Research roundup: Lesson for insurance exchanges from Europe; Health care disparities among Hispanics

Apr 15 2013

Each week, KHN reporter Alvin Tran compiles a selection of recently released health policy studies and briefs.

Health Affairs: Health Insurance Exchanges In Switzerland And The Netherlands Offer Five Key Lessons For Operations Of US Exchanges – As states and the federal government begin creating insurance exchanges under the health law, researchers highlight several lessons from Switzerland and the Netherlands. Those countries have private insurance markets with five aspects of success: "risk-adjustment mechanisms-;which provide premium adjustments intended to compensate health plans for enrolling people expected to have high medical costs" are "sophisticated and continually updated;" the importance of identifying barriers to enrollment among those eligible; a simple application process for subsidies; clear negotiating power for insurers on prices and quality of service; easy availability of reliable data regarding providers' costs and quality of care for insurers and consumers. "American policy makers will need to conduct ongoing analyses of the different ... [exchanges] to learn what works best to create incentives for efficiency," the authors concluded (van Ginneken, Swartz, and Van der Wees, 4/8).

Health Affairs/Robert Wood Johnson Foundation: Health Policy Brief: The Multi-State Plan Program - The insurance markets for individuals and small businesses are highly concentrated in some states, meaning a single insurer could dominate the market. To spur competition and increase the number of options for individuals, the federal health law created the Multi-State Plan Program and put it under the direction of the Office of Personal Management (OPM). "OPM must certify at least two issuers to be able to sell coverage in the exchanges in time for open enrollment on October 1, 2013," the author writes. "Also, under the law, insurers participating in the multistate program must offer at least two plans through each exchange." This brief delves into the program's background and explores the OPM's role and potential challenges as its administrator (Goodell, 4/3).

JAMA Pediatrics: Association Between State Laws Governing School Meal Nutrition Content And Student Weight Status – By studying 4,800 eighth-graders from 40 states, researchers aimed to determine if school meal nutrition standards that exceeded the Department of Agriculture's school meal standards improved the weight status of adolescents. "The results of this study suggest that in states with laws that encouraged or required a specific number of fruits/vegetables, reductions in trans fats, 1% skim milk, and/or a minimum proportion of whole grains, students who obtained school lunches had a more favorable weight status, particularly among participants eligible for a free/reduced-price lunch," the authors wrote. "The evidence supporting stringent school meal standards is far from conclusive, but this study provides promising signs of the potential for the USDA updated standards to improve student weight status" (Taber, Chriqui, Powell and Chaloupka, 4/8).

The Kaiser Commission on Medicaid and the Uninsured/Kaiser Family Foundation: Health Coverage For The Hispanic Population Today And Under The Affordable Care Act –The authors of this brief write: "The more than 50 million Hispanics living in the United States make up 17 percent of the total population and are the nation's fastest growing racial or ethnic group. Many Hispanics continue to face disparities in health coverage and care, and they have the highest uninsured rate among racial/ethnic groups, with nearly one in three lacking coverage. The Affordable Care Act (ACA) could help many uninsured Hispanics through the law's expansion of Medicaid and the creation of new health insurance exchange marketplaces with tax credits to help moderate-income people purchase coverage" (4/9).

Here is a selection of news coverage of other recent research: 

NPR' SHOTS blog: Seniors In The South Are More Apt To Be Prescribed Risky Drugs
Health care types have spent years trying to make the point that seniors are being prescribed medications are unnecessary and dangerous. But the message hasn't really sunk in. More than 20 percent of people with Medicare Advantage coverage are taking at least one high-risk medication, a new study finds (Shute, 4/11).

Medscape: Adverse Drug Events Found By Mining Clinical Notes In EHR
Mining unstructured clinical notes written in electronic health records (EHRs) can be used as a strategy to identify early signs of adverse drug events, according to the findings of a new study by Paea LePendu, PhD, and colleagues from Stanford University in California. The authors published their findings online April 10 in Clinical Pharmacology and Therapeutics (Barber, 4/10).

Medscape: Drug Reps Provide Little Information On Harmful Effects
Pharmaceutical sales representatives (PSRs) rarely present serious adverse events during their sales calls. France has stricter standards than the United States and Canada, and therefore presentation of "minimally adequate safety information" is slightly higher in France than in these North American countries. Barbara Mintzes, PhD, from the School of Population and Public Health, University of British Columbia in Vancouver, Canada, and colleagues published the results of their prospective cohort study online April 10 in the Journal of General Internal Medicine (Pullen, 4/10).