Research roundup: Insurance coverage in the Great Recession; PCIP vs. CHIP

Every week, Kaiser Health News reporter Shefali S. Kulkarni compiles a selection of recently released health policy studies and briefs.

Archives Of Internal Medicine: Effect Of MRI On Treatment Results Or Decision Making In Patients With Lumbosacral Radiculopathy Referred For Epidural Steroid Injections --The researchers how physicians examined claims of lower back back pain and note that part of the "rising economic cost of this epidemic is the burgeoning use of indiscriminate imaging," specifically MRIs. Researchers divided patients into two groups and "the treating physician in group 1 patients was blinded to the MRI results, while the physician for group 2 patients decided on treatment after reviewing the MRI findings." The authors conclude: "our results suggest that although MRI may have a minor affect on decision making, it is unlikely to avert a procedure, diminish complications, or improve outcomes. Considering how frequently ESIs are performed, not routinely ordering an MRI before a lumbosacral ESI may save significant time and resources" (Cohen et. al., 12/12).

New England Journal of Medicine: The Relationship Between Hospital Admission Rates And Rehospitalizations -- This study looks at the regional variation in the number of patients with congestive heart failure or pneumonia who are readmitted to the hospital within 30 days. The researchers found "a substantial association between regional rates of rehospitalization and overall admission rates. Although most interventions designed to reduce readmissions thus far have focused on better disease management and the coordination of care, our results underscore the importance of policy efforts directed at reducing the general incentives to use hospital services" (Epstein, Jha and Orav, 12/14).

Kaiser Family Foundation/The Urban Institute: Changes In Health Insurance Coverage In The Great Recession, 2007-2010 -- The authors of this issue brief write: "While the number of uninsured children declined in recent years, the number of uninsured adults rose. The only notable drop in uninsured adults was for young adults ages 19-25 in 2010, most likely due to the provision of the health reform law that permits young adults to stay on their parents' insurance. The paper also considers trends in coverage by work status, race and ethnicity, citizenship status and geographical region" (Holahan and Chen, 12/15). 

Government Accountability Office: Pre-Existing Condition Insurance Plan: Comparison of Implementation and Early Enrollment With The Children's Health Insurance Program --  Pre-existing condition insurance plans (PCIP) are the high-risk pools set up in the 2010 health law to provide coverage to uninsured people with medical problems. The study looks at the amount of time it took to implement PCIPs and CHIP in all states, the enrollment trends for the two programs and trends in enrollment, "between states that had high risk pools prior to the enactment of [Patient Protection and Affordable Care Act], and those that did not." The report concludes that "enrollment in the PCIP and CHIP programs was slow to start but increased steadily over the first year, ending with more than 27,000 and 705,000 enrollees, respectively" (12/13).