KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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Research Roundup: AHCA’s Impact On Medicaid; Hearing Aids In Free Clinics

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

Urban Institute: The Impact Of The AHCA On Federal And State Medicaid Spending And Medicaid Coverage: An Update 
This paper examines the coverage and financing impacts of the Medicaid provisions of the American Health Care Act (AHCA), including the reduction in the federal matching rates for ACA and pre-ACA expansion populations and per capita caps. Estimates for three scenarios of state responses to the bill’s changes are provided... The first scenario would reduce federal spending by $373.6 billion from 2019 to 2028, the second by $803.2 billion, and the third by $938.3. (Holahan et al., 6/16)

JAMA: Income Disparities in Cardiovascular Risk Factors in the United States
Are there socioeconomic disparities in 10-year predicted absolute cardiovascular disease risk and individual risk factors (systolic blood pressure, smoking, diabetes, and total cholesterol) among U.S. adults? A cross-sectional analysis using data on adults 40 to 79 years of age without established cardiovascular disease ... showed the percentage of adults with diabetes and the mean total cholesterol level did not vary by income. The authors concluded that adults in each socioeconomic stratum have not benefited equally from efforts to control cardiovascular risk factors. (Odutayo, Gill, Shepherd, et al, 6/7)

JAMA Psychiatry: Efficacy Of A Maternal Depression Prevention Strategy In Head Start
In this randomized clinical trial of 230 Head Start mothers, those receiving problem-solving education experienced a 60% incident rate of depressive symptom episodes compared with those not receiving it. Among the subpopulation with low symptom levels at baseline, those receiving problem-solving education experienced a 39% incident rate. The efficacy of problem-solving education demonstrates the promise of embedding maternal depression prevention programs in Head Start; additional effectiveness studies are necessary to develop meaningful public health programs. (Silverstein et al., 6/14)

JAMA Otolaryngology–Head & Neck Surgery: Comprehensive Hearing Aid Intervention At A Free Subspecialty Clinic
Is it possible to provide free, comprehensive audiologic services to indigent patients? In this observational cohort study at a preexisting free clinic, 34 patients were identified as eligible for a free hearing aid and 20 of these patients (59%) received hearing aids. The value of services provided was estimated to be $2260 per patient. It is feasible to provide free, comprehensive audiologic care, including hearing aids and fitting, in a well-established, free clinic model. (Wertz et al., 6/15)

New England Journal of Medicine: Changes In Hospital Quality Associated With Hospital Value-Based Purchasing 
The Patient Protection and Affordable Care Act (ACA) established value-based purchasing programs throughout Medicare, including the Hospital Value-Based Purchasing (HVBP) program... Our estimates of the effect of HVBP on clinical process, patient experience, and mortality were small, not consistent with one another in the direction of the association, and generally nonsignificant. The significant reduction in 30-day risk-standardized mortality among patients who were admitted to the hospital for pneumonia was driven by an increase in mortality in the matched sample of Critical Access Hospitals. (Ryan et al. 6/15)

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