Tag Archives: healthcare costs

Smoking cessation treatment among newly covered individuals under the ACA

Smoking cessation is not innovative or trendy or even particularly exciting, but as a primary care doctor, in most cases helping a patient quit smoking is the best thing that I can do to help that patient over their lifetime. Without question. And for that reason, I always make it a priority to talk about it… Read More »

The Political Context of Medicaid Expansion

Republican Congressional leaders are currently debating how to repeal the Affordable Care Act (ACA) as part of the budget reconciliation process. Much of the debate over the ACA has focused on the individual mandate (and here) and the affordability (here and here) of coverage in the state-based marketplaces. The House version of the legislation, however,… Read More »

Do Not Repeal the ACA Without a Comparable Replacement

I once saw a breast cancer so advanced that the tumor had eroded through the woman’s chest wall. This wasn’t in a foreign country with little access to healthcare – it was in the city where I attended medical school: New Haven, Connecticut. The patient worked a full-time job and raised a family, but did… Read More »

Lessons from Analyses of Health Insurance Expansions from the 1980s through 2012

In a recent Medical Care article, Guy and colleagues analyzed health insurance expansions among parents from 1999 through 2012 to assess the impacts of four different types of public and private expansions. They primarily examined changes in parents’ health insurance coverage, but they also analyzed whether expanding coverage for parents could “spill over” and raise coverage… Read More »

The HOSPITAL Score – A Prediction Tool for Potentially Preventable (and Therefore Costly) Readmissions

In the era of value-based care, caregivers and policymakers alike are intensely interested in strategies to reduce 30-day hospital readmissions. Researchers continue to offer up helpful tools in this effort. Recently published online ahead of print in Medical Care, Burke and colleagues make an important contribution with their article The Hospital Score Predicts Potentially Preventable 30-Day Readmissions… Read More »

Should Women Rush to Get IUDs Post-Election? They Should’ve Been Rushing all Along!

The unintended pregnancy rate (reflecting pregnancies that are unwanted or mistimed) for women in the U.S. has hovered at around 50% for the last 35 years.  Only recently has that rate dropped to 45%, but the burden continues to fall most heavily on poor, undereducated women, women from racial or ethnic minority backgrounds, and young women.  Much talk… Read More »

Healthcare Utilization Rates after Oregon’s 2008 Medicaid Expansion: The Long View

Expanding health insurance coverage may improve health care access [PDF] and reduce financial stress [PDF]. Ideally, having health insurance and the resultant access to care should improve health outcomes and well-being, although the evidence is complicated and mixed. One thing is sure: expanded insurance coverage typically leads to more utilization – a concern for policymakers and administrators because… Read More »

Economic Burden of the Opioid Epidemic

According to the U.S. Department of Health & Human Services, in 2014, more than 240 million prescriptions were written for opioids, which is more than sufficient for each American adult to have one full bottle of opioids. Prescription drugs are second only to marijuana as the most abused category of drug in the United States. A recent article… Read More »

Tools to improve coordination in primary care

Last month, I left readers with a bit of cliffhanger: How do we actually improve care coordination? Last time, I suggested there were some great ideas, and now it’s time to delve into three promising strategies: 1) individualize and personalize the electronic medical record (EMR); 2. fix the hospital discharge process; and 3) make it a part of normal practice to measure care coordination. Read on for more about each of these tools…

Affordable Care Act reduced cost-sharing for long-acting reversible contraceptive methods

Since January 2013, most private insurance plans have been required to cover contraceptive services without patient cost-sharing. While health insurance plans have covered some methods of contraception with low cost-sharing, not all plans or methods have been covered equally. This is particularly the case of long-acting reversible contraceptive (LARC) methods, intrauterine devices (IUDs) and implants,… Read More »

Is Care Coordination the Magic Bullet in Primary Care?

Decades of thoughtful research into how we design health care systems has shown that primary care is essential.  We know enough to confidently say that systems responsible for the overall health of patients (like health insurance plans or the Veterans Administration) that choose to skimp on primary care do so at their own peril.  But in a time… Read More »

Which Bias is Which?

Comparative Effectiveness Research (CER) seeks to compare alternative treatments and ways to deliver healthcare to inform healthcare decisions. It can provide evidence of the harms, benefits, and effectiveness of different treatment options. As the number of studies in CER continues to grow, it is vitally important that the types of bias that exist as a function of the study design be explained. In a Medical Care article published in April, Dr. Sebastien Haneuse lays out definitions and examples of selection bias and confounding bias in CER, with a particular emphasis on distinguishing between the two.

The Impact of Gasoline Costs on the Healthcare Industry

The higher the cost of gasoline, the higher the healthcare costs for the treatment of injuries caused by motorcycle crashes. In an article published ahead of print in Medical Care this week, He Zhu and colleagues discuss the association between gas prices in the United States, hospital costs, and utilization for both motorcycle and non-motorcycle related injuries. Remember… Read More »