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The Opioid Crisis: Treating Addiction and Saving Lives

An Audio Webinar

By NIHCM

Transforming Health Care Through Evidence and Collaboration

An estimated 2.1 million Americans have an opioid use disorder, according to the latest national data. Opioid overdose takes the lives of 4.6 Americans every hour. With a crisis of this magnitude, it is easy to lose sight of the fact that effective, life-saving treatments are out there. Medication-assisted therapy and the opioid-reversing drug naloxone, for example, are two highly effective interventions for addiction and overdose, but access barriers persist.

In this part of our opioid webinar series, we explored ways to expand the use of evidence-based treatment, including:

  • Strategies to smooth access to key drug therapies through standing orders to dispense and removal of prior authorization requirements
  • Federal and private-sector initiatives to protect the patients from sub-standard or fraudulent addiction treatment
  • A multi-sector collaboration to adopt principles of care for substance abuse treatment and to help practitioners stay abreast of the evidence
  • Ideas for using pharmacy data to identify potential abuse and for deploying telehealth technology to improve access to treatment

***

On the Future of Healthcare [video]

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By NIHCM Foundation

This briefing brought together leading health care experts with diverse backgrounds to discuss the future of health care, including potential policy reforms and new ways of thinking about long-term care, the consumer experience and the concept of value in health care.

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cenergistic

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NIHCM – Small Business Health Insurance Coverage

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In a Post-ACA World

In this Expert Voices essay, Sabrina Corlette examines developments in the small group market since the passage of the ACA and considers the future outlook.

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kidney

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NIHCM – Small Business Health Insurance Coverage in a Post-ACA World

Conclusion

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On Valuing Physician Work in Medicare

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Time for a Change?

By Miriam J. Laugesen PhD
[Assistant Professor, Department of Health Policy and Management, Mailman School of Public Health, Columbia University]

via: NIHCM Foundation | 1225 19th Street, NW | Suite 710 | Washington | DC | 20036 www.nihcm.org

The Government Accountability Office (GAO) just released an important review of the way the Relative Value Scale Update Committee (RUC) and CMS value physician services for Medicare. The report finds significant flaws in the data and processes used, echoing a recent Expert Voices essay by RUC researcher Miriam Laugesen.

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spreadsheet

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Assessment

In this essay, Dr. Laugesen illustrates inaccuracies with work time estimates and the shortcomings of specialty society surveys. She also highlights ways to introduce greater precision and transparency to the process of updating Medicare physician fees. Read more…

EVEN MORE:

Gail Wilensky
The Outlook for Reforming Payments to Graduate Medical Education

John Iglehart
Meeting the Demand for Primary Care: Nurse Practitioners Answer the Call

David Dranove
Federal Antitrust Enforcement in Health Care

Michael L. Millenson
Paradigm, Not Pill: The New Role of Patient-Centered Care

Conclusion

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Spending for Private Health Insurance in the United States

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Health Costs Doubled in the Past Decade

By NIHCM Foundation www.NIHCM.org

The total cost of health care for a typical family with employer-sponsored coverage has more than doubled in the past decade to nearly $21,000 per year, outpacing both inflation and income growth.

Skyrocketing health care costs are already straining budgets and could jeopardize the availability of affordable coverage under the ACA. To shed light on the factors behind increased spending on private insurance, this brief examines

  • trends in premiums and cost-sharing in the group and non-group markets,
  • how premium dollars are spent by insurers,
  • which sectors are driving premiums upward, and
  • the importance of price increases in explaining spending growth.

healthcare costs

Assessment

Read more…

Conclusion

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Community Rating and Guaranteed Issue in the Individual Health Insurance Market

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Expert Voices

[By Staff Reporters]

In this essay Dr. Anthony Lo Sasso provides empirical evidence of the adverse selection that resulted when states adopted community rating and guaranteed issue requirements in their individual health insurance markets but did not implement complementary mechanisms to keep lower risk individuals in the insurance risk pools.

Results of Adverse Selection

Such adverse selection can raise premiums, destabilize markets and even lead to market failure through the following cycle of events:

  • Community rating prohibits differential premiums based on health status, effectively lowering premiums for individuals in poorer health and increasing them for healthier individuals.
  • Guaranteed issue allows people to purchase coverage when they get sick, decreasing the need to maintain insurance coverage.
  • Healthy individuals respond by dropping coverage and entering the market only when they need coverage, thus the pool of enrollees becomes increasingly older and sicker.
  • This adverse selection pushes premiums for all remaining enrollees higher, provoking further departures by those at the healthier end of the spectrum.
  • Premiums increase again to reflect the ever-worsening risk pool of enrollees.
  • The cycles continue, further destabilizing the market and potentially leading to complete market collapse.

Assessment

Dr. Lo Sasso’s findings highlight the importance of providing effective mechanisms to protect the integrity of the risk pool in conjunction with the community rating and guaranteed issue provisions contained in the SCOTUS upheld Patient Protection and Affordable Care Act.

Link: EV-LoSassoFINAL

Conclusion

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Evaluating ACOs at Mid-Launch

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Moving Forward but Challenges Ahead

[By ME-P Staff]

Accountable Care Organizations [ACOs] are generating considerable attention for their potential to improve the value of our health care spending through better coordination of care and new payment incentives that focus on quality and efficiency of care.

The Challenges

Yet, even as ACOs develop at a fairly rapid clip across the nation, they face substantial challenges.

For example, In this essay, Steven Lieberman reviews the ACO landscape in both the public and private sectors and examines the major obstacles confronting these emerging organizations, including limited tools for influencing patient choice, the need for immediate and sustained cost savings, and system-wide concerns about rising costs due to enhanced market power.

Assessment

Link: http://nihcm.org/images/stories/EV_Lieberman_FINAL.pdf

Conclusion

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Controlling Health Care Spending [An NIHCM Foundation Webinar]

The Imperative to Act and Diverse Views of the Road Forward

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The U.S.now spends $2.5 trillion annually on health care, accounting for well over 17 percent of GDP and growing rapidly with challenging fiscal consequences. Despite the imperative to control spending, we face much uncertainty about how to move to a more sustainable path.

Political opposition threatens implementation of the Affordable Care Act, and many of its cost-control measures are still unproven. A long-term fix for Medicare physician payment remains elusive. The trigger mechanism activated by the failure of the Super Committee is poised to affect myriad health programs, but decisions on the specific cuts await sure-to-be intense congressional negotiations.

And, the many ideas for entitlement reform that were advanced during deficit reduction talks continue to generate much debate but little consensus.

Topics

To shed light on these complex issues, this webinar will feature leading health policy experts discussing topics including:

  • health spending growth and the implications for government budgets, employers and individuals
  • the societal trade-offs we face as health spending grows and as we think about ways to control spending
  • alternative viewpoints on the viability of cost control approaches now being tried and the most promising options for the future.

Assessment

Visit NIHCM Foundation’s website to view an agenda and additional resources on health care spending. And, please register by noon (EST) on February 1st.

Conclusion        

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

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More Evidence of the Association between Hospital Market Concentration and Higher Prices and Profits

NIHCM Expert Voices in Health Care Policy

By James C. Robinson, PhD

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In this essay, Dr. James Robinson presents results from his latest work showing that the prices hospitals charge to private insurers for 6 common procedures are 30 to 50 percent higher when the hospital is located in a market where it faces less competition from other hospitals.

These findings add to the already substantial body of research showing that consolidation in hospital markets confers market power that enables hospitals to secure higher prices.

When seen in the context of current policies encouraging additional provider consolidation through accountable care organizations [ACOs], this work serves as an important reminder that ongoing vigilance of the potential anti-competitive effects of these new delivery systems is needed along with other measures to counteract growing market power of providers.

About the Author:

James C. Robinson, PhD is the Leonard D. Schaeffer Professor of Health Economics and Director, Berkeley Centerfor Health Technology, University of California, at Berkeley.

Conclusion

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Understanding US Health Care Spending

Dear ME-P Colleagues,

Nancy Chockley, President and CEO

The NIHCM Foundation is pleased to announce the release of a new data brief, Understanding U.S. Health Care Spending.

In it, we examine why we spend more than $8,000 per person on health care and the factors driving spending growth. Our analysis documents the extreme concentration of expenditures, with just 5 percent of the population responsible for almost half of all spending, and demonstrate the importance of rising spending for hospital and physician services as the primary drivers of expenditure growth.

Findings are based on NIHCM analysis of the most recent data from the National Health Expenditure Accounts and the Medical Expenditure Panel Survey.

We hope that you find this publication helpful for your own work.

Sincerely,
Julie Schoenman [Director of Research and Development]

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Essay on Medicare Pricing Distortions

In Physician Fee Schedules

By Nancy Chockley PhD
President & CEO
NIHCM Foundation

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Leaving Medicare F-F-S Reimbursement

While there is near universal agreement that we need to move away from Medicare’s fee-for-service [F-F-S] physician payment system, Dr. Robert Berenson argues that in the short term we still need to focus on improving the current physician fee schedule.

Reasons Why?

Not only are the value-based payment systems that most reformers envision still many years from widespread reality, the existing fee schedule prices will serve as the building blocks for some of the newer aggregate payment approaches.

Assessment

In his Expert Voices essay, Dr. Berenson offers thoughts on how to improve the system in ways that both address current payment system woes and serve as a step toward future value-based payment systems.

Link: http://nihcm.org/pdf/NIHCM-EV-Berenson_FINAL.pdf

Contact

phone: 202-296-4426
email: nihcm@nihcm.org
website: www.nihcm.org

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Taxing Sin to Modify Behavior and Raise Revenue‏

NIHCM Expert Voices

By Nancy Chockley PhD [President & CEO]
[NIHCM Foundation]

Sin taxes on tobacco and alcohol have a long history in the U.S., and many credit cigarette taxes as being the single most effective strategy in achieving our dramatic reductions in smoking.  Similar taxes have been proposed in recent years as one weapon in our fight against rising obesity rates, and a new study has just added support for this policy by showing that higher prices for sweetened sodas are associated with lower caloric intake, lower weight, and better health.

Rationale Reviews

In his essay, Dr. Jonathan Gruber reviews the rationales for and experience with sin taxes for cigarettes and alcoholic beverages, and offers his insights on using sin taxes to combat obesity.

http://www.nihcm.org/pdf/ExpertVoices_Gruber_April2010.pdf

Related Others

Other recent “Expert Voices” essays on health reform include:

Assessment

I hope you enjoy reading these essays and those that follow, down-line.

Phone: 202-296-4426
email:
nihcm@nihcm.org
Website: www.nihcm.org

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Why America Spends More on Healthcare

A McKinsey Global Institute Review

By Nancy Chockley; PhD
President & CEO
NIHCM FoundationRed Cross

Path breaking work by the McKinsey Global Institute (MGI) shows that, relative to other peer countries from the Organization for Economic Cooperation and Development, the U.S. spends nearly $650 billion more on health care than would be expected after adjusting for cross-country differences in wealth.  Fully two-thirds of this added spending occurs in the outpatient sector. 

Out-Patient Services

The highly profitable nature of many outpatient services coupled with the incentives of a fee-for-service payment system are contributing to greater intensity of outpatient care and helping to fuel this spending.  In this essay, “Why America Spends More on Health Care,” Eric Jensen and Lenny Mendonca describe MGI’s work to examine all sectors of the American health care system and identify factors responsible for the higher-than-expected spending.  

More Examples

Other recent Expert Voices essays on health reform include:

Channel Surfing

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Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. 

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

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