Category Archives: Health Care

Drug Overdose Rates Are Highest in Places With the Most Economic and Family Distress

Source: Shannon Monnat, Carsey School of Public Policy at the University of New Hampshire, National Issue Brief #134, Spring 2018

From the summary:
The U.S. drug overdose problem has reached epidemic levels, prompting President Trump to declare a public health emergency. Since 2000, 786,781 people in the United States have died from drug overdoses and other drug-related causes, with nearly 40 percent of those deaths occurring in the last three years alone.

The news media regularly portrays the drug overdose epidemic as a national crisis, but some places have much higher drug mortality rates than others. On average, rates are higher in counties with higher levels of economic distress and family dissolution, and they are lower in counties with a larger per capita presence of religious establishments. These findings hold even when controlling for demographic differences, urban or rural status, and health care supply.

KEY FINDINGS
– In 2016, the national drug-related mortality rate per 100,000 persons ranged from a low of 9.9 in Nebraska to a high of 60.3 in West Virginia.
– From 2006 to 2015, counties with the highest levels of economic distress experienced an average of 7.9 more drug-related deaths per 100,000 persons than counties with the lowest levels. This difference is the equivalent of nearly 40,000 excess deaths in the most economically distressed counties over the 10-year period.
– Counties with the highest levels of family dissolution (divorce/separation and single-parent families) had an average of 8.1 more drug-related deaths per 100,000 persons than counties with the lowest levels.
– Counties with the highest per capita presence of religious establishments had an average of 4.7 fewer drug-related deaths per 100,000 persons than counties with the lowest presence of religious establishments.

Related:
Press Release

Employment Effects of the Affordable Care Act Medicaid Expansions

Source: Pauline Leung, Alexandre Mas, Industrial Relations: A Journal of Economy and Society, Volume 57, Issue 2, April 2018
(subscription required)

From the abstract:
We examine whether the recent expansions in Medicaid from the Affordable Care Act reduced “employment lock” among childless adults who were previously ineligible for public coverage. We compare employment in states that chose to expand Medicaid versus those that chose not to expand, before and after implementation. We find that although the expansion increased Medicaid coverage by 3.0 percentage points among childless adults, there was no significant impact on employment.

Warning: Short-Term Health Plans = Higher Premiums for Older Adults

Source: Jane Sung and Lina Walker, AARP Blog, Thinking Policy, March 21, 2018

You might have thought that efforts to unravel the Affordable Care Act (ACA) were over, but newly proposed regulations and legislation are once again threatening to have similar harmful effects for older adults ages 50-64 who rely on individual market coverage. On February 21, 2018, the Trump Administration proposed new federal rules calling for significant expansion of a category of insurance products known as “short-term limited duration” insurance plans. More recently, Congress is considering legislation that would block states, who typically regulate these plans, from taking steps to protect consumers from the harms of these proposed federal rules once they are finalized. Unfortunately, these changes would result in much higher premiums for older adults and people with preexisting health conditions buying individual policies through the ACA Marketplace.

Criteria: U.S. And Canadian Not-For-Profit Acute Care Health Care Organizations

Source: Jennifer J. Soule, S&P Global Ratings, March 19, 2018
(subscription required)

S&P Global Ratings is publishing its methodology for assigning ratings to U.S. and Canadian not-for-profit acute care stand-alone hospitals and health care systems. Our methodology classifies the primary credit factors that we review as part of either the enterprise profile or the financial profile. While many of an organization’s activities affect both profiles, we believe our approach clearly identifies the various ways that strategic and operational activities affect an organization.

State Prison Partnerships Can Improve Public Health and Safety

Source: Maria Schiff and Stephen Fehr, Stateline, March 19, 2018

Nearly all people in prison eventually leave, many of them with chronic diseases or behavioral conditions that may affect public health and safety in the communities where they will live. In a positive trend, corrections departments are partnering with health care agencies in some states to make it possible for offenders’ conditions to be treated when they re-enter the community.

Officials say the collaborations – in states such as Connecticut, Iowa, Missouri and Ohio— are promising because they can improve public health and safety while providing states with a better return on the money spent on treating offenders while they are in prison. Departments of correction collectively spent $8.1 billion on prison health care in fiscal 2015…..

U.S. tax law fuels changes to employee benefit and compensation programs

Source: Willis Towers Watson, February 21, 2018

Willis Towers Watson’s recent pulse survey on impacts from the new tax law reveals that the most common changes organizations have made or are planning or considering include expanding personal financial planning, increasing 401(k) contributions, and increasing or accelerating pension plan contributions. Other potential changes include increasing the employer health care subsidy, reducing or holding flat the employee payroll deduction, or adding a new paid family leave program in accordance with the Family Medical and Leave Act’s tax credit available for paid leave for certain employees.

Related:
Press Release

The Potential Impact of Short-Term Limited-Duration Policies on Insurance Coverage, Premiums, and Federal Spending

Source: Linda J. Blumberg, Matthew Buettgens, Robin Wang, Urban Institute, Research Report, February 2018

From the abstract:
On February 20, 2018, the Departments of Treasury, Labor, and Health and Human Services released a proposed regulation that would increase the maximum length of short-term, limited-duration insurance policies to one year. These plans, sold to individuals and families, are not federally required to comply with the Affordable Care Act regulations that prohibit annual and lifetime benefit limits, require coverage of all essential health benefits, and otherwise prohibit insurers from setting premiums or choosing whether to sell coverage to particular people based on applicants’ health status and health history. As such, these plans do not meet minimum essential coverage standards under the law; thus, the Congressional Budget Office does not consider them private insurance. If implemented, the rule would permit these plans to compete against the ACA-compliant plans.

Importantly, this change would be implemented on top of an array of other significant policy changes made since the beginning of 2017. We analyze the implications of the 2017 policy changes relative to the ACA as originally designed and implemented, in addition to the potential consequences of the proposed expansion to short-term limited-duration policies. In estimating the effects of these changes on insurance coverage, premiums, and federal spending, we take into account the variations in state circumstances and state-specific laws on short-term plans.

This brief was updated February 26, 2018. The title and notes for table 4 were altered to remove references to current law that had been inadvertently copied from tables 1–3.

Supreme Court: Union Retiree Health Benefits Weren’t Vested for Life

Source: Allen Smith, SHRM, February 22, 2018

Draft language in CBAs and benefits documents thoughtfully.

Retiree health care benefits end when a collective bargaining agreement (CBA) between a company and a union expires, unless the CBA provides otherwise, the Supreme Court ruled Feb. 20. The decision underscores the importance of giving careful thought to all language proposed and agreed to at the bargaining table, said David Pryzbylski, an attorney with Barnes & Thornburg in Indianapolis. Make sure the language in the CBA clearly expresses the parties’ intent, he stated. Benefits documents should as well, labor relations attorneys say. ….

Workers’ compensation and the working poor: Occupational health experience among low wage workers in federally qualified health centers

Source: Liza Topete, Linda Forst, Joseph Zanoni and Lee Friedman, American Journal of Industrial Medicine, Early View, January 31, 2018
(subscription required)

From the abstract:
Background:
The working poor are at highest risk of work-related injuries and have limited access to occupational health care.

Objectives:
To explore community health centers (CHCs) as a venue for accessing at risk workers; and to examine the experience, knowledge, and perceptions of workers’ compensation (WC) among the working poor.

Methods:
Key informant interviews were conducted among patients in waiting rooms of rural and urban CHCs.

Result:
Fifty-one interviews of minority workers across sectors identified 23 prior work-related injuries and mixed experiences with the WC system. Barriers to reporting and ways to overcome these barriers were elucidated.

Conclusions:
Patients in CHCs work in jobs that put them at risk for work-related injuries. CHCs are a good site for accessing at-risk workers. Improving occupational healthcare and appropriate billing of WC insurance should be explored, as should best practices for employers to communicate WC laws to low wage workers.