Recently in Health Care Category

Source: Anthony Webb and Natalia Zhivan, Center for Retirement Research at Boston College, Issue in Brief, IB#10-4, March 2010

The brief's key findings are:
Health care costs loom as a major risk for retirees, with nursing home care as the real wild card.

A typical couple at age 65 can expect to spend over its remaining lifetime:
-$197,000 with a 5-percent risk of exceeding $311,000, excluding nursing home care; or
-$260,000 with a 5-percent risk of exceeding $570,000, including nursing home care.
Households need to figure out how to handle such risk.
See also:
- Abstract
- Working Paper

Source: Lena M. Chen, Ashish K. Jha, Stuart Guterman, Abigail B. Ridgway, E. John Orav, Arnold M. Epstein, Archives of Internal Medicine, Vol. 170 no. 4, 2010
(subscription required)

From the abstract:
Background: Hospitals face increasing pressure to lower cost of care while improving quality of care. It is unclear if efforts to reduce hospital cost of care will adversely affect quality of care or increase downstream inpatient cost of care.

Conclusions: The associations are inconsistent between hospitals' cost of care and quality of care and between hospitals' cost of care and mortality rates. Most evidence did not support the "penny wise and pound foolish" hypothesis that low-cost hospitals discharge patients earlier but have higher readmission rates and greater downstream inpatient cost of care.
See also:
Decreasing Hospital Costs While Maintaining Quality: Can It Be Done?

Source: National Association of Public Hospitals and Health Systems, Policy Brief, February 2010

Since the beginning of the economic recession, safety net health systems have treated more patients overall, including 23 percent more uninsured patients. These health systems have also
provided 10 percent more uncompensated care to low-income populations.This research brief explores how safety net organizations remain critical to the nation's health care system.

Source: Kenneth E. Thorpe, Lydia L. Ogden and Katya Galactionova, Health Affairs, Published online February 18, 2010
(subscription required)

From the abstract:
Medicare beneficiaries' medical needs, and where beneficiaries undergo treatment, have changed dramatically over the past two decades. Twenty years ago, most spending growth was linked to intensive inpatient (hospital) services, chiefly for heart disease. Recently, much of the growth has been attributable to chronic conditions such as diabetes, arthritis, hypertension, and kidney disease. These conditions are chiefly treated not in hospitals but in outpatient settings and by patients at home with prescription drugs. Health reform must address changed health needs through evidence-based community prevention, care coordination, and support for patient self-management.

Source: Christopher J. Truffer, Sean Keehan, Sheila Smith, Jonathan Cylus, Andrea Sisko John A. Poisal, Joseph Lizonitz, and M. Kent Clemens, Health Affairs, Published online February 4, 2010
(subscription required)

From the abstract:
The economic recession and rising unemployment--plus changing demographics and baby boomers aging into Medicare--are among the factors expected to influence health spending during 2009-2019. In 2009 the health share of gross domestic product (GDP) is expected to have increased 1.1 percentage points to 17.3 percent--the largest single-year increase since 1960. Average public spending growth rates for hospital, physician and clinical services, and prescription drugs are expected to exceed private spending growth in the first four years of the projections. As a result, public spending is projected to account for more than half of all U.S. health care spending by 2012.

Source: Steven M. Albert, Richard Schulz, Alberto Colombi, MetLife, February 2010

From the summary:
Employees responsible for eldercare report more health problems than non-caregiving employees and cost U.S. employers an estimated $13 billion annually. Demographic trends indicate that a greater number of employees of all ages will assume the role of family caregiver for an increasingly older population. In combination, these trends mean that more employees will be dealing with eldercare issues. This brings to the forefront an urgent need for employers to actively address how to best facilitate the realities of employees dealing with eldercare responsibilities.

Key Findings

*The estimated average additional health cost to employers is 8% more for those with eldercare responsibilities.

*This differential in health care for caregiving employees is estimated, conservatively, as costing U.S. employers $13.4 billion per year.

*Employees providing eldercare were more likely to report fair or poor health, and are more likely to report depression, diabetes, hypertension, or pulmonary disease

Source: Katherine Baicker, David Cutler and Zirui Song, Health Affairs, Vol. 29 no. 2, Published online 14 January 2010
(subscription required)

From the abstract:
Amid soaring health spending, there is growing interest in workplace disease prevention and wellness programs to improve health and lower costs. In a critical meta-analysis of the literature on costs and savings associated with such programs, we found that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent. Although further exploration of the mechanisms at work and broader applicability of the findings is needed, this return on investment suggests that the wider adoption of such programs could prove beneficial for budgets and productivity as well as health outcomes.

Source: Stephen Blakely, Employee Benefit Research Institute, EBRI Issue Brief no. 339, February 2010

Since the vast majority of Americans who have health coverage get it through their jobs, one obvious question raised by the health reform legislation pending in Congress is: How might it affect the U.S. employment-based health benefits system? At a recent day-long conference sponsored by EBRI, more than a dozen experts from a wide range of specialties found consensus on one point: Imposing a tax on health benefits (such as the proposed tax on so-called "Cadillac" health plans) is likely to cause major cuts in health benefits and might result in structural changes in the employment-based benefits system.
See also:
Press release

Source: Katherine Baicker, David Cutler and Zirui Song, Health Affairs, published online January 14, 2010
(subscription required)

From the abstract:
Amid soaring health spending, there is growing interest in workplace disease prevention and wellness programs to improve health and lower costs. In a critical meta-analysis of the literature on costs and savings associated with such programs, we found that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent. Although further exploration of the mechanisms at work and broader applicability of the findings is needed, this return on investment suggests that the wider adoption of such programs could prove beneficial for budgets and productivity as well as health outcomes.

Source: Pamela Doty, Kevin J. Mahoney, and Mark Sciegaj, Health Affairs, Vol. 29 no. 1, 2010
(subscription required)

From the abstract:
Consumer-directed long-term care service programs give participants the flexibility they want, while reducing unmet need for home and community-based services and supports. States' efforts to expand such programs under Medicaid, including those supported by federal Cash and Counseling demonstration and evaluation grants, are often hindered by challenges related to costs, staffing and organizational issues, new infrastructure requirements, and resistance from stakeholders. Yet states have developed a number of successful strategies for overcoming these challenges, even in financially trying times. Their experiences offer valuable insights, guidance, and encouragement to other states contemplating consumer-directed service expansions.