Research roundup: Health spending on kids with special needs

Jun 10 2013

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

Health Affairs: Recession Led To A Decline In Out-Of-Pocket Cost Spending For Children With Special Health Care Needs – Between 2008 and 2010, the rate of growth for health care spending declined. The recession, many researchers believe, was a key contributor to this decline. In this study, researchers explored whether the recession also had an impact on health care spending for children, especially those with special health care needs. They analyzed nationally representative survey data to examine trends in out-of-pocket spending for privately insured families from 2001 to 2009. "We found that the recession of 2007-09 was not associated with a decline in out-of-pocket spending for most children. However, adults in those children's families experienced significant declines in out-of-pocket spending during the recession," suggesting that parents may have cut back their own care to continue to provide for their children,  the authors write. They  found, however, "a significant reversal in the spending trend for children with special health care needs." The authors suggests that "policy efforts to bolster coverage for families with children are needed to protect the health care use of both children and parents during times of economic hardship" (Karaca-Mandic, Yoo, Sommers, 6/2013).

American Journal Of Preventive Medicine: Menu Labeling Regulations And Calories Purchased At Chain Restaurants –The federal menu labeling law will soon require all large chain restaurants to post caloric information on menus. Currently, 21 U.S. jurisdictions have adopted similar regulations. The authors examined the impact of menu labeling on calories purchased across 50 sites from 10 chain restaurants in King County, Wash., which includes Seattle. Using survey data and receipts of purchases collected from consumers, the researchers compared the averages of calories purchased at intervals before and after restaurants adopted the regulations. They found no significant changes in calorie intake for the first six months, but after 18 months calories purchased  at some chain restaurants and among women in King County decreased. "Implementation of similar regulations nationwide could reach millions of Americans, given the large number of restaurant patrons and the high frequency of eating out," the authors conclude (Krieger et al., June, 2013).

The Kaiser Family Foundation: Key Lessons From Medicaid And CHIP For Outreach And Enrollment Under The Affordable Care Act -- The authors of this issue brief review five lessons learned through past enrollment campaigns for Medicaid and CHIP to help give perspective for the outreach and enrollment challenge for the online insurance marketplaces created by the federal health law. Those lessons are: Individuals want coverage and value Medicaid as a choice; outreach campaigns must combine both broad-based messaging and targeted efforts to eligible families; enrollment procedures must be simple and accessible; one-on-one assistance needs to be available; simplifying renewals and extending eligibility or lengthening the time between renewals will help cut costly drop-offs in coverage. "The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces," the authors write. "However, effective outreach and enrollment efforts will be key to ensuring these new coverage opportunities translate into increased coverage. ... it is important to recognize that enrollment into new coverage options will likely be a long-term effort. As such, it will be important for there to be adequate resources for outreach and enrollment over time to identify and utilize lessons learned as new enrollment efforts and experiences unfold (Stephens and Artiga, 6/4).

The Heritage Foundation: The Obama Medicare Agenda: Why Seniors Will Fare Worse – Current seniors are already facing high Medicare costs, according to the authors of this brief. They add that these costs will only grow over the next five years as a result of the federal health law. "Through the enactment of the Patient Protection and Affordable Care Act (PPACA), the Obama Administration and its allies in Congress have already committed to increasing seniors' out-of-pocket costs," the authors write. They add that the 2012 Medicare trustees report suggests seniors' standard Medicare Part B monthly premiums will increase from $99.90 to $128.20 between 2012 and 2017. In this brief, they also raise concerns regarding President Barack Obama's latest budget proposal for the 2014 fiscal year. "It does not substantially reform the financially desperate Medicare program; it simply shift costs to seniors," the authors assert. "America needs a sound Medicare policy. The Obama Administration's agency for increase costs for Medicare beneficiaries, plus the latest budget tweaks to administrative payments, will not reverse the troubled program's unsustainable course," they conclude (Moffit and Senger, 5/23).  

JAMA Pediatrics: Reducing Racial/Ethnic Disparities In Childhood Obesity – In this study, researchers aimed to determine the extent to which racial/ethnic disparities in obesity and overweight are explained by differences in risk factors during pregnancy, infancy, and early childhood. The researchers recruited women during early pregnancy from a Massachusetts hospital and garnered data regarding their children through interviews and surveys. They found that black and Hispanic children by the age of 7 were twice as likely as whites to be overweight or obese. "Our findings suggest that racial/ethnic disparities in childhood obesity may be explained by factors operating in infancy and early childhood and that eliminating these factors could eliminate the disparities in childhood obesity," they wrote. "These factors include differences in modifiable early feeding behaviors, such as breastfeeding and timing of the introduction of solid foods, accelerated infant weight gain, and early childhood obesity-related risk factors, including insufficient sleep, the presence of a television set in the room where the child sleeps, and consumption of sugar-sweetened beverages and fast food, all of which have been found previously to be more prevalent among blacks and Hispanics than among whites" (Taveras et al., 6/1).

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

MedPage Today: Just 1 Doc In 10 Meets Meaningful Use Criteria
More physicians are using electronic health records (EHRs), but a significantly smaller proportion of eligible physicians say they have met the first stage of meaningful use criteria, a study found. In a national survey, 43.5% of physicians in March 2012 reported having a basic EHR -- up from 34% in 2011 -- but only 9.8% said they met meaningful use criteria, reported Catherine M. DesRoches, PhD, of Mathematica Policy Research in Cambridge, Mass., and colleagues (Struck, 6/5).

Reuters: Quit-Smoking Treatments Safe, Effective: Review
Popular smoking cessation treatments - such as nicotine replacements and antidepressants - improve people's chances of kicking the habit without much risk, according to a review of past research. "It seems very clear that medications can help. They're not the magic bullet but you do improve your chances of quitting -- generally -- if you try them. And as far as we can tell, they're safe to use," said Kate Cahill, who led the study (Seaman, 5/30).