November 25, 2016
The state’s most recent enrollment reports show more than 650,000 able-bodied adults have enrolled in Medicaid since the Obamacare expansion, and this enrollment shows no sign of slowing down. This is nearly twice as many adults as the state said would ever enroll and more than the state said would ever even be eligible.
Expansion costs are also significantly over projections. Despite promises from the administration of former Gov. Pat Quinn that total expansion costs would “only” hit $2.7 billion in the first two years, costs actually came in at $4.7 billion – 70 percent higher than promised.
Source: Hundreds on Medicaid waiting list in Illinois die while waiting for care | Illinois Policy | Illinois’ comeback story starts here
October 29, 2016
In 2014, the United States Food and Drug Administration announced that chain restaurants with 20 or more locations would be required to put calorie labels on the menu. The merits of the policy depend in large part on three empirical issues: 1) if calorie labels help correct calorie under- or overestimation biases; 2) if the labels lead to changes in consumer behavior, which may improve physical health; and 3) if they have an impact on psychological health. This paper presents data from an online experiment (N = 1,323) in which participants were randomly presented with pictures of food and drink items from major fast-food companies either with or without calorie labels. The following findings are reported. First, there was calorie overestimation bias among participants, and the respondents thought, on average, that products contained more calories than was actually the case. Second, calorie labels both made participants perceive the products as healthier, and made them more likely to intend to purchase said items. Third, calorie labels did not have any discernible effects either on the expected utility from consuming the products, or on the participants’ experienced well-being. Thus, while calorie labels did not appear to have any negative effects on psychological health, they did seem to correct a calorie overestimation bias, which may inadvertently improve the perceived healthiness of foods and beverages high in calories, and could also potentially lead consumers to buy more, rather than fewer, such products.
Source: Calorie Overestimation Bias and Fast Food Products: The Effects of Calorie Labels on Perceived Healthiness and Intent to Purchase by Simon Hedlin :: SSRN
October 29, 2016
This paper exploits longitudinal insurance claims data and a cost-sharing subsidy that has exempted co-payment and coinsurance of healthcare services for children under the age of 3 in Taiwan. We use a regression discontinuity design to estimate its effect on children’s healthcare utilization. Our results show that cost-sharing subsidy significantly increases the utilization of outpatient care, especially low-value care at high-cost hospitals. In contrast, the utilization of inpatient care is price insensitive. Finally, we find that a lower level of cost-sharing has little impact on children’s health.
Source: Patient Cost Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design by Hsing-Wen Han, Hsien‐Ming Lien, Tzu-Ting Yang :: SSRN
July 14, 2016
As a strategy to improve Americans’ health status and reduce healthcare costs, the Affordable Care Act (ACA) allows employers to place up to 30% of total health insurance spending “at risk” for employees. Employees can keep/earn that share by participating in programs to reduce chronic disease risk factors and/or by controlling their cholesterol, blood pressure, and body mass indexes (BMI). Partly as a result of this provision, chronic disease risk factors have become a primary focus of many if not most major employers in America. Whether these wellness programs have worked is beyond the scope of this posting, but is unresolved. In 2010 Health Affairs published an oft-cited (albeit challenged and undefended) meta-analysis finding savings with these programs. This conclusion was directionally confirmed (except for randomized control trials, which showed a negative return on investment) by a 2014 meta-analysis in a wellness trade journal. Conversely, the Incidental Economist published several pieces on the questionable finances and other concerns raised by these programs. The Bloomberg BNA Healthcare Policy Report published a concise summary of the “con” argument. A 2014 RAND study of PepsiCo found no savings.
Source: Chronic Disease in the Workplace: Are We Fighting the Wrong Battle?
April 2, 2015
as our colleagues at PolitiFact noted, in-patient deaths were already declining before the Affordable Care Act was implemented. The Centers for Disease Control and Prevention found a 60,000 decline in patient deaths in the decade before 2010. This is not quite the same statistic, but it indicates that before the ACA was passed into law, progress was already being made in reducing deaths from conditions acquired in hospitals.
But officials say there is also little question that the half-billion dollars in ACA funding sparked significantly greater cooperation among thousands of hospitals. On pressure ulcers and adverse drug reactions, “we already had practices that we knew had worked,” another official said, but the Partnership for Patients took it to the next level by involving thousands of hospitals in a concerted effort to promote those practices. The law also created the CMS Innovation Center, which tests new ideas at participating hospitals for delivering better service without increasing costs.
via Obama’s claim the Affordable Care Act was a ‘major reason’ in preventing 50,000 patient deaths – The Washington Post.
March 24, 2015
The number of Medicaid-enrolled patients with newly identified diabetes increased by 23% (14,625 vs. 18,020 patients) in the 26 states (and District of Columbia) that expanded Medicaid compared with an increase of 0.4% (11,612 vs. 11,653 patients) in the 24 states that did not expand Medicaid during this period. Similar differences were observed in younger and older adults and for both men and women.
CONCLUSIONS This study suggests that in the states that expanded Medicaid under the ACA, an increased number of Medicaid patients with diabetes are being diagnosed and treated earlier. This could be anticipated to lead to better long-term outcomes.
via Surge in Newly Identified Diabetes Among Medicaid Patients in 2014 Within Medicaid Expansion States Under the Affordable Care Act.
March 23, 2015
A patchwork of experiments across the country are trying to better manage these cases. The Center for Health Care Strategies, a policy center in New Jersey, has documented such efforts in 26 states. Some are run by private insurers and health care providers, while others are part of broader state overhaul efforts. The federal government is supporting some, too, through its $10 billion Innovation Center, set up under the Affordable Care Act.
via Health Care Systems Try to Cut Costs by Aiding the Poor and Troubled – NYTimes.com.