Healthcare Business Week in Review: Healthcare Costs; Health Insurance Marketplaces, Diabetes Management

Friday, November 22nd, 2013
This post was written by Cheryl Miller

The United States spends more money on healthcare than other developed countries, and yet their outcomes are worse, according to a new study from Johns Hopkins.

But political infighting is preventing the country from achieving ways to deliver care more effectively and efficiently.

The study, published in JAMA, attempts to dispel several common misconceptions informing the current healthcare debate. Among them: that the aging of the population and the large numbers of tests and treatments being prescribed have been primarily responsible for escalating healthcare costs. Researchers assert that the prices of drugs, medical devices and hospital costs have driven up the costs of healthcare in this country over the last decade, and that it’s not the elderly that are ratcheting up healthcare costs, but those under 65 with chronic conditions.

What is needed to fix the system? An investment in primary care doctors, and a unified government, among other things.

Policymakers can start coming together on the latest news from the White House: insurers can extend current insurance plans that would otherwise be canceled into 2014, and Americans whose plans have been canceled can choose to re-enroll in the same kind of plan.

In the past few weeks, some Americans have been notified by their health insurance companies that plans they bought on the old individual insurance market were being cancelled, often because these plans no longer met the ACA’s requirement to cover basic benefits like prescription drugs or doctors’ visits. These people now have an additional year of coverage.

Some news that no one can debate: 106,185 Americans selected health plans in the first reporting period of open enrollment (October 1st through November 2nd) ; 975,407 customers made it through the process but have not yet selected a plan; and an additional 396,261 customers were determined eligible for Medicaid or the Children’s Health Insurance Program (CHIP). These results, from an issue brief from HHS, show that the level of interest is strong, and that enrollment should grow substantially throughout the next five months.

In other news: diabetic patients treated in the ED who were enrolled in a program sending daily automatic text messages improved their level of control over their diabetes and their medication adherence, according to a study from the Keck School of Medicine at the University of Southern California in Los Angeles.

The text messaging program, called TExT-MED, is low cost and widely available for those patients who have no other source of medical care.

Don’t forget to participate in our fourth comprehensive Reducing Hospital Readmissions Benchmark Survey. While great strides have been made in the reduction of 30-day all-cause hospital readmissions, CMS still docked reimbursement for more than 2,200 hospitals in 2013 for exceeding 30-day readmission rates for heart failure, pneumonia and myocardial infarction. In 2015, CMS penalties will extend to acute COPD and elective hip and knee replacements. Describe how your organization is working to reduce hospital readmissions by January 3, 2014 and receive an e-summary of the results once they are compiled.

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