Research roundup: Hospital readmissions; researchers mistrust social media; premiums in Washington state

Jun 16 2014

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

JAMA Surgery: Evaluation Of Hospital Readmissions In Surgical Patients
Reducing hospital readmissions is a major target for current quality improvement and cost-containment efforts. National policy makers have developed a tool that uses administrative data to analyze all-cause hospital readmissions and determine whether each readmission is susceptible to financial penalties. This tool is yet to be implemented, however. Using a cohort of general surgery patients, the current study demonstrates that administrative data failed to correctly identify the reason for hospital readmission in nearly one-third of cases. Similarly, the readmission measure failed to identify nearly two-thirds of planned readmissions. ... Implementation of this readmission measure may result in unwarranted financial penalties for hospitals. (Sacks et al., 6/11).

JAMA Internal Medicine: Association Of Marketing Interactions With Medical Trainees' Knowledge About Evidence-Based Prescribing
In recent years, numerous US medical schools and academic medical centers have enacted policies preventing pharmaceutical sales representatives from interacting directly with students. ... We surveyed a nationally representative sample of first- and fourth-year medical students and third-year residents. ... Among physician trainees, our survey showed an association between positive attitudes toward industry-physician interactions and less knowledge about evidence-based prescribing and greater inclination to recommend brand-name drugs. Policies intended to insulate trainees from pharmaceutical marketing may promote better educational outcomes (Austad et al., 6/9).

Health Affairs: Translating Research For Health Policy: Researchers' Perceptions And Use Of Social Media
Academic journals, public health agencies, and health care organizations are increasingly using social media to communicate health information. ... We conducted a survey of health policy researchers about using social media and two traditional channels (traditional media and direct outreach) to disseminate research findings to policy makers. Researchers rated the efficacy of the three dissemination methods similarly but rated social media lower than the other two in three domains: researchers' confidence in their ability to use the method, peers' respect for its use, and how it is perceived in academic promotion. Just 14 percent of our participants reported tweeting, and 21 percent reported blogging about their research or related health policy in the past year. Researchers described social media as being incompatible with research, of high risk professionally, of uncertain efficacy, and an unfamiliar technology (Grande et al., 6/6).

The Kaiser Family Foundation: A Look At CBO Projections For Medicaid And CHIP
Generally once a year, the Congressional Budget Office (CBO) releases a detailed "baseline" for federal spending for Medicaid, CHIP and the ACA that serves as a neutral benchmark for Congress to measure the budgetary effect of proposed legislation and as a reference point for analysis of Medicaid enrollment and spending. This baseline assumes current law remains in place, but adjusts for changes in the economy and other factors ... Compared to the CBO Medicaid baseline from March 2012, federal spending projected for 2020 in the April 2014 baseline is 14% lower due to a number of factors including the Supreme Court decision effectively making the ACA Medicaid expansion an option. ... Due to the ACA, the number of uninsured is expected to decline by 26 million by 2024 (Rudowitz, 6/5). 

Related: Medicaid Enrollment: An Overview Of The CMS April 2014 Update

The Kaiser Family Foundation: Visualizing Income And Assets Among Medicare Beneficiaries: Now And In The Future
Many Medicare beneficiaries live on fixed incomes supplemented by the savings they accumulated during their working years. Their income and accumulation of savings is tied to many life experiences, including their education, health status, marital status, number of work years, household income, periods of unemployment, investments, years of homeownership, access to employer retirement benefits, inheritance, other financial supports, and various economic factors. This interactive tool describes the income, savings and home equity of people on Medicare in 2013, and in 2030 (6/12). 

Avalere Health: Washington State Rate Analysis: Carriers with Low 2014 Market Share Hold Down Premiums in 2015
A new analysis from Avalere Health finds that proposed rate increases for 2015 exchange plans in Washington state were lowest among carriers with the smallest share of the 2014 market. Molina, which captured only 1 percent of 2014 exchange enrollment in the state, proposed a nearly 7 percent average rate decrease for 2015. In addition, other low enrollment carriers, Kaiser Permanente and BridgeSpan Health, each proposed average increases of less than 2 percent. Washington state is the first to release both 2015 rate filings ... "Consumers enrolling through the exchange are extremely price sensitive and tend to focus primarily on premiums," said Dan Mendelson, CEO at Avalere Health. "In this vibrant market, plans that gained a minimal share in 2014 will naturally want to price their products more competitively in 2015" (6/12).

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

Reuters: Putting Dying Wishes In Medical Record Helps Them Happen
When patients' end-of-life preferences are entered as instructions in their medical record, their wishes are more likely to be honored, a new study suggests. The study was done in Oregon, one of two states with an end-of-life planning program called POLST (Physician Orders for Life-Sustaining Treatment). ... "POLST records and honors wishes in a way that (medical professionals understand) and can implement across settings of care," said Dr. Susan Tolle, an internist at Oregon Health and Science University in Portland and the study's senior author. ... "Although it is probably more important how you die than where you die, where you die can strongly affect how you die," they write in the Journal of the American Geriatrics Society (Belisomo, 6/9).

NPR: Doctors Don't Know What Women Want To Know About Birth Control
Women have choices in contraception, from pills and injections to intrauterine devices and the NuvaRing. ... Doctors tend to think it's most important to discuss how to use contraceptives and which methods are most effective at preventing pregnancy, according to the poll , which was published in the journal Contraception. Women, on the other hand, are often more concerned about safety, side effects and how the contraceptives work (Singh, 6/10).

The Associated Press: Healthy Seniors Tested In Bid To Block Alzheimer's
In one of the most ambitious attempts yet to thwart Alzheimer's disease, a major study got underway Monday to see if an experimental drug can protect healthy seniors whose brains harbor silent signs that they're at risk. Scientists plan to eventually scan the brains of thousands of older volunteers in the U.S., Canada and Australia to find those with a sticky build-up believed to play a key role in development of Alzheimer's -; the first time so many people without memory problems get the chance to learn the potentially troubling news (Neergaard, 6/9).

The Hill: Cancer Survivors Keep Paying Cancer Costs Long After Recovery
Even after fighting off cancer, survivors often face severe challenges, such as high medical costs and productivity loss from missed work, according to a new study from the Centers for Disease Control and Prevention. The CDC analyzed cancer survivors' medical cost data between 2008 and 2011 and found they face serious financial burdens because of clinical follow-ups, managing long-term and late effects of their treatments, and monitoring for recurrence of the disease and other cancers because of increased risk (Al-Faruque, 6/12).