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RAND: Most health IT studies fail to capture long-term effects
Studies about the value of health information technology can be improved by broadening the reviews to include both costs and benefits, and lengthening study periods to capture long-term implications, according to a new RAND Corporation analysis. Researchers found most studies looking at the effects of health IT adoption were too short to consider long-term effects. "We propose a new set of standards for evaluation that will produce results likely to prove valuable to policymakers," lead author Robert Rudin said. The findings were reported in the American Journal of Managed Care. (Healthcare Informatics; RAND announcementAJMC



Readmissions 1: Community factors often at play 

Another study suggests variance in hospital readmission rates may be due to community factors rather than the fault of individual hospitals. A recent study by the Health Research & Educational Trust finds 58 percent of variation existed at the county level. CMS withholds up to 3 percent of reimbursement if readmission rates are higher than anticipated; the authors suggest that "more effective policies might be directed at the wider system of care, including primary care and nursing home quality." (Cardiovascular Business)


Readmissions 2: Post-surgical complications often to blame  

A recent study finds that complications related to surgery are the most common reasons patients are readmitted. These complications include infection, intestinal obstruction and bleeding. Most occurred after patients were discharged; however, if patients experienced complications while hospitalized, they were also more likely to be readmitted. "The most powerful methods for reducing harm are feedback, learning from the best, and working in collaboration," Dr. Lucian L. Leap writes in an editorial about the study, published in JAMA. (Daily Rx; JAMA)


Panelists: Simplify, don't repeal ACA

An ideologically diverse panel at the National Health Policy Conference recently concluded that simplification of the Affordable Care Act may be a viable alternative to repeal. Although the proposed course of action varied among panelists, several agreed that major problems have stemmed from estimating future income based on outdated tax data, and requirements to pay back tax credits for those who underestimated their income. Panelists also agreed that simplifying rather than repealing is unlikely as long as Republicans maintain control of Congress. (Kaiser Health News)

Innovation & Transformation

Report: Brokers may have key role in ACA after all

A new report from The Urban Institute delineates the early barriers to brokers' full engagement in the Affordable Care Act. It highlights the main concerns with their having a more prominent role and offers options for making them more effective in enrolling the uninsured. As federal and state funding for navigators and other publicly funded assisters decreases in the coming years, brokers and agents may end up playing an important role in expanding coverage and in ensuring those already enrolled maintain their coverage. (The Urban Institute)


Google and Mayo team up to improve health-related searches

Google and The Mayo Clinic have joined forces to provide relevant and accurate medical information to search engine users, validated by Mayo Clinic physicians. When a user searches for a common ailment they will now be presented with a "knowledge graph" including symptoms and treatments, commonly affected ages and whether the ailment is critical or contagious. The service is not intended to replace the advice of a medical professional. (Healthcare Informatics)
Consumers & Providers

About 4 million Americans fall into "coverage gap"

Roughly 4 million adults fall into a netherworld of coverage, eligible neither for Medicaid nor subsidies to reduce insurance premiums. The Affordable Care Act insurance provisions were written with the assumption that all states would expand Medicaid; however, 22 states did not.
The New York Times explores how low-income individuals are doing whatever they can to bolster their wages in order to qualify for aid, but earning more than the poverty level is proving difficult for some. Fifty-four percent of people in the coverage gap already work full- or part-time; 86 percent live in the South. (The New York Times)


Keckley skeptical about value-based purchasing timeline

The Obama Administration's recent pledge to raise the level of Medicare payment linked to quality may be unattainable--at least on the current timeline--warns Paul Keckley, managing director of the Navigant Center for Healthcare Research and Policy Analysis. "It's great that we have some targets. But the likelihood that we can be as successful as they imagine, I think that's very low," he says. He also predicts increasing lobbying efforts by hospital organizations to make the timeline less aggressive. (HealthLeaders Media)


Many uninsured don't explore options
According to new research from the Kaiser Family Foundation, 53 percent of those who remain uninsured, despite being eligible for financial assistance, say the price of health coverage keeps them from buying it. But many didn't research their coverage options, according to the survey: Fifty-nine percent never looked at an exchange or shopped Medicaid. "The findings show how important it is to come up with more effective strategies, in person, online and elsewhere, for educating people about their eligibility for coverage and financial assistance under the law," said Rachel Garfield, the report's lead author, in a statement. (The Hill)


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New & Noted   

Cadillac tax conundrum: To make the ACA fiscally sustainable, the high-premium excise tax--the "Cadillac" tax--may end up increasing at a rate that becomes politically unsustainable, Chris Jacobs of America Next writes in a Wall Street Journal blog post. (Wall Street Journal)


De facto discrimination: The Affordable Care Act was supposed to end coverage denials based on pre-existing conditions. But as a New England Journal of Medicine study suggests, some insurers are still finding ways to keep sick people off their rolls.The Atlantic reports on the study in an article entitled "Using Drugs to Discriminate--Adverse Selection in the Insurance Marketplace." (The AtlanticNEJM)


A decade of data compromised: It's worse than first thought: Anthem said last week hackers accessed customer data going back to 2004. Earlier this month, the insurance giant announced hackers had accessed databases containing Social Security numbers, birth dates, addresses and other personal information of up to 80 million Americans. (Los Angeles Times)



NPR offers a glimpse into the cyber underworld 

NPR recently looked at the "cyber underworld"--the black market for stolen data. Criminals are trying to figure out how to turn every piece of our digital life into cash, it reported. After an hour poking around the Web, the reporter and an expert found an advertisement by someone selling Medicare IDs. A "value pack" that includes 10 people's Medicare numbers sells for about $4,700. Health care companies saw a 72 percent increase in cyberattacks from 2013 to 2014, according to Symantec. One possible reason: Providers are racing to digitize health records, create apps and acquire other companies without even knowing how big their own networks are. (NPR)


MarketVoices...quotes worth reading


"We took the most complex health care system on God's green earth, and made it 10 times more complex."


This tax season will "be a bonanza for H&R Block, and a disaster for people who were supposed to be helped the most by the ACA."


--- Jon Kingsdale, first head of the Massachusetts health exchange created under that state's forerunner to the ACA, in Kaiser Health News


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Sandy Mau




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Wednesday, Feb. 18, 2014



















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