“An estimated 19,416 individuals died of a drug overdose in the United States in the first 3 months of 2020 compared with 16,682 in the same 3-month period in 2019, according to preliminary data released last week by the US Centers for Disease Control and Prevention’s (CDC’s) National Center for Health Statistics. The agency also estimates that 75,500 overdose deaths occurred in the 12-month period between March 2019 and March 2020, an increase of approximately 10%. If this increased rate for drug overdose deaths holds, the United States is on track to reach a new all-time record for overdose fatalities … Read More
All posts by Anupam
As we stagger through the first (and possibly second) wave of the COVID-19 pandemic in America, there have been proclamations of transforming healthcare delivery with technology alternating with arguments that healthcare will quickly return to normal with in-office encounters and its associated hassles (i.e., co-payments, waiting rooms, exposure to other patients who might be infected). I have been skeptical of telemedicine’s potential to move beyond urgent care for primarily self-limited conditions. I am optimistic that telemedicine (and/or remote patient monitoring) could augment physical offices managing patients with chronic disease, but we as an industry have not generated the evidence to … Read More
“Today, the Centers for Medicare & Medicaid Services (CMS) released a report showing the trend of lower premiums and increased issuer participation for HealthCare.gov will continue for 2021 year. The average premium for the second lowest cost silver plan (also called the benchmark plan) dropped by 2% for the 2021 coverage year and, when looking at states that are using HealthCare.gov in both 2020 and 2021, 22 more issuers will offer coverage in 2021, for a total of 181 issuers delivering more choice and competition for consumers. [..] Three years of declining average benchmark plan premiums combine to deliver an … Read More
“Total knee arthroplasty is a common procedure for end stage osteoarthritis of the knee, with more than 100,000 knee arthroplasties performed each year in the United Kingdom and more than 700,000 in the United States. Projections of future surgical volumes suggest further substantial increases. Although total knee arthroscopy is effective at reducing pain and improving physical function for most patients, around 20% report dissatisfaction with the postoperative outcome. [..] Meta-analyses suggest that uniform postoperative physiotherapy for all patients after total knee arthroplasty compared with no treatment offers short term benefit but is not effective at improving patient outcomes at one … Read More
“Managed care is the dominant method for financing and delivering services in the Medicaid program, with more than 71 million individuals (74% of all Medicaid beneficiaries) enrolled in a managed care plan in 2016. Under most managed care arrangements, state Medicaid programs negotiate a prepaid, capitated rate with a managed care plan to provide comprehensive services rather than directly reimbursing health care providers (eg, hospitals, physician groups, and clinics). By transferring financial risk to managed care plans, capitated payments increase predictability in costs for state Medicaid programs and provide an incentive for plans to reduce spending on hospitalization and emergency … Read More
“Use of noninvasive ventilation (NIV), such as continuous or bilevel positive airway pressure, has increased in select populations of patients with respiratory failure (eg, those with acute exacerbations of chronic obstructive pulmonary disease [COPD] or congestive heart failure [CHF]) because of improved outcomes (ie, increased survival, shorter length of stay, and lower costs) compared with IMV [invasive mechanical ventilation]. As a result of the expanded use of NIV, use of IMV among these populations has substantially decreased over time. Use of NIV to improve survival has been established; however, its use has also been suggested to achieve palliation in persons … Read More
“After 2 decades of efforts relying largely on quality measurement and performance-linked payment incentives, we need new ideas and new conversations. As revealed by health care workers’ response to the Covid-19 pandemic, professionalism in health care may be an underused resource. Reframing quality improvement around the linchpin of care delivery — physician agency — could provide much-needed direction by elucidating strategies that address problems of information or motivation when professionals act as agents on their patients’ behalf. [..] A central concept in health economics is that the physician acts as an agent for the patient, determining what the patient’s problem … Read More
This week’s refresh of the excess mortality count from the CDC (last updated October 14 [I think]). The federal agency identified over 274,000 excess deaths across the country since the start of this year (about 2,000 more than last week’s estimate). The overall excess mortality rate decreased slightly from 11.2% last week to 11.1% this week. Data from the CDC’s National Center for Health Statistics, updated October 14, 2020
“A key contributor to underinsurance is growing enrollment in high-deductible health plans for those on the health insurance exchanges and in employer-sponsored health plans. Solutions such as consumer education, health savings accounts, and targeted cost-sharing reductions have been explored to help alleviate concerns of cost-related non-adherence to needed medical care, yet one-third of privately insured Americans report difficulty affording health care. [..] Given high health care prices, increasing deductibles (the average annual deductible in employer-sponsored insurance increased from $533 in 2009 to $1,655 in 2019), and growing high-deductible health plan enrollment (from 25.3 percent in 2010 to 47.0 percent in … Read More
“As the toll from coronavirus disease 2019 (COVID-19) mounted in the pandemic’s early months, it soon became apparent that people with diabetes and hypertension, among other factors, were at heightened risk of severe disease. But obesity didn’t attract as much attention, according to nutrition scholar Barry Popkin, PhD, of the University of North Carolina (UNC) at Chapel Hill. [..] If you contract the novel coronavirus, “You have more than double the likelihood of going into the hospital if you’re obese and 50% more likelihood of dying,” Popkin said in a recent interview with JAMA. “Those 2 statistics really shook me.” … Read More