Category Archives: Health Care

The Case for Single-Price Health Care

Source: Paul S. Hewitt and Phillip Longman, Washington Monthly, Vol. 50 no. 4/5/6, April/May/June 2018

We could largely solve the cost crisis simply by making Medicare prices universal.

Related:

Their Own Medicine
Source: Fran Quigley, Washington Monthly, Vol. 50 no. 4/5/6, April/May/June 2018

Patient activists were once at the forefront of lowering the cost of life-saving medication. To solve today’s prescription drug crisis, they’ll have to find their voice again.

Assessing The Value Of 40 Years Of Local Public Expenditures On Health

Source: Jonathon P. Leider, Natalia Alfonso, Beth Resnick, Eoghan Brady, J. Mac McCullough, and David Bishai, Health Affairs, Vol. 37 no. 4, 2018
(subscription required)

From the abstract:
The US public and private sectors now spend more than $3 trillion on health each year. While critical studies have examined the relationship between public spending on health and health outcomes, relatively little is known about the impact of broader public-sector spending on health. Using county-level public finance data for the period 1972–2012, we estimated the impact of local public hospital spending and nonhospital health spending on all-cause mortality in the county. Overall, a 10 percent increase in nonhospital health spending was associated with a 0.006 percent decrease in all-cause mortality one year after the initial spending. This effect was larger and significant in counties with greater proportions of racial/ethnic minorities. Our results indicate that county nonhospital health spending has health benefits that can help reduce costs and improve health outcomes in localities across the nation, though greater focus on population-oriented services may be warranted.

Affordable Care Act’s Cadillac Tax Could Affect One-Fourth Of Workers With Employer Health Coverage By 2025

Source: Mark J. Warshawsky and Michael Leahy, Health Affairs, Vol. 37 no. 4, April 2018
(subscription required)

From the abstract:
The excise tax on high-cost health insurance plans (known as the Cadillac tax) under the Affordable Care Act (ACA) is an important part of the law’s attempt to control rising health care costs. Analysts using different data sources have come to divergent estimates of how many people would be affected by this tax. We used the National Compensation Survey from the Bureau of Labor Statistics, which is better suited to this analysis because of its law-relevant details on employer-provided health benefits. Our research clarifies an important area of empirical uncertainty, thereby informing the debate about the ACA and its proposed replacements. Our base estimate of impact, 12 percent of workers participating in employer-provided health plans in 2020, lies in the middle of other estimates, but it is considerably more comprehensive, accurate, and delineated by worker characteristics (region, number of employees at the firm, industry, occupation, and so on) than others. Workers affected at the highest rate include those in education occupations and high-income workers, while those in industries involving manual labor and public safety are affected at some of the lowest rates.

High-performance insights – best practices in health care

Source: Willis Towers Watson, Best Practices in Health Care Employer Survey Report, 2017

Key survey findings:
– Confidence is strong
Despite uncertainty about health care legislation, employer confidence in offering health benefits reached its highest level since the passage of the Affordable Care Act in 2010. Ninety-two percent of employers said they are “very confident” their organization will continue to sponsor health benefits in five years.

– Cost pressures remain
Employers expect health care costs to increase by 5.5%1 in 2018, up from a 4.6% increase in 2017. They plan to step up cost management strategies over the next three years, including evaluation of emerging health care delivery solutions and improved patient navigation and health engagement.

– Creating a cost advantage
Best-performing companies have created a cost advantage of more than $2,000 per employee per year (PEPY) over the national average by adding value through a broad set of activities to control costs and improve workforce health. Their cost advantage over high-cost companies rises to more than $3,500 PEPY.

– Emphasizing clinical conditions
Employers put more emphasis on specific clinical areas – notably diabetes (76%), musculoskeletal (69%) and mental health (65%) – to improve member health and reduce costs.

– Proactive management of pharmacy benefit costs
Employers take more aggressive steps to curb pharmacy costs and utilization (particularly for specialty) by re-examining benefit contract terms and looking beyond PBMs to integrate with the medical plan.

– Prioritizing the employee health experience
Over the next three years, employers plan to improve the employee experience by adding choice, providing decision-support tools, and enhancing enrollment platforms and navigation.

– Health and well-being as a key competitive advantage
Increasingly organizations view their health and well-being programs as a key factor to attract talent, and many organizations plan to broaden their efforts to support employees’ physical, emotional and financial well-being.

3 Game-Changing Wellness Trends

Source: Alexander Alonso, HR Magazine, Vol. 63 no. 3, April 2018
(subscription required)

Use of personal data and customized programs could help elevate employees’ work performance….

….While companies that have robust participation in wellness activities are indeed likely to have better organizational outcomes than those that don’t, is that really because of employees’ improved health? The answer is no.

Rather, wellness is a part of defining culture and articulating an organization’s values—a healthy workforce among them. For employees, the programs drive a greater understanding of the company’s culture by linking the culture to their personal outcomes. After all, good health at its core is about workers’ quality of life…..

Examining the Impact of Federal Employee Wellness Programs and Employee Resilience in the Federal Workplace

Source: Stephanie A. Pink-Harper and Beth Rauhaus, Journal of Health and Human Services Administration, Vol. 40, No. 3, Winter 2017
(subscription required)

From the abstract:
The term “family-friendly” has been broadened to “employee-friendly” to encompass employees who may not benefit from traditional familial benefits. This change in terminology, focusing on employees in a general sense, has not necessarily resulted in policies that are beneficial to a dynamic, diverse public service. As demographics and lifestyles of federal government employees change, human resource policies will need to adapt to meet the needs of this population. This research explores the impact that employee-friendly policies (i.e. family, health, and socio-economic) have on the employee, and the workplace environment. This project attempts to bridge the gap between the theory- driven creation of employee-friendly policies and the practice of beneficial policies that employees will take advantage of. Results suggest that as demographics of the public service change, the need for human resource practices to be modified becomes even more apparent to achieve an appropriate work-life balance. In order to address these challenges, this work offers policy recommendations for increased levels of job satisfaction, which focus on benefits useful in improving federal public servants’ wellness.

Assessing The Value Of 40 Years Of Local Public Expenditures On Health

Source: Jonathon P. Leider, Natalia Alfonso, Beth Resnick, Eoghan Brady, J. Mac McCullough, and David Bishai, Health Affairs, Vol. 37, No. 4, April 2018
(subscription required)

From the abstract:
The US public and private sectors now spend more than $3 trillion on health each year. While critical studies have examined the relationship between public spending on health and health outcomes, relatively little is known about the impact of broader public-sector spending on health. Using county-level public finance data for the period 1972–2012, we estimated the impact of local public hospital spending and nonhospital health spending on all-cause mortality in the county. Overall, a 10 percent increase in nonhospital health spending was associated with a 0.006 percent decrease in all-cause mortality one year after the initial spending. This effect was larger and significant in counties with greater proportions of racial/ethnic minorities. Our results indicate that county nonhospital health spending has health benefits that can help reduce costs and improve health outcomes in localities across the nation, though greater focus on population-oriented services may be warranted.

Healthcare for All

Source: Dissent, Spring 2018
(subscription required)

Articles include:
Crisis and Opportunity
Adam Gaffney
The left will not live forever on the sidelines of political power. When we have an opportunity to remake our healthcare system, we must be sure to seize it.
Introducing the special section of our Spring issue.

How to Win Medicare for All
Josh Mound
For a progressive program of government-provided healthcare to make it into law, survive, and thrive, it must be popular.

Undocumented, Uninsured, Unafraid
Beatrix Hoffman
In the fight for healthcare for all, single-payer and immigrant rights activists face serious obstacles, but also the opportunity to demonstrate the benefits of true universalism.

Cashing in on Despair
George Karandinos
Profiteering is distorting the response to the opioid epidemic as much as it shaped its origin.

The Class Politics of Teeth
Mary Otto
Inequalities in oral health and dental access reflect our deepest social and economic divides.

Single-Payer or Bust
Adam Gaffney
By providing a single tier of coverage to all, with automatic enrollment, comprehensive benefits, and no cost-sharing, single-payer provides a distinct—and more egalitarian—vision of universality.