Category: HEALTH NEWS

Market-based reforms in health care, such as public reporting of quality, may inadvertently exacerbate disparities. We examined how the Centers for Medicare and Medicare Services’ five-star rating system for nursing homes has affected residents who are dually enrolled in Medicare and Medicaid (“dual eligibles”), a particularly vulnerable and disadvantaged population. Specifically, we assessed the extent to which dual eligibles and non–dual eligibles avoided the lowest-rated nursing homes and chose the highest-rated homes once the five-star rating system began, in late 2008. We found that both populations resided in better-quality homes over time but that by 2010 the increased likelihood of choosing the highest-rated homes was substantially smaller for dual eligibles than for non–dual eligibles. Thus, the gap in quality, as

The Affordable Care Act (ACA) dramatically expands health insurance for addiction treatment and provides unprecedented opportunities for service growth and delivery model reform. Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change. In light of these challenges, we conducted a national survey to examine how Single State Agencies for addiction treatment—the state governmental organizations charged with overseeing addiction treatment programs—are helping programs respond to new requirements under the ACA. We found that most Single State Agencies provide little assistance to addiction treatment programs. Most agencies are helping programs develop collaborations with other health service programs. However, fewer than half reported providing help in modernizing systems to support insurance participation, and only one in three provided

Potentially avoidable hospitalizations are studied as an indirect measure of access to primary care. Understanding the determinants of these hospitalizations can help improve the quality, efficiency, and equity of health care delivery. Few studies have tackled the issue of potentially avoidable hospitalizations in France, and none has done so at the national level. We assessed disparities in potentially avoidable hospitalizations in France in 2012 and analyzed their determinants. The standardized rate of potentially avoidable hospitalizations ranged from 0.1 to 44.4 cases per 1,000 inhabitants, at the ZIP code level. Increased potentially avoidable hospitalizations were associated with higher mortality, lower density of acute care beds and ambulatory care nurses, lower median income, and lower education levels. This study unveils considerable variation in the rate of potentially avoidable hospitalizations in spite of France’

Fear-based public health campaigns have been the subject of an intense moral and empirical debate. We examined how New York City, under Mayor Michael Bloomberg, used fear-based appeals to confront three challenges to public health: high rates of tobacco use, obesity, and HIV infection. New York City’s use of this type of messaging may have set a precedent. Other state and local health departments will have to navigate how and whether to use fear in a context where it is possible to assert that it can serve the interests of public health. But this will not reduce the need to carefully balance efficacy, uncertainty, stigma, marginalization, emotional burdens, justice, community participation, and scientific credibility.

Where a physician is educated—in a public or a private institution—affects his or her practice choices, including the likelihood of choosing a career in primary care. It is important to monitor the educational pipeline for physicians to ensure that a robust cadre of professionals is entering the health care workforce from public-sector institutions to meet the growing demand for primary care providers.

Federal regulations establish special enrollment periods—times outside of open enrollment periods—during which people may enroll in or change their health insurance plans offered through the federal and state-based exchanges, or Marketplaces. To be eligible, a person must experience a shift in income or another “qualifying life event,” such as a change in marital status or the number of dependents, or the loss of minimum essential health coverage. We produced an upper-bound estimate that 3.7 million nonelderly adults with coverage through a federal or state Marketplace could have experienced a qualifying life event and become eligible for a special enrollment period because of income shifts. In addition, more than 8.4 million nonelderly adults who did not have Marketplace coverage—three-quarters of whom had no

In spring 2015 Congress passed legislation to extend funding for the Children’s Health Insurance Program (CHIP) through the end of fiscal year 2017. This two-year extension pushes to 2017 the question of whether CHIP funding will end, allowing states to end their separate state CHIP programs. Also, when the Affordable Care Act’s maintenance-of-effort requirements expire after 2019, states will be allowed to roll back Medicaid- and CHIP-eligibility thresholds to minimum levels allowed by federal law. This study investigated the potential health insurance options available to low-income children if these events happen. If all states roll back coverage to federal statutory minimums, then, among children in families with incomes up to 400 percent of the federal poverty guidelines, the share ineligible for public coverage or subsidized

When her mother is hurt, a health care executive finds that the standardized care she championed isn’t always appropriate.

SOURCE: Health Affairs current issue – Read entire story here.

SOURCE: Health Affairs current issue – Read entire story here.

SOURCE: Health Affairs current issue – Read entire story here.