cost-conscious .... Many proposals advance the concept of premium support without providing all of the details needed to assess the possible effects of the proposal on key stakeholders. Other proposals are more detailed, although they differ markedly in their specific policy features, and these differences have important implications for Medicare beneficiaries, the federal budget, health care providers, and private health plans. This issue brief is intended to highlight some of the key questions that could be considered once proposals’ details emerge. (Jacobson and Neuman, 7/19)

The Kaiser Family Foundation: Medicaid's Most Costly Outpatient Drugs
With over 70 million beneficiaries, many of whom have complicated health needs, Medicaid is one of the largest providers of prescription drugs in the United States. State Medicaid agencies have a variety of mechanisms to help control outpatient drug spending that they have been using widely for the past decade. However, new prescription drugs are always coming to market, and the health needs of the Medicaid population change over time, especially as enrollment grows because of ACA Medicaid expansion. As a result, it is helpful for policy makers to understand which drugs used by the Medicaid program are most expensive. In this issue brief, we determine the 50 most costly drugs before rebates used by the Medicaid program from January 2014 through June 2015. (Young et al., 7/15)

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

Forbes: 43 States Fail To Make Health Price Information Available
There are 43 states that fail to adequately make healthcare price information available to consumers despite pressure from employers and policymakers for greater transparency, a new analysis shows. Just six states earn a passing grade of a C or better and a seventh state gets a D when it comes to price transparency, according to the latest analysis from the nonprofit Health Care Incentives Improvement Institute and Catalyst for Payment Reform. (Japsen, 7/26)

Reuters: With Reference Pricing, Patients Spend Less On Diagnostic Testing
When employers and insurers use reference pricing for diagnostic tests, the average price paid for those tests dips by almost a third, according to a new U.S. study. Under reference pricing, which is commonly used in Europe for medications, insurers reimburse up to a certain limit, depending on the medication or service, and the patient must pay the rest out of pocket if the price charged is higher. Patients have an incentive to choose medications or services as close to the reference price as possible to reduce their own spending. “There’s no reason to believe the quality of the tests varies across labs,” said lead author James C. Robinson of the University of California, Berkeley. (Doyle, 7/26)