New on the Web 53 (February 2009)
From the Commonwealth Fund: “The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way”
From Community Catalyst: “Expanding Coverage for Dependents”
From Health Affairs: “The Effect of Medicare Part D Coverage on Drug Use and Cost Sharing among Seniors without Prior Drug Benefits,” “Consumer-Driven Health Care: Promise and Performance”
From the Kaiser Commission on Medicaid and the Uninsured: “Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2005,” “Rethinking Medicaid’s Financing Role for Medicare Enrollees”
From the Kaiser Family Foundation: “Health Care on a Budget: An Analysis of Spending by Medicare Households,” “Spending to Survive: Cancer Patients Confront Holes in the Health Insurance System”
From KaiserEDU.org: “Health Insurance and Access to Health Care: The Evidence”
From Mathematica: “SCHIP Children: How Long Do They Stay and Where Do They Go?”, “SoonerCare Managed Care History and Performance: 1115 Waiver Evaluation”
From the Urban Institute: “Health Savings Accounts and High-Deductible Health Insurance Plans: Implications for Those with High Medical Costs, Low Incomes, and the Uninsured”
From the Commonwealth Fund:
The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way provides details on the comprehensive health care reform strategy of the Commonwealth Fund’s Commission on a High Performance Health System. The report outlines multiple coordinated steps that could increase Americans’ health security, including ensuring coverage for all, improving quality of care, and reducing health care costs. It lays out five essential strategies for reform, examines policy options, and assesses the positive impact that these policies could have on the health care system. (February 2009)
From Community Catalyst:
Expanding Coverage for Dependents finds that young adults are one of the fastest-growing groups without health insurance. The report proposes changing state laws to allow young people to remain on their parents’ health insurance plans beyond age 18. However, most states continue to place restrictions on which dependents are eligible for coverage by limiting it to those who are students, who live with their parents, or who do not have access to other forms of insurance. (February 2009)
From Health Affairs:
The Effect of Medicare Part D Coverage on Drug Use and Cost Sharing among Seniors without Prior Drug Benefits finds that seniors participating in the Part D program cut back on their medications by an average of 14 percent once they hit the “doughnut hole” coverage gap. Those who reached the coverage gap were typically people with chronic conditions who filled an average of five prescriptions per month. (February 2009) SUBSCRIPTION REQUIRED
Consumer-Driven Health Care: Promise and Performance analyzes the evolution of consumer-driven health care in terms of its original vision, subsequent implementation, and the transformations it has gone through as it moves into its second decade. Growth of high-deductible health plans and individually purchased insurance has been slower than anticipated. (January 2009) SUBSCRIPTION REQUIRED
From the Kaiser Commission on Medicaid and the Uninsured:
Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2005 provides the latest data on the total Medicaid enrollment and spending attributable to dual eligibles, with state-level estimates available in interactive tables and maps. The brief finds that dual eligibles comprise 18 percent of the Medicaid population but account for 46 percent of Medicaid spending. (February 2009)
Rethinking Medicaid’s Financing Role for Medicare Enrollees examines coverage of the nearly 9 million dual eligibles, the low-income elderly, and people with disabilities who are enrolled in both Medicare and Medicaid. The brief explores the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, including having the federal government pick up the full cost of Medicare premiums, cost-sharing, gaps in Medicare-covered services, and long-term care services. (February 2009)
From the Kaiser Family Foundation:
Health Care on a Budget: An Analysis of Spending by Medicare Households reports that in 2006, out-of-pocket healthcare spending accounted for 14.1 percent of all expenditures for Medicare households and that one in four households devoted more than one-quarter of total household expenditures to health care. This group includes a disproportionate share of Medicare households that are low- and middle-income, that have older members, and that live in rural areas. (February 2009)
Spending to Survive: Cancer Patients Confront Holes in the Health Insurance System highlights the challenges that cancer patients may face in paying for life-saving care even when they have private health insurance. High cost-sharing, caps on benefits, and lifetime maximums contribute to high out-of-pocket costs, while waiting periods and restrictions on eligibility for public programs can leave patients who are too ill to work without an affordable insurance option. (February 2009)
From KaiserEDU.org:
Health Insurance and Access to Health Care: The Evidence is a narrated slide tutorial that reviews the body of evidence on the health consequences of being uninsured. The presenter discusses the impact of health insurance on the use of and access to health care services, such as primary and preventative care, as well as the treatment for and survival rates of cancer patients and those who have experienced a heart attack. (February 2009)
From Mathematica:
SCHIP Children: How Long Do They Stay and Where Do They Go? highlights findings from a seven-state study examining retention of children in SCHIP and enrollees’ coverage after they leave the program. Once enrollees leave SCHIP, they are far more likely to become uninsured and remain uninsured for some time than they are to obtain private coverage. The findings suggest that the extent to which SCHIP has substituted for private insurance is well below the rates estimated in other studies. (January 2009)
SoonerCare Managed Care History and Performance: 1115 Waiver Evaluation summarizes the results of a comprehensive evaluation of Oklahoma’s Medicaid managed care program from its inception in 1993 through 2008. The report assesses the impact of key policy and implementation decisions on enrollment trends, member access to care, provider participation, the health of enrolled members, and the financial costs to Oklahoma. (January 2009)
From the Urban Institute:
Health Savings Accounts and High-Deductible Health Insurance Plans: Implications for Those with High Medical Costs, Low Incomes, and the Uninsured examines the potential for HSAs and HDHPs to reduce health care spending and decrease the number of uninsured. The study finds that the tax structure and incentives built into HSAs make them most attractive to high-income and healthy people who are already advantaged by the current system and that they tend to shift more of the health financing burden onto those needing significant amounts of care. As such, it is not clear that cost containment or reductions in the uninsured will follow. (February 2009)
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