KHN Morning Briefing

Summaries of health policy coverage from major news organizations

full issue

Research Roundup: Access To Care Under ACA; Collaboration On Drug Development

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Health Affairs: Growing Insurance Coverage Did Not Reduce Access To Care For The Continuously Insured
Recent expansions in health insurance coverage have raised concerns about health care providers’ capacity to supply additional services and how that may have affected access to care for people who were already insured. When we examined data for the period 2008–14 from the Medical Expenditure Panel Survey, we found no consistent evidence that increases in the proportions of adults with insurance at the local-area level affected access to care for adults residing in the same areas who already had, and continued to have, insurance. This lack of an apparent relationship held true across eight measures of access, which included receipt of preventive care. It also held true among two adult subpopulations that may have been at greater risk for compromised access: people residing in health care professional shortage areas and Medicaid beneficiaries. (Abdus and Hill, 5/2)

Health Affairs: Enrollment In A Health Plan With A Tiered Provider Network Decreased Medical Spending By 5 Percent
Employers and health plans are increasingly using tiered provider networks in their benefit designs to steer patients to higher quality and more efficient providers in an effort to increase value in the health care system. We evaluated the impact of a tiered-network health plan on total health care spending and on inpatient, outpatient, and outpatient radiology spending for nonelderly enrollees in a commercial health plan in 2008–12. The tiered network was associated with $43.36 lower total adjusted medical spending per member per quarter ($830.07 versus $873.43), which represented about a 5 percent decrease in spending, relative to enrollees in similar plans without a tiered network. (Sinaiko, Landrum and Chernew, 5/1)

The New England Journal of Medicine: Academic, Foundation, And Industry Collaboration In Finding New Therapies
[T]he pharmaceutical industry has been hesitant to initiate early-stage programs to treat so-called orphan diseases. ... In the past two decades, disease-focused foundations ... have formed partnerships with industry and federal agencies to share the financial risk of therapeutic development, shorten the early translational pipeline, and advance research .... In addition, foundations and their academic partners have accelerated early development by providing access to patient populations for clinical trials and assistance from disease-specific experts in study design .... In this review, we will focus on three diseases — cystic fibrosis, multiple myeloma, and type 1 diabetes mellitus — to illustrate how collaborations among academic institutions, foundations, and industry partners have evolved to address the therapeutic challenges of these conditions. (Ramsey et al., 5/4)

The New England Journal of Medicine: Bystander Efforts And 1-Year Outcomes In Out-Of-Hospital Cardiac Arrest
We linked nationwide data on out-of-hospital cardiac arrests in Denmark to functional outcome data .... Among the 2855 patients who were 30-day survivors of an out-of-hospital cardiac arrest during the period from 2001 through 2012, a total of 10.5% had brain damage or were admitted to a nursing home and 9.7% died during the 1-year follow-up period. During the study period, among the 2084 patients who had cardiac arrests that were not witnessed by emergency medical services (EMS) personnel, the rate of bystander CPR increased from 66.7% to 80.6% ..., the rate of bystander defibrillation increased from 2.1% to 16.8% ..., the rate of brain damage or nursing home admission decreased from 10.0% to 7.6% ..., and all-cause mortality decreased from 18.0% to 7.9% .... In adjusted analyses, bystander CPR was associated with a risk of brain damage or nursing home admission that was significantly lower than that associated with no bystander resuscitation. (Kragholm et al., 5/3)

The Kaiser Family Foundation: State Variation In Medicaid Per Enrollee Spending For Seniors And People With Disabilities
Seniors and people with disabilities account for a minority (23%) of Medicaid program enrollment but a majority (64%) of spending. This is due to their greater health and long-term care needs and more intensive services use compared to adults and children whose eligibility is not based on old age or disability. ... Medicaid spending per enrollee for seniors and people with disabilities also varies substantially across states and reflects the fact that many eligibility pathways and services relevant to seniors and people with disabilities are optional. ... A per capita cap could lock in historical state differences in the scope of coverage and spending for seniors and people with disabilities. (Musumeci and Young, 5/1)

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