More people getting health insurance under the Affordable Care Act didn’t impair access for those who were already insured, according to research published in
Health Affairs. “This lack of an apparent relationship held true across multiple measures of access to care, including receipt of preventive care. It also held true even in two subpopulations whose members may have been at greater risk for compromised access: adults residing in geographic Health Professional Shortage Areas and adult Medicaid beneficiaries.” (
Health Affairs)
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By a 217-213 vote, the House passed legislation last week repealing elements of the Affordable Care Act and replacing them with a Republican plan. But the legislation faces an uphill battle in the Senate. In his
Health Affairs Blog post, Timothy Jost offers insights into what’s in the House legislation and what isn’t. And
The
New York Times reports that, in a “rare show of unity,” hospitals, providers, health insurers and some consumer groups are, generally, “speaking with one voice and urging significant changes” to the legislation. Kaiser offers a helpful tool comparing the ACA and AHCA, side-by- side.(
Health Affairs Blog;
The New York Times;
Kaiser Family Foundation comparison)
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Penalizing hospitals for their 30-day Medicare readmissions may have unintended negative consequences according to research published in
Health Affairs. Hospitals that received frequent penalties experienced “a sizable financial impact… [that limited] their ability to meet the needs of the populations they serve and invest in quality improvement activities,” according to researchers. They concluded: “For many hospitals, the current penalty structure leads to persistent penalization, which could limit their capacity to reduce penalty burden. Alternative penalty structures could avoid persistent penalization, while still motivating readmission reduction.” (
Health Affairs)
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In 2015 Loyola researchers noted that EHR adoption was the biggest single factor in reducing the “weekend effect” of longer hospital stays, higher mortality rates and increased
readmissions for patients undergoing non-elective surgery on weekends. Now they know why. Patients at hospitals with electronic operating room scheduling were 33 percent less likely to experience the weekend effect than patients at paper-based hospitals. Patients were 35 percent less likely to experience the weekend effect at hospitals with electronic bed-management systems. (
HealthLeaders Media;
JAMA Surgery)
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Innovation & Transformation
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Hospitals and oncology practices increasingly are offering urgent care services specifically for cancer patients. The approach makes sense: It provides the most efficient and appropriate care, and it keeps immunocompromised patients out of rooms full of sick people. Moreover, pain, nausea, fever and dehydration are common side effects of traditional chemotherapy, and newer immunotherapy treatments can cause serious and sudden reactions if the body attacks healthy organs and tissues. Those symptoms can be difficult for non-cancer specialists to evaluate. (Kaiser Health News; Advisory Board Daily Briefing)
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Not long ago, Virginia Medicaid clients seeking a residential treatment program for substance abuse had four choices; today, they have 71. In this article,
Stat looks at how Virginia dramatically expanded treatment options for addiction while navigating arcane and archaic federal laws that limit opportunities for many seeking help overcoming addictions. (
Stat)
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Doctors are beginning to pay attention to injuries and other harms--such as brain damage or kidney failure--that can afflict people who survive an overdose. “One way to think about this would be that an overdose is like a concussion, where you have a traumatic injury to the brain,” explains Alex Walley, MD, associate professor of medicine at Boston University School of Medicine. “If the person doesn’t die, the brain recovers, but they may be, like with a concussion, more susceptible to a future event. And then there also may be cumulative damage that occurs.” (Kaiser Health News)
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Only 31 percent of medical practices the Medical Group Management Association surveyed fully use EHR analytics, and 11 percent said they don’t perform any analytics on their EHR data. Don’t blame the doctors, though: MGMA Principal Derek Kosiorek points out that most EHRs weren't built for data analytics, but as data repositories. But, he adds, analytics tools are “improving in exciting ways and will soon live up to the promise that brought us into the electronic age.” (
Healthcare IT News)
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Doctors prescribed fewer marketed brand-name drugs when teaching hospitals restricted access to pharmaceutical sales representatives, according to research published in JAMA. The researchers reported “modest but significant reductions” in six of the eight drug classes studied and at nine of the 19 hospitals reviewed. (JAMA; ProPublica)
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Failed merger aftermath: Aetna reported a quarterly net loss related to costs from its failed acquisition of Humana. The insurer said it will consider cutting exposure on the Obamacare exchanges. (
Reuters)
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Moving to value:
Anthem reports that 58 percent of its medical spend is linked to value-based care models. More than 75 percent of that is attributable to shared savings, shared risk and population-based payment models. The insurer has 159 ACO agreements. (
Forbes)
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VA to shutter facilities: The Department of Veterans Affairs may close as many as 1,165 facilities nationwide as part of its effort to privatize more medical care. VA Secretary David Shulkin revealed the plan during a Congressional hearing. (
Fierce Healthcare)
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Last month, McKinsey’s Center for U.S. Health System Reform and the Duke-Margolis Center for Health Policy sponsored a live webcast that featured policy experts, health care thought leaders, senior private sector executives and government leadership who discussed state and private sector innovation and the future of U.S. health care.(
MedPage Today;
webcast)
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MarketVoices...quotes worth reading
“To me, this is not a reform. This is just a debacle."--Michael J. Dowling, chief executive of Northwell Health, a large health system in New York, quoted in The New York Times on the health care legislation passed last week. He warns that hospitals that serve low-income patients "will just be drowning completely."
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Copyright 2009-2017,
H2R Minutes
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