Health Policy Research Roundup

Commonwealth Fund: Implementation Choices for the Children's Health Insurance Program Reauthorization Act of 2009 – This report examines two key areas of the implementation process of the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 – outreach and enrollment, and quality of care – and issues a set of recommendations. "Recommendations include: giving funding priority to states that will adopt or maintain key simplifications… ensuring quality measures focus on priority health needs for children, and building quality measurement and improvement capabilities into electronic health information systems, among others," according to a Commonwealth Fund description of the report (Simpson, Fairbrother, Touschner and Guyer, 9/10).

Health Affairs: How A New "Public Plan" Could Affect Hospitals' Finances And Private Insurance Premiums – Using a model to estimate the financial impact of the a government-run, or "public plan," on hospitals and private payers, the authors of this paper find that while "a high level of enrollment of uninsured people in the government-run plan with no enrollment of the privately insured positively affects hospital margins … as the privately insured enroll in the public plan in rising proportions, this positive effect is eventually reversed, and hospital patient-revenue margins decrease." Also, "as DSH payments are reduced or eliminated, the public plan that pays at Medicare rates plus 10 percent negatively affects safety-net hospitals" (Dobson, DaVanzo, El-Gamil and Berger, 9/15).

Urban Institute: Health Reform in Massachusetts: An Update on Insurance Coverage and Support for Reform as of Fall 2008 – This policy brief reflects on the progress made by the state of Massachusetts since its health reform initiative in 2006, particularly the impacts of health reform insurance on adults between the ages of 18 and 64 years, the main target of the reform initiative. According to the study, the numbers of uninsured adults in this group fell 70% from 13% in Fall 2006 to 4% in Fall 2008, "well below the national uninsurance rate of 19.7 [percent]." The brief also includes information on the necessary next phase of health reform in Massachusetts, focused on driving down the costs of health care (Long and Stockley, 9/1).

RAND Health: Potential Societal Savings From Reduced Sodium Consumption in the U.S. Adult Population – By reducing American's consumption of sodium to the recommended maximum value of 2,300 mg per day could slash the annual number of cases of hypertension nationally by 11 million and save $18 billion in health care costs, according to a study published in the American Journal of Health Promotion. The RAND Health researchers obtained population-level data on Americans' blood pressure, antihypertensive medication use, and sodium intake from the National Health and Nutrition Examination Survey and used a simulation model to calculate annual health care savings (Palar and Sturm, Sept./Oct. 2009).

Health Affairs: Understanding The Current Population Survey's Insurance Estimates And The Medicaid 'Undercount' – The authors of this paper examine why Medicaid recipients tend fail to report their health coverage to the Annual Social and Economic Supplement to the Current Population Survey, collected by the Census Bureau, which, in turn, leads to an inflation in the numbers of uninsured and mischaracterization of the population. Because "[s]uch an overestimate could cause overestimates of the costs of health care expansion proposals," "[u]nderstanding this undercount is therefore crucial for health insurance reform policy simulations," the authors write. They propose more work is done to explore additional data sources that could provide better estimates of the uninsured (Klerman, Davern, Call, Lynch and Ringel, 9/10).

Kaiser Family Foundation: Data Note: Americans' Satisfaction With Insurance Coverage - Overall, the Foundation’s August 2009 tracking poll found that most Americans with insurance give their plan a favorable rating, and most are satisfied with various aspects of their coverage and care. However, on closer examination, the data finds that younger Americans, those with lower incomes and those who report being in poor personal health are significantly less likely to say they are satisfied with their insurance than their counterparts. And though most Americans say their insurance is "excellent" or "good," these positive ratings do not necessarily paint a complete picture, as significant portions of those who rate their insurance positively still say they face problems paying their medical bills or are dissatisfied with certain aspects of their coverage. Additionally, recent Foundation polls indicate that substantial portions of insured people are concerned about the cost of their health care and insurance, the adequacy of their insurance to meet potential health care needs, and the stability of their insurance coverage. (9/17)

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