Research Roundup - February 2016


State Considering How to Increase Hospital Transparency

By Priyanka Dayal McCluskey | The Boston Globe | Jan. 26, 2016

Recent reports that underscore persistent variations in healthcare prices charged by different Massachusetts hospitals have led to renewed calls for greater transparency around what patients pay for medical services. The Massachusetts Legislature has mandated the creation of a price and quality transparency website but the state’s Center for Health Information and Analysis  is having difficulty identifying what healthcare data consumers need in a price transparency tool. [Link]


Missouri Hospital Association Launches New Pricing Tool; Local Hospitals Mostly Absent

Dora Grote | Kansas City Business Journal | Feb. 3, 2016

Focus on Hospitals, the Missouri Hospital Association’s consumer-focused website, offers pricing data for participating Missouri hospitals. The launch of pricing data is concurrent with a complete revision of Missouri’s hospital quality transparency program.  In reality, only 80% of hospitals in the state are participating. [Link]


A Novel Plan for Healthcare: Cutting Costs, Not Raising Them

By Reed Abelson | The New York Times | Feb. 17, 2016

Intermountain Healthcare, a nonprofit health system in Salt Lake City, is promising to sharply cut costs rather than pass them on. Its new health plan, SelectHealth Share, is guaranteeing to hold yearly rate increases to one-third to one-half less than what many employers across the country typically face. Under the Intermountain plan, employees also are required to take more responsibility for their health by agreeing to participate in programs like a health risk assessment or have a health screening like a cholesterol check or colonoscopy if they are over 50. [Link]


Vermont Takes Next Step in Global Budgeting: Releases All-Payer Model

By National Academy for State Health Policy| Feb. 2, 2016

Vermont has laid out the critical components of the state’s conception of an all-payer model. Vermont’s approach distinguishes itself by setting spending targets for almost all services – not just hospital care. [Link]

Recent Reports

The Patient-Centered Medical Home's Impact on Cost and Quality: Review of Evidence

Marci Nielson, et al. | Patient-Centered Primary Care Collaborative | February 2016

The Annual Review of the Evidence provides a summary of PCMH cost and utilization results from peer-reviewed studies, state government evaluations, industry reports, and new this year, independent federal program evaluations published between October 2014 and November 2015. It reviews the recent evidence for PCMH and advanced primary care in light of new developments in health system payment reform including Medicare’s transition to value-based payments. [Link]

Evaluating the Patient Engagement, Quality and Safety of Mobile Health Applications

By Karandeep Singh, et al. | Commonwealth Foundation | Feb. 18, 2016

The number of consumers using smartphone and tablets continues to increase and these technologies serve as a potentially promising tool for engaging patients in their healthcare, particularly those with high healthcare needs. The authors of the report developed criteria for patient engagement, quality and safety of mobile apps. [Link]

Searching for Savings in Medicare Drug Price Negotiations

By Juliette Cubanski and Tricia Neuman | Kaiser Family Foundation | Feb. 9, 2016

After many years of slow growth, prescription drug spending growth is on the rise, raising fiscal concerns for public and private payers and worries about affordability among consumers.This issue brief provides a short history of the concept of allowing Medicare to negotiate drug prices, describes various approaches, and assessments of their potential savings from the Congressional Budget Office and considers the prospects for action in the future. [Link]

Six Steps to Transform Healthcare Now

NORC at the University of Chicago | Feb. 17, 2016

Healthcare leaders from across the industry have identified six "common-sense solutions" to improve the U.S. healthcare system, touching on subjects including data interoperability, Medicare payment policies and care of chronically ill patients. [Link]

Evaluating Medicare’s Payment and Delivery Reform Initiatives

Susan Baseman, et al. | Kaiser Family Foundation | Feb. 22, 2016

Policymakers, healthcare providers, and researchers continue to call for “delivery system reform”—changes to the way healthcare is provided and paid for in the U.S.—to address concerns about rising costs, quality of care and inefficient spending. This paper describes the framework and concepts of three payment models that CMS is currently testing and implementing within traditional Medicare—medical homes, ACOs, and bundled payments. Early evidence shows that many of the models are meeting quality targets and showing improvements in quality of care, but to date, overall net savings to Medicare are relatively modest, with large variation between models. [Link]

Commentary/ News

CMS and AHIP's Quest to Tame the Wilds of Healthcare Quality Measures

By Melanie Evans | Modern Healthcare | Feb. 16, 2016

The CMS and the trade group America's Health Insurance Plans announced an agreement to adopt a core set of quality measures for providers. The agreement—which outlines seven sets of quality measures to be used across public and private payers—is the first to be announced by the Core Quality Measures Collaborative, which includes the CMS, AHIP, the American Academy of Family Physicians and the National Partnership for Women and Families. The National Quality Forum, an endorsement body for industry quality standards, was a technical adviser. [Link]

Innovation Waivers and the ACA: As Federal Officials Flesh Out Key Requirements for Modifying the Health Law, States Tread Slowly

By Kevin Williams, et al. | Commonwealth Fund | Feb. 17, 2016

Starting in 2017, the ACA gives states the chance to use alternative approaches to realizing the cost, coverage and quality goals of the law. States can pursue “innovation waivers,” sometimes known as 1332 waivers, that allow them to modify key parts of the ACA. As 2017 quickly approaches, the Obama administration published guidelines that supplies important considerations for states to weigh as they explore their waiver options and explains the “guardrails” designed to protect the ACA’s objectives. [Link]

New Online Tools Offer One Path to Lower Drug Prices

By Katie Thomas | The New York Times | Feb. 9, 2016

Americans have come to rely on their smartphones to buy everyday items. There is still no price transparency around  buying prescription drugs and most major pharmacies do not list the price of the drugs they sell.  A few entrepreneurs say they are aiming to fundamentally change the way people buy drugs, bringing the industry into the digital age by disclosing the lowest prices for generic prescriptions to allow comparison-shopping. [Link]

I Went to the Hospital to Stay Sane. I Left with Bills I Could Never Pay

By Stephanie Land | Vox | Feb. 11, 2016

This first-person piece explores the debt a young women incurred after staying in a mental hospital. The author argues that our health system frames mental health as a luxury service and often insurance does not cover many needed mental health services. [Link]

Tapping Real-World Evidence to Achieve Better Value in Healthcare

By Jeffrey Bloss | The Hill | Feb. 9, 2016

Payers, physician groups, engaged patients, biopharmaceutical companies are all focused on value and related frameworks. But as these frameworks are evaluated and put into place, we need appropriate guardrails that preserve evidence-based decision-making by patients and physicians. [Link]