Research Roundup: Long-Term Care Financing; Hospitals’ EHRs; Doctors’ Views Of Health Law
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Health Affairs:
Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending
Under current policies, ... individuals [needing long-term care services and supports (LTSS)] will fund roughly half of their paid care out of pocket. ... [R]elatively few people purchase private long-term care insurance or save sufficiently to fully finance LTSS; many will eventually turn to Medicaid for help. ... [W]e looked at a front-end-only benefit that provides coverage relatively early in the period of disability but caps benefits, a back-end benefit with no lifetime limit, and a combined comprehensive benefit. We modeled mandatory and voluntary versions of each option, and subsidized and unsubsidized versions of each voluntary option. ... If the primary goal is to significantly increase insurance coverage, the mandatory options would be more successful than the voluntary versions. If the major aim is to reduce Medicaid costs, the comprehensive and back-end mandatory options would be most beneficial. (Favreault, Gleckman and Johnson, 11/16)
Health Affairs:
Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist
We used 2008–14 national data ... to examine hospital [electronic health record] EHR trends. We found large gains in adoption, with 75 percent of US hospitals now having adopted at least a basic EHR system — up from 59 percent in 2013. However, small and rural hospitals continue to lag behind. ... We also saw large increases in the ability to meet core stage 2 meaningful-use criteria (40.5 percent of hospitals, up from 5.8 percent in 2013); much of this progress resulted from increased ability to meet criteria related to exchange of health information with patients and with other physicians during care transitions. ... Our findings suggest that nationwide hospital EHR adoption is in reach but will require attention to small and rural hospitals and strategies to address financial challenges. (Adler-Milstein et al., 11/11)
JAMA/The Kaiser Family Foundation:
Experiences And Attitudes Of Primary Care Practitioners After The ACA
Based on a survey of primary care clinicians in early 2015, this Visualizing Health Policy infographic examines the experiences and attitudes of primary care practitioners ... after the Affordable Care Act’s (ACA’s) major coverage provisions took effect in January 2014. ... [T]heir opinions about the health care law are sharply divided along political party lines. Generally, primary care physicians have a more negative view of health reform’s effect on the cost of patient care, but a more positive view of the law’s impact on patient access .... About 6 of 10 primary care clinicians say they’re seeing more newly insured patients or patients covered by Medicaid .... Large shares — 66% of nurse practitioners and physician assistants and 50% of physicians — report that they’re currently accepting new Medicaid patients. (Hamel et al., 11/17)
The Urban Institute/Robert Wood Johnson Foundation:
More Than 10 Million Uninsured Could Obtain Marketplace Coverage Through Special Enrollment Periods
Enrollment in health insurance marketplaces is generally limited to annual open enrollment periods (OEPs). However, some events, such as termination of health coverage due to job loss, can qualify consumers for special enrollment periods (SEPs) that let them sign up for marketplace plans at other times. We estimate [that about] 12.9 million people could enroll using SEPs who would otherwise lose coverage and be uninsured at the end of the year ... [and] [a]n additional 20.6 million could use SEPs to prevent temporary coverage gaps. ... Based on an August 2015 report from the Centers for Medicare and Medicaid Services (CMS), we estimate that fewer than 15 percent of these uninsured consumers are enrolling through SEPs for which they qualify. (Buettgens, Dorn and Recht, 11/17)
The Kaiser Family Foundation:
Women’s Health Insurance Coverage
Among the 97.5 million women ages 19 to 64 residing in the U.S., most had some form of coverage in 2014. However, gaps in private sector and publicly-funded programs left almost one in eight women uninsured. ... This factsheet reviews major sources of coverage for women residing in the U.S. in 2014, the first full year of the Affordable Care Act’s (ACA’s) major coverage expansion, and discusses the likely changes and impact of the law on women’s coverage in future years. (11/11)
Here is a selection of news coverage of other recent research:
Reuters:
Texas Law Leads To More Attempts At Self-Induced Abortions: Study
A Texas law aimed at restricting abortions, which took effect in 2013, has led to more women trying to end a pregnancy on their own, while the number of clinical procedures in the state has declined, according to a study released on Tuesday. The study showed that poor women bear the brunt of the law. "Poverty, limited resources, and local facility closures limited women's ability to obtain abortion care in a clinic setting and were key factors in deciding to attempt abortion self-induction," the Texas Policy Evaluation Project found. (Herskovitz, 11/17)
The Associated Press:
Rare TB Case Shows Difficulty Diagnosing, Treating Children
When a 2-year-old returned sick from a visit to India, U.S. doctors suspected tuberculosis even though standard tests said no. It would take three months to confirm she had an extreme form of the disease — a saga that highlights the desperate need for better ways to fight TB in youngsters in countries that can't afford such creative care. Drug-resistant tuberculosis is a global health threat, and it's particularly challenging for young children who are harder even to diagnose, much less treat. Doctors at Johns Hopkins Children's Center are reporting how they successfully treated one of the few tots ever diagnosed in the U.S. with the worst kind — extensively drug-resistant TB, or XDR-TB, that's impervious to a list of medicines. (11/16)
NBC News:
Women Still Spurn Most Effective Types Of Birth Control, CDC Finds
American women are still spurning the most effective methods of birth control in favor of the pill and sterilization, government researchers said Tuesday. But women almost universally use birth control of some sort, with 60 percent of women currently using contraception and 99 percent of women who have ever had sex having used it at some point, the team from the National Center for Health Statistics found. (Fox, 11/10)
Reuters:
Advising People About Heart Risk Genes Helped Cut Cholesterol: Study
People who were told their genetic risk for heart disease had lower levels of LDL, the so-called bad cholesterol, six months later, according to a new study that offers a first glimpse of how doctors might use genetic information in clinical practice. In the study presented on Monday at the American Heart Association meeting in Orlando, Florida, researchers at Mayo Clinic in Rochester, Minnesota, tested the theory that incorporating genetic risk information into an assessment of a person's heart disease risk could lead to lower levels of LDL, the portion of cholesterol that leads to heart attacks and strokes. (Steenhuysen, 11/9)