Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine: Assessment Of Out-Of-Network Billing For Privately Insured Patients Receiving Care In In-Network Hospitals
Although surprise medical bills are receiving considerable attention from lawmakers and the news media, to date there has been little systematic study of the incidence and financial consequences of out-of-network billing. … Out-of-network billing appears to have become common for privately insured patients even when they seek treatment at in-network hospitals. The mean amounts billed appear to be sufficiently large that they may create financial strain for a substantial proportion of patients (Sun, Mello, Moshfegh et al, 8/12)
New England Journal of Medicine: Early Effects Of An Accountable Care Organization Model For Underserved Areas
Provider participation in AIM was associated with a differential reduction in total Medicare spending of $ 28.21 per beneficiary per month relative to the comparison group, which amounted to an aggregate decrease of $ 131.0 million. Over the same period, CMS made $ 76.2 million in prepayments and paid an additional $ 6.2 million in shared savings to ACOs in which shared savings exceeded the prepayments. After we accounted for this $ 82.4 million in CMS spending, the aggregate net reduction was $ 48.6 million, which corresponded to a net reduction of $ 10.46 per beneficiary per month. Decreases in the number of hospitalizations and use of institutional post-acute care contributed to the observed reduction in overall spending. (Trombley, Fout, Brodsky et. al, 8/8)
RAND: Improving The Quality Of Mental Health Care For Veterans: Lessons From RAND Research
More than 9 million veterans are enrolled to receive care from the VA health care system. To serve this population, VA operates the nation’s largest health care system providing both inpatient and outpatient services, with 172 VA medical centers and 1,069 outpatient clinics across the country. In 2018, VA delivered mental health care to an estimated 1.7 million veterans. Compared with nonveterans, veterans are disproportionately older, male, and less healthy. (8/13)
The Henry J. Kaiser Family Foundation: The Effects Of Medicaid Expansion Under The ACA: Updated Findings From A Literature Review
A substantial body of research has investigated effects of the Medicaid expansion under the Affordable Care Act (ACA) on coverage; access to care and related measures (including utilization, quality of care and health outcomes, provider capacity, and affordability and financial security); and various economic measures. This issue brief summarizes findings from 324 studies of the impact of state Medicaid expansions under the ACA published beginning in January 2014 (when the coverage provisions of the ACA went into effect) and updates earlier versions of this brief with studies through June 2019. (Antonisse, Garfield, Rudowitz and Guth, 8/15)
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.