“We believe the U.S. health care system should embrace this moment as an opportunity to shift the locus of preventive care from face-to-face annual exams to a strategy that focuses on population health: clinical registries that readily identify all preventive services for which a patient is due; annual prevention kits for patients that facilitate widespread deployment of home-based testing, shared decision making, and self-scheduling of preventive screening tests and procedures in more convenient and approachable community settings; and robust community-based strategies involving navigators to overcome health disparities in underserved populations. The first step in this strategy is developing a robust, … Read More
All posts by Anupam
“Our study of the quality of end-of-life care in MA [Medicare Advantage] plans comes as the Centers for Medicare & Medicaid Services is set to start testing a “carve-in” of hospice services in 2021, meaning that hospice will be a covered benefit within MA and therefore MA plans will take a more active role in hospice services. Currently, the hospice benefit is “carved out” from MA, although MA plans are still involved in the care of hospice enrollees through several mechanisms. Older adults in MA are more likely to receive hospice services, potentially through direct care coordination or by contracting … Read More
“Health care delivery organizations have faced a myriad of important management challenges during the Covid-19 pandemic. Some of the challenges are idiosyncratic to the individual organization; others, however, are broadly faced by almost every health care delivery organization and are likely to be faced in any major disaster. The first key challenge is the lack of adequate capacity to handle the surging patient volume. [..] A second challenge is the need for real-time redesign of care models for patients. Given the highly contagious nature and severity of the infection, it is necessary for physicians, nurses, and other clinicians to discover … Read More
[Chernew:] I personally don’t like thinking of the payment mix as a portfolio problem because I see a whole range of broader [problems], with the fee-for-service payment writ large. Of course, I see a lot of problems with population-based payments or episode-based payments, as well. But given what happened, delivery systems are understanding that they are facing this service risk and that [..] moving to population-based payment models will give them both a little more mobility and I would argue a little more flexibility and a little more incentive to maintain and build an efficient health care system when we … Read More
On October 7th, the US Department of Health & Human Services published the Surgeon General’s Call to Action to Control Hypertension. The report uses a blood pressure threshold of 130/80 mm Hg as its definition of control. The manuscript includes a goal to optimize patient care for hypertension control and sector-specific recommendations to influence hypertension. Healthy lifestyle changes that could influence blood pressure control include: Losing weight Reducing sodium intake (more specifically, following the Dietary Approaches to Stop Hypertension [DASH] diet promoted by the National Heart, Lung and Blood Institute) Increasing physical activity, and Quitting smoking The report suggests referring … Read More
“This report provides data on individual health insurance market enrollment trends for people who purchase health insurance with (subsidized) and without (unsubsidized) advanced premium tax credits (APTC). From plan years 2016 to 2019, unsubsidized enrollment declined by 2.8 million people, representing a 45 percent drop nationally. At the state level, the percentage change in unsubsidized enrollment over this period ranged from a 4 percent drop in Rhode Island to a 90 percent drop in Iowa. [..] average monthly enrollment across the individual market nationally decreased by 3 percent between 2018 and 2019. Eighty percent of the decrease in enrollment between … Read More
“As measured by the GHS [Global Health Security] Index, the US was better positioned than most other countries to respond to COVID-19. The Index includes 140 questions that assess national capacities or abilities among 6 categories: (1) prevention of the emergence, release, or spread of pathogens; (2) early detection and reporting for epidemics of potential international concern; (3) rapid response to and mitigation of the spread of an epidemic; (4) sufficient and robust health system to treat affected patients and protect health workers; (5) commitments to improving national capacity, financing plans to address gaps, and adhering to global norms; and … Read More
“tobacco cessation after cancer diagnosis is often associated with improved quality of life, fewer complications related to cancer treatment, and longer survival. In a 2018 study, the prevalence of cigarette smoking among adult cancer survivors was 11.8%, and many cancer survivors who quit smoking after a diagnosis may resume smoking. Failure to address the unique challenges of cessation contributes to lack of success in initial cancer treatment due to ongoing smoking and has been associated with an estimated incremental cost of nearly $11,000 per year per smoking patient. Tobacco abstinence is the strongest predictor of cancer survival, after cancer type … Read More
“the health care industry is strenuously resisting this drive for transparency. High-price providers fear public disclosure would force them to lower their rates, since many cannot prove they actually offer higher-quality care. Commercial health plans also fear transparent prices. It would erode their market advantage by enabling competing plans to demand similar rates from providers. [..] Last November, the administration released separate rules requiring hospitals and health insurers to publish their privately negotiated rates for hundreds of non-emergency, “shoppable” services. Hospital groups are fighting in court to block the yet-to-be-enforced hospital rule, arguing that it’s overly burdensome and that the … Read More
“We compared US COVID-19 deaths and excess all-cause mortality in 2020 (vs 2015-2019) to that of 18 countries with diverse COVID-19 responses. We compared the US to Organisation for Economic Co-operation and Development countries with populations exceeding 5 million and greater than $25 000 per capita gross domestic product. For each country, we calculated the COVID-19 per capita mortality rate and grouped countries by mortality: (1) low (COVID-19 deaths, <5/100,000), (2) moderate (5-25/100,000), and (3) high (>25/100,000). We used Poisson regression for comparisons across countries. [..] In the 14 countries with all-cause mortality data, the patterns found for COVID-19–specific deaths were … Read More