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This Week in Health Care Reform: June 14th, 2019

ER bills see a dramatic increase over the past decade; prices for top-selling drugs continue to rise; Medicaid expansion is found to have led to fewer heart-related deaths; and, a new study takes a look at how patients view social health factors.

Week in Review

Skyrocketing ER Bills: According to a new report from the Health Care Cost Institute (HCCI), hospital emergency rooms (ERs) substantially increased their prices from 2008 through 2017.  In fact, over that span, the average cost of a visit to the ER more than doubled, going up 176 percent.  But, more than that, HCCI’s analysis also found that hospitals and doctors have steadily been billing for more complex care, allowing them to collect more lucrative fees from consumers, employers, and insurers.  These practices – which some experts have categorized as hospitals being handed a blank check for emergency care – continue to draw attention to the role that hospitals have quietly played in driving up overall health care costs.

Rx Price Increases: A new study published in the Journal of the American Medical Association (JAMA) found a significant rise in the price of many popular prescription drugs in the U.S. over the past six years.  In it, researchers examined the prices for dozens of the top-selling drugs between January 2012 and December 2017, discovering that virtually all of them rose on a regular basis.  Alarmingly, the median price among those drugs went up 76 percent during that period, with over 4 of 5 of them more than doubling in price.  The data, which also pointed to substantial increases in insurer and out-of-pocket costs for top-selling, brand name drugs, only served to highlight the exigent threat to our health care system posed by unimpeded price hikes in the pharmaceutical market.

Medicaid Expansion: New research links the expansion of Medicaid benefits to fewer deaths from heart-related conditions.  Also appearing in JAMA, the study established “lower cardiovascular mortality in middle-aged adults” in states that expanded their programs under the Affordable Care Act.  According to the researchers, a “significantly smaller increase” in cardiovascular mortality rates was observed in counties whose states had expanded their Medicaid programs compared with those who hadn’t.  Given the results of the study, they go on to offer that policymakers would do well to consider “the high burden of cardiovascular risk factors among individuals…with lower socioeconomic status” in the ongoing debate surrounding expansion of Medicaid and changes to eligibility

SDoH Study: W
ith one-third of patients in the U.S. struggling with social determinants of health (SDoH) – some being among the most vulnerable patient populations – it’s become clear that an integral component of achieving better population health outcomes requires a focus on whole-person health.  A new study takes a deep dive into patients’ views of SDoH and, critically, what that means for stakeholders.  Released by Anthem’s Public Policy Institute (PPI), the analysis discovered that individuals living with chronic or acute conditions have a much narrower view of SDoH than that of the media or researchers.  Specifically, these patients are focused on day-to-day health influencers, such as finding the right doctor or nutritional food, whereas the media and researchers tend to focus on structural factors, such as education and income level.  In speaking to the importance of the findings, PPI’s Jenn Kowalski pointed out how better understanding the manner in which patients interact with SDoH enables stakeholders to identify and design improved ways of helping them more effectively manage those interventions.      

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