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Industry News
Retail clinics may actually increase medical spending by leading consumers to get more care, according to research published in Health Affairs. "We found that roughly two-fifths of retail clinic visits for low-acuity conditions represented substitution, while the other three-fifths represented new utilization. In total, the increased spending from new utilization outweighed the savings from substitution." Those additional visits led to an increase in overall health care spending of $14 per person annually. The study doesn't contradict earlier research that found retail clinics provide care of similar quality for lower costs, Kaiser Health News reports. Rather, it suggests those savings are more than offset by increased use of medical services. (Health Affairs; Kaiser Health News)
Last year's final enrollment numbers in the federal and state insurance exchanges fell just short of the administration's goal of 9.1 million customers. The report from the Health and Human Services Department said about 8.8 million consumers were still signed up and paying premiums at the end of last year. That's a difference of about 3 percent. (Associated Press)
Stigma notwithstanding, HMOs are making a comeback, The New York Times reports. Insurers are already promoting them via government health insurance exchanges, and they are trying to persuade more companies and their employees to sign up. "We're starting to see the resurgence of interest," says Steve Hamman of the Health Care Service Corporation, which operates several Blue Cross plans. One big difference in today's HMOs: The primary care physician isn't the gatekeeper for all specialty services. (The New York Times)
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Innovation & Transformation
Colorado's Medicaid expansion added $3.8 million to the economy and created 31,074 new jobs, according to a new report from the Colorado Health Foundation. By 2034, that is projected to expand to $8.5 billion and 43,018 jobs. The report concludes that "in the two years since implementation, expansion in the state has had a significant positive effect on the economy at no expense to the general fund." Among other findings: Average household earnings are $643 higher as a result of expansion. (Denver Post)
Most Americans are satisfied with the health care they receive; however, many still experience significant problems with costs, insurance coverage and access, according to an NPR/Robert Wood Johnson Foundation/Harvard T.H. Chan School of Public Health poll. Fifteen percent say there has been at least one time in the past two years when they needed, but could not access, health care. This may partially explain why 33 percent say they have received care in the emergency department at least once during that period and 23 percent of recent patients say they use the ED more than they used to. (RWJF)
When it comes to improving access to specialty care, especially for underserved populations, e-consults may be the solution, according to research published in the Annals of Family Medicine. About half of cardiology reviews at a community health center could be sent electronically, and e-consultations were completed almost a month faster than in-person follow-ups. Clinicians and specialists communicated and shared case information using an EHR system. (FierceHealthIT; Annals of Family Medicine)
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Over the past decade everyone seemed to be talking about how individuals could be more active in managing their health. But that's just not going to happen until patients have the right tools. The latest issue brief from the Commission for Case Manager Certification examines the role that access to their own health data plays in getting patients more actively engaged in their health and care. The brief and the accompanying webinar, The Latest on Patient Privacy Rights: Consumers and Electronic Access to Health Data, feature Christine Bechtel, coordinator of the GetMyHealthData Campaign. (issue brief; webinar)
CareFirst BlueCross BlueShield's patient-centered medical home includes no penalties or risks for physicians, and it treats patient consults conducted online the same as office visits. CEO Chet Burrell told the American Academy of Family Physicians board that 90 percent of plan physicians have joined the program and the average practice received an additional $41,000 in revenue in 2014, plus a participation fee.(AAFP News)
Providers are making the shift to value-based care, but they don't feel very adept at it, says Pam Jodock of HIMSS. Only 3 percent of providers responding to a HIMSS survey said they believe their organization is highly prepared to make the transition. Nevertheless, many providers have moved forward, hoping to figure it out as they go along. One fear is that just as Meaningful Use required providers to use technology not yet available, many providers don't have the tools to deliver value-based care, Health Data Management reports. (Health Data Management)
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New & Noted
Consolidation and disparities: Researchers and academics must further explore the impact--if any--of consolidation on health care disparities. "How will health care consolidation affect health and health care disparities? How will it affect minority and low-income communities? We don't know, and that's the problem," Michael Ulrich of Yale Law writes in the Health Affairs Blog. (Health Affairs Blog)
Maximizing HSA value: Using a health savings account is one of the best ways to build a retirement cash flow that avoids Medicare surcharges, but many consumers are not taking full advantage of the benefits. (InvestmentNews)
Kaiser picks site: Kaiser Permanente has announced the site for its medical school: Pasadena. The school plans to break ground on the Kaiser Permanente School of Medicine in 2017, and the first class of students will arrive in 2019. (Becker's Hospital Review)
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Multi-media
A new video from AHRQ's Health Care Innovations Exchange describes former patient Bob Luckin's journey from patient to patient advisor at Florida's Broward Health North Hospital, one of 11 hospitals currently participating in AHRQ's Patient- and Family-Centered Care Learning Community. (video)
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MarketVoices...quotes worth reading
"No physician in his right mind ought to take insurance risk." -- CareFirst BlueCross BlueShield'sCEO Chet Burrell, quoted in AAFP News
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