Health policy research round up - Medicare and Massachusetts

Nov 13 2009

Robert Wood Johnson Foundation: The Secrets of Massachusetts' Success - "By the summer of 2008, less than two years after Massachusetts' health reform law became effective, only 2.6 percent of state residents were uninsured—the lowest proportion ever recorded for any state." This study by the RWJF-funded State Health Access Reform Evaluation (SHARE) initiative "explains how national reforms can use similar methods to avoid the pitfalls that have plagued other coverage expansions."  Through a review of published studies and a series of interviews with policymakers and other stakeholders, the researchers note key factors contributing to the state's success. Among these factors was the creation of a single application form and system of eligibility determination. (Dorn, Hill and Hogan, 11/11).

Circulation: Heart Failure: Recent National Trends in Readmission Rates after Heart Failure Hospitalization - Using 2004-2006 Medicare administrative data to identify all fee-for-service beneficiaries admitted to a U.S. acute care hospital for heart failure and discharged alive, the authors of this study find that almost a quarter of heart failure patients with Medicare are readmitted within 30 days. The readmission rates remained "virtually identical" over the three years examined, according to the study (Ross et al., 11/10).

Kaiser Family Foundation: Medicare Part D 2010 Data Spotlights - In these briefs, researchers analyze key aspects of the Medicare Part D plans that will be available to Medicare beneficiaries in 2010, including the benefit's coverage gap, or "doughnut hole," and changes to the drug benefit since it went into effect in 2006 (Hoadley, Cubanski, Hargrave, Summer and Neuman, 11/9).

Kaiser Commission on Medicaid and the Uninsured: State Variation and Health Reform: A Chartbook - "As the health reform debate progresses, the impact of reform on individual states will vary based on their economic situation, current health insurance coverage, and health care expenditures," write the authors of this chartbook that compiles data related to state variation, such as the states' economic profile, rates of uninsured rates, health care costs and insurance markets, among other things (Marks, Schwartz and Donaldson, 11/11).

Kaiser Family Foundation: Survey on the U.S. Role in Global Health Update - A follow-up to a survey conducted in March 2009. Some key findings include: the majority of Americans support maintaining (32%) or increasing (34%) spending on global health, despite the economic recession; Americans favor investments in programs that help developing countries develop overall health systems (58%) over disease-specific programs (36%); Americans favor giving health aid money to international organizations like the Global Fund to Fight AIDS, Tuberculosis and Malaria (74% in favor), religious or faith-based groups working to improve health in developing countries (55%) and local non-profit organizations in developing countries (53%) over developing country governments (29%). The survey, which was conducted by phone in Spanish and English, included a nationally representative random sample of 1,205 adults ages 18 and older (Brodie, Hamill, Cho and Buscho, 11/12).

Health Affairs: Hospital Governance And The Quality Of Care - Researchers explore the role that board of directors at hospitals have in the quality of hospital care. "Among our nationally representative sample of chairs of boards of directors from nonprofit U.S. hospitals, a little over half identified clinical quality as one of the two top priorities for board oversight," the study authors write. "Although 69 percent of board chairs thought that the CEO had great influence on quality of care, just 44 percent identified quality performance as one of the two most important criteria for evaluating the CEO's performance." The study highlights the fact that "[m]ajor opportunities exist to shift the knowledge, training, and practices of hospital boards to promote a focus on improved clinical quality" (Jha and Epstein, 11/7).