Research Roundup: The Health Law; Primary Care; And Patient Safety
Each week, KHN compiles a selection of recently released health policy studies and briefs.
Who Entered And Exited Individual Market Before And After ACA?
The Affordable Care Act (ACA) made it easier for older adults and those with medical conditions to enroll in individual-market coverage by eliminating risk rating and limiting age rating. While the ACA also encourages young and healthy people to enroll through subsidies and the individual mandate, it’s not clear whether these incentives have been sufficient to prevent the risk pool from becoming disproportionately old and sick. (Glied and Jackson, 11/29)
The Henry J. Kaiser Family Foundation:
Some Can Get Marketplace Plans With No Premiums,Though With Higher Deductibles And Cost-Sharing
Many low-income consumers who are eligible for federal financial help under the Affordable Care Act can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis from KFF (the Kaiser Family Foundation). Such plans come with higher deductibles and out-of-pocket maximums, however. (11/26)
JAMA Internal Medicine:
Association Of Team-Based Primary Care With Health Care Utilization And Costs Among Chronically Ill Patients
Empirical study findings to date are mixed on the association between team-based primary care initiatives and health care use and costs for Medicaid and commercially insured patients, especially those with multiple chronic conditions. (Meyers et al, 11/26)
Patient Safety In Inpatient Psychiatry: A Remaining Frontier For Health Policy
Behavioral health care has been slow to take up robust efforts to improve patient safety. This lag is especially apparent in inpatient psychiatry, where there is risk for physical and psychological harm. Recent investigative journalism has provoked public concern about instances of alleged abuse, negligence, understaffing, sexual assault, inappropriate medication use, patient self-harm, poor sanitation, and inappropriate restraint and seclusion. However, empirical evidence describing the scope of unsafe experiences is limited. (Shields, Steward, and Delaney, 11/5)
Segregated Neighborhoods, Segregated Schools?
More than 60 years ago, the courts deemed school segregation unconstitutional, yet across the country many students still attend school primarily with students who look like them. Research shows that the racial composition of the public school student population has changed substantially over the past 25 years, but student racial sorting among schools has remained relatively stable. A growing body of research shows that school segregation matters for the educational and socioeconomic outcomes of students of color. To fix it, however, we have to understand why racial segregation has persisted. (11/28)