Research Roundup: Highlights From Recent Releases

Kaiser Family Foundation: Kaiser Health Tracking Poll- August 2009 -- Despite the escalating ad war and the heated town hall debate, a slim majority of the public still seems to favor moving forward with health reform, according to the poll.  Fifty-three percent of Americans believe that "taking on health care reform is more important than ever, compared to 42 percent who say we cannot afford to take on health reform right now" (8/20).

Robert Wood Johnson Foundation: Impact of the Economy on Health Care -- This issue brief reviews the impact of the current economic situation in the U.S. on health care, drawing from a collection of reports from across the country. As reported in the brief, though the recession "almost immediately leads to loss of coverage for many people… The effects of the economy also include changes in the demand for (or access to) health care—as well as the financial status of practitioners and health organizations," according to a Robert Wood Johnson Foundation description of the report (Bernstein, 8/14).

Health Affairs: Putting the Public's Money Where Its Mouth Is -- This research paper details the results of a national survey designed to investigate Americans' support of an expansion of health coverage, including Medicaid expansion, subsidies for low-income Americans and the chronically ill, based upon their willingness to pay in higher income taxes. According to the study, the survey of 3,344 U.S. adults showed though a "clear majority of Americans, including a majority of higher-income households, supported" a subsidy for the chronically ill "even at 150 percent of its baseline cost," only "a slim majority (51.3 percent) of Americans were willing to pay 5 percent more in federal income taxes to expand Medicaid to half of the uninsured." The authors write, though, "Our results reflect a tension in public opinion recognized by previous investigators: a desire for reform but limited willingness to endorse the income transfers necessary to do so" (Kessler and Brady, 8/18).

Health Affairs: Reforming The Medicaid Disproportionate-Share Hospital Program – Though Medicaid disproportionate-share hospital (DSH) program is being considered by policy makers a way to help pay for health coverage expansion, "the specific approach that policymakers may use to extract savings from this program is not yet clear," write the authors of this paper, which outlines several approaches to reforming the program. The paper includes "ten-year budget estimates for variations on a specific financing approach that would link future federal spending on state Medicaid DSH allotments to objective indicators of uncompensated care volume at the state level" – an approach, the authors write "could produce as much as $44 billion in federal savings in the program and also address the wide federal DSH funding variations across states," as well as suggestions on how to implement the policy and ensure federal spending on Medicaid DSH is more directly connected than it is now to the delivery of care for vulnerable populations" (McKethan, Nguyen, Sasse and Kocot, 8/18).

Center for Studying Health System Change : Does Telemonitoring of Patients—The eICU—Improve Intensive Care? -- "While nearly 10 percent of U.S. hospital intensive care unit beds use advanced telemonitoring—known as eICUs— there has never been a systematic evaluation of how the innovative approach to caring for critically ill patients affects quality and costs," according to a Center for Studying Health System Change description of this study, which sought to better understand why hospitals choose to adopt or reject eICUs. Based on interviews "with clinicians in the five hospital systems with an eICU, clinicians in 19 non-eICU hospitals in the 12 markets, and national experts on ICU staffing, quality and ICU telemedicine," researchers found that "[h]ospitals adopting eICUs generally were motivated by the potential to improve clinical quality and patient safety rather than expectations of cost savings from reduced complications and lengths of stay." Whereas, "among hospitals not adopting eICUs, there was general agreement that the limited potential benefits did not justify significant upfront and ongoing operating costs—estimated at $3 million to $5 million in startup costs for 100 ICU beds, along with ongoing annual operating and staff costs of $1.3 million to $2.3 million per 100 beds" (8/20).

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