Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs.
New England Journal of Medicine: Electronic Health Records And Quality Of Diabetes Care -- This study focuses on one chronic condition to examine how EHRs could improve the quality of health care. Researchers "analyzed data from a retrospective cohort of primary care practices of seven diverse health care organizations that publicly reported achievement of quality standards for adults with diabetes between July 2007 and June 2010." They concluded that "EHR sites were associated with higher levels of achievement of and improvement in regionally vetted standards for diabetes care and outcomes" (Cebul et. al., 8/31).
National Governors Association: State Health Insurance Exchanges And Children's Coverage: Issues For State Design Decisions -- Insurance policies for children will be sold through the insurance exchanges mandated in the 2010 federal health law, "either as part of family coverage or as an individual children’s plan," according to this brief, which adds: "As states weigh various design options, the impact on children should be considered." Among the suggestions: promote continuity of coverage, create a one-stop portal for public programs, maintain benefit packages and cost-sharing requirements, and emphasize outreach activities (Dehner, 8/29).
Kaiser Family Foundation: The Budget Control Act of 2011: Implications for Medicare -- This brief "provides an overview of the new law, describing the timeline and process for raising the debt ceiling and lowering the federal deficit. It describes the role of the new Joint Select Committee on Deficit Reduction, examines how Medicare spending could be affected by changes proposed by the Committee, or if that process fails, by sequestration. The brief also summarizes prior laws that were designed to reduce the federal deficit" (Jacobson, Levinson and Neuman, 9/1).
Government Accountability Office: Private Health Insurance: Early Experience Implementing New Medical Loss Ratio Requirements -- The health law, the Patient Protection and Affordable Care Act (PPACA), requires that insurers spend a certain percentage of premiums on medical claims: the medical loss ratio. The GAO examined insurer data and interviewed a sample of seven insurers and found: "Most of the insurers GAO interviewed were reducing brokers' commissions and making adjustments to premiums, as well as making changes to other business practices, in response to the PPACA MLR requirements. Almost all of the insurers said they had decreased or planned to decrease commissions to brokers in an effort to increase their MLRs" (Dicken et al., 8/29).
KHN summarized news coverage of this report: GAO Reviews Impact Of Health Law's Medical-Loss Ratio Provision
Journal Of Public Health Policy: Mortality Amenable To Health Care In The U.S.: The Roles Of Demographics And Health Systems Performance -- This study looks at the number of deaths from specific causes, before the age of 75, that are possibly preventable with effective health care, also known as "amenable mortality." The authors examined data from each state and the District of Columbia using CDC data and found: "There is over two-fold variation in amenable mortality, strongly associated with the percentages of state populations that are poor or black. ... Overall, there appear to be opportunities for states to focus on specific modifiable health system performance indicators," and to track health outcomes (Schoenbaum et. al., 8/29).
Journal of General Internal Medicine: Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults -- The stress of caring for older adults with chronic illnesses can take a toll. Researchers look at the health care task difficulty (HCTD) and how that could be "associated with increased strain and depression among caregivers of multimorbid older adults." By conducting a cross-sectional study of more than 300 caregivers and assessing the difficulty of their tasks on a scale of 0-16, researchers concluded that "health-system-based educational and empowering interventions might improve caregiver well-being" (Giovannetti, et. al., 8/27).
Urban Institute: Consumer Operated and Oriented Plans (CO-OPs): An Interim Assessment of Their Prospects -- This report looks at some of the challenges with the health law's Consumer Operated and Oriented Plans (CO-OPs), "nonprofit, member-governed health plans that create innovative care delivery models to serve the individual and small group markets in various states." The author writes: "CO-OPs may become important insurance options in some markets, but it is difficult to foresee their having a transformative effect that was expected of the public option," which failed to muster enough legislative support to be included in the health law (Gray, 8/31).