Substantial Physician Turnover And Beneficiary 'Churn In A Large Medicare Pioneer ACO [Accountable Care Organizations]
Alternative payment models, such as accountable care organizations (ACOs), attempt to stimulate improvements in care delivery by better alignment of payer and provider incentives. However, limited attention has been paid to the physicians who actually deliver the care. In a large Medicare Pioneer ACO, we found that the number of beneficiaries per physician was low (median of seventy beneficiaries per physician, or less than 5 percent of a typical panel). We also found substantial physician turnover: More than half of physicians either joined (41 percent) or left (18 percent) the ACO during the 2012–14 ...
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Hsu, J., Vogeli, C., Price, M., Brand, R., Chernew, M. E., Mohta, N., Chaguturu, S. K., Weil, E., Ferris, T. G. Tags: Medicare, Physicians Accountable Care Organizations Source Type: research
Seat-Belt Use In US Counties: Limited Progress Toward Healthy People 2020 Objectives [Disability & Injury]
Spikes in automobile fatalities in 2015 and 2016 have renewed discussions about automobile safety. We measured the prevalence of reported seat-belt compliance in every US county from 2002 to 2012 and found considerable variation. (Source: Health Affairs)
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Sunshine, J., Dwyer-Lindgren, L., Chen, A., Mokdad, A. H. Tags: Public Health Disability & amp; Injury Source Type: research
Preventing Disability: The Influence Of Modifiable Risk Factors On State And National Disability Prevalence [Disability & Injury]
Disability levels in the United States declined during the 1980s and 1990s, but these declines stalled more recently. Using data for 2013 from the Behavioral Risk Factor Surveillance System, we estimated the percentages of national and state disability that could be prevented through reductions in five modifiable health risk factors associated with disability: cigarette smoking, obesity, diabetes, high cholesterol, and hypertension. Taking into account risk-factor prevalence and the association between each risk factor and disability, we evaluated the fraction of disability preventable if risk factors were reduced under tw...
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Mehta, N. K., Patel, S. A., Ali, M. K., Venkat Narayan, K. M. Tags: Health Promotion/Disease Prevention, Public Health Disability & amp; Injury Source Type: research
Low-Income Children With Chronic Conditions Face Increased Costs If Shifted From CHIP To Marketplace Plans [Maternity & Children's Coverage]
In this study we explored two current policy alternatives: extending federal funding for CHIP or enrolling children in the existing health insurance Marketplace plans. We simulated annual out-of-pocket expenses using detailed health plan data from CHIP and federally facilitated Marketplace plans for a nationally representative cohort of children with chronic conditions, conducting comparisons at four different percentage categories of the federal poverty level. If CHIP funding is not renewed and children with chronic conditions shift to coverage under Marketplace plans, their families face increased annual out-of-pocket ex...
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Peltz, A., Davidoff, A. J., Gross, C. P., Rosenthal, M. S. Tags: Medicare, Physicians Maternity & amp; Children ' s Coverage Source Type: research
State And Federal Coverage For Pregnant Immigrants: Prenatal Care Increased, No Change Detected For Infant Health [Maternity & Children's Coverage]
We present new evidence on the impact of states’ public health insurance expansions for pregnant immigrant women (both state-funded and expansions under the Children’s Health Insurance Program) on their prenatal care use, mode of delivery, and infant health. Our quasi-experimental design compared changes in immigrant women’s outcomes in states expanding coverage to changes in outcomes for nonimmigrant women in the same state and to women in nonexpanding states. We found that prenatal care use increased among all immigrant women following coverage expansion and that cesarean section increased among immigra...
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Wherry, L. R., Fabi, R., Schickedanz, A., Saloner, B. Tags: Maternal And Child Health, Medicaid Maternity & amp; Children ' s Coverage Source Type: research
Women In The United States Experience High Rates Of Coverage 'Churn In Months Before And After Childbirth [Maternity & Children's Coverage]
Insurance transitions—sometimes referred to as "churn"—before and after childbirth can adversely affect the continuity and quality of care. Yet little is known about coverage patterns and changes for women giving birth in the United States. Using nationally representative survey data for the period 2005–13, we found high rates of insurance transitions before and after delivery. Half of women who were uninsured nine months before delivery had acquired Medicaid or CHIP coverage by the month of delivery, but 55 percent of women with that coverage at delivery experienced a coverage gap in the ensuing six...
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Daw, J. R., Hatfield, L. A., Swartz, K., Sommers, B. D. Tags: Health Reform, Insurance Coverage, Maternal And Child Health Maternity & amp; Children ' s Coverage Source Type: research
Cross-Currents And Complexities Abound [Web First]
The effort to repeal, replace, and repair the ACA faces myriad policy and political challenges. (Source: Health Affairs)
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Jost, T. S. Tags: Health Reform, Affordable Care Act Web First Source Type: research
Designing A Health System That Works For The Tribe [Entry Point]
After a crisis at its Indian Health Service hospital, the Rosebud Sioux Tribe imagines a health system that finally meets its needs. (Source: Health Affairs)
Source: Health Affairs - April 3, 2017 Category: Global & Universal Authors: Bylander, J. Tags: Hospitals, Rural Health Care Entry Point Source Type: research
Maternity Coverage, Children, Disability, And More [From The Editor-in-Chief]
(Source: Health Affairs)
Source: Health Affairs - April 3, 2017 Category: Global & Universal Tags: Health Reform From The Editor-in-Chief Source Type: research
Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims [Web First]
The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants’ health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments....
Source: Health Affairs - March 29, 2017 Category: Global & Universal Authors: Jacobs, P. D., Cohen, M. L., Keenan, P. Tags: Health Care Finance, Health Reform, Managed Competition, Insurance Market, Affordable Care Act Web First Source Type: research
Cross-Currents And Complexities Abound [Web First]
The effort to repeal, replace, and repair the ACA faces myriad policy and political challenges. (Source: Health Affairs)
Source: Health Affairs - March 29, 2017 Category: Global & Universal Authors: Jost, T. S. Tags: Health Reform, Affordable Care Act Web First Source Type: research
The Volume Of TV Advertisements During The ACAs First Enrollment Period Was Associated With Increased Insurance Coverage [Web First]
The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau’s American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics. We found that c...
Source: Health Affairs - March 14, 2017 Category: Global & Universal Authors: Karaca-Mandic, P., Wilcock, A., Baum, L., Barry, C. L., Fowler, E. F., Niederdeppe, J., Gollust, S. E. Tags: Health Reform, Insurance Coverage, Affordable Care Act Web First Source Type: research
Cross-Currents And Complexities Abound [Web First]
The effort to repeal, replace, and repair the ACA faces myriad policy and political challenges. (Source: Health Affairs)
Source: Health Affairs - March 12, 2017 Category: Global & Universal Authors: Jost, T. S. Tags: Health Reform, Affordable Care Act Web First Source Type: research
Designating The Health Workforce As A Global Good [From the Publisher]
(Source: Health Affairs)
Source: Health Affairs - March 5, 2017 Category: Global & Universal Authors: Kenyon, T. Tags: Access To Care, Health Professions Education, International Issues, Workforce Issues From the Publisher Source Type: research
Meeting Elderly Patients Nonmedical Needs [Letters]
(Source: Health Affairs)
Source: Health Affairs - March 5, 2017 Category: Global & Universal Authors: Lutwak, N., Dill, C. Tags: Access To Care, Elderly Letters Source Type: research
