KHN Morning Briefing

Summaries of health policy coverage from major news organizations

full issue

Research Roundup: Impact Of GOP Lawsuit; Co-Ops’ Failures; Plan Choices For Patients With HIV

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

The Urban Institute: The Implications Of A Finding For The Plaintiffs In House V. Burwell
[In a lawsuit] the House of Representatives claims that the cost-sharing reductions (CSRs) the Obama administration paid to low-income enrollees ... in Marketplace coverage were inappropriate .... We use the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM) to estimate the amifications of eliminating federal reimbursement of CSRs. ... We find that premiums for silver Marketplace plans would increase $1,040 per person on average. ... The higher premiums would in turn lead to higher federal payments for Marketplace tax credits because such payments are tied to the second-lowest-cost silver plan premium. ... On net, Marketplace enrollment would decrease by 1.0 million people because enrollees ineligible for tax credits could find less expensive coverage elsewhere, and federal government costs would increase $3.6 billion in 2016. (Blumberg and Buettgens, 1/27)

The Urban Institute: What Does The Failure Of Some Co-Ops And The Possible Pullout Of United Healthcare Mean For The Affordable Care Act?
[T]he failure of several health insurance cooperatives (co-ops) ... has received widespread media attention. Some have argued that ... their failure is a major blow to the ACA’s viability. Also recently, United Healthcare (United), the nation’s largest insurer, announced in an investor call that is considering withdrawing from many or all marketplaces in 2017. In this brief we look at the experience of co-ops and United, and we argue that they have not been major players in many markets and their exits will not be overly disruptive. Further, we provide evidence that health insurance markets are increasingly dominated by competition among Blue Cross–affiliated insurers, managed-care insurers that previously served the Medicaid population ... and provider-sponsored insurers. (Holahan, Blumberg and Wengle. 1/27)

The Kaiser Family Foundation: Marketplace Health Plan Options For People With HIV Under The ACA: An Approach To More Comprehensive Cost Assessment
This analysis provides estimates of the costs HIV positive individuals might expect to face when enrolled in marketplace health plans and describes the characteristics of plans that might offer the greatest value. Altogether, costs in 300 different enrollment scenarios are examined .... The plans with the lowest premiums examined here were not, in most cases, the most cost-effective plan option based on either of the cost measures used in this analysis. This analysis suggests that enrollees at the lowest income levels, who have the greatest access to cost-sharing reduction (CSR) subsidies, could find the lowest expected costs in silver level plans .... Commonly, silver plans provide the least liability for those at lower incomes while platinum plans provided the least liability for those with higher incomes. (Dawson and Kates, 1/28)

Commonwealth Fund/Annals Of Internal Medicine: Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care
The field of behavioral economics is built on the premise that human behavior is not always rational. ... Health care organizations are increasingly entering into contracts that reward them for improving outcomes and reducing spending. But they often struggle to translate these goals into effective incentive programs for physicians making the decisions that are key to achieving cost savings and quality improvements. Monetary incentive programs fail to account for the way emotions and social status, among other variables, factor into providers’ decisions. ... Insights from behavioral economics can help health care organizations engage providers by working with human limitations rather than fighting against them. (Emanuel et al., 1/19)

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

Reuters: More Research Needed To Prevent Elder Abuse
Maltreatment and abuse have important effects on the health, quality of life and even the lifespan of elderly people, but there is very little evidence on ways to stop it, according to a new research review. Elder maltreatment can include physical injury, emotional abuse like screaming or threatening, illegal use of financial resources, sexual abuse, intentional or unintentional neglect, as well as using physical or chemical restraints. (Doyle, 1/23)

Reuters: Adding Behaviorial Therapy To Meds Reduces Depression Long-Term
When depression does not respond to antidepressant medication, replacing it with cognitive behavioral therapy (CBT) or adding CBT to treatment may be effective and last for several years, according to a trial in the U.K. Three to five years after having up to 18 CBT sessions, trial participants were less depressed than those who didn’t get the added behavioral therapy, suggesting a long-term benefit that makes CBT cost-effective, the authors conclude. (Doyle, 1/27)

NPR: Why Poverty May Be More Relevant Than Race For Childhood Obesity
As researchers have searched for ways to explain the childhood obesity epidemic in the U.S., many have posited that a child's race or ethnicity alone can put them at greater risk of becoming overweight or obese. Kim Eagle, a professor of internal medicine and health management and policy at the University of Michigan, was skeptical of this thinking. His hunch was that poverty was a much more important part of the equation. (Rancano, 1/22)

The Miami Herald: Study Finds African American Children Have Low Hodgkin Lymphoma Survival Rates In Florida
A new study on pediatric Hodgkin lymphoma from the UM Sylvester Comprehensive Cancer Center has found that African-American children and teenagers diagnosed with the disease have substantially inferior survival rates than their white and Hispanic counterparts. But they fare even worse in Florida than on a national level. Lymphoma cancer – where white blood cells in the immune system grow abnormally – is the third most common form of cancer in children and teenagers. Hodgkin lymphoma makes up almost half of all lymphoma diagnoses and is highly curable. According to the American Cancer Society, the first stage of the disease has a 90 percent five-year survival rate. (Miller, 1/24)

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