Health policy research roundup

Urban Institute: Variation in Insurance Coverage Across Congressional Districts New Estimates from 2008 -- Drawing from data from the American Community Survey, the authors of this brief explore the variation in rates of uninsurance, public and private coverage across congressional districts. "The picture that emerges is that … rates of private coverage are lowest in districts that have higher poverty rates, which tend to be concentrated in the South and West; … the needs in these high-poverty districts have led many to have above average rates of public coverage; and … despite these higher rates of public coverage, uninsurance remains most serious in districts with low rates of private coverage," the authors write (Kenney, Lynch, Zuckerman and Phong, 10/5).

Urban Institute: The Cost of Failure to Enact Health Reform: Implications for States -- The authors of this brief use the Health Insurance Policy Simulation Model (HIPSM) to estimate the impact that would be felt by each of the 50 states and the District of Columbia if health insurance reform is not enacted. Under the worst-case scenario, within 10 years, the authors estimate: "the number of uninsured could grow by at least 10 percent in every state," leading the total number of uninsured Americans to reach 65.7 million; "Businesses would see their premiums continue to increase—more than doubling in 27 states"; and "Every state would see its Medicaid/CHIP spending rise by more than 75 percent by 2019" (Garrett, Holahand, Doan and Headen, 10/1).

Annals of Internal Medicine: Associations Between Structural Capabilities of Primary Care Practices and Performance on Selected Quality Measures -- This study finds routine use of electronic medical records by primary care physicians was associated with higher performance across several quality measures. RAND researchers studied more than 300 groups of primary care physicians in Massachusetts, finding "that practices that used multifunctional electronic health records," such as electronic reminders, "were more likely to deliver better care for diabetes and provide certain health screenings than those that did not," according to a RAND description of the study (Friedberg et al., 10/6).

UCLA Center for Health Policy Research: California Budget Cuts Fray the Long-Term Care Safety Net - This brief examines the impact of the 2009 state budget cuts for community-based long-term care (LTC) programs, scheduled to go into effect Oct. 1, on older adults as well as their families and service providers. Based upon recent data, a literature review and a series of interviews with government and service workers, the authors note, "Among the most vulnerable: seniors with Alzheimer's disease whose families rely on state-funded Alzheimer's centers that will soon lose all of their state funding," according to a UCLA description of the report. "Also impacted are low-income seniors with disabilities, who often rely on a web of safety-net programs that both supplement their incomes and give them access to free or subsidized in-home care" (Wallace, Benjamin, Villa and Pourat, Oct. 2009).

Kaiser Family Foundation: Medicare Part D Spotlight: Part D Plan Availability in 2010 and Key Changes Since 2006 -- This issue brief provides analysis of the Medicare drug plan options that will go into effect in 2010, as indicated by the Centers for Medicare & Medicaid Services on Oct. 1, 2009. The brief includes information on the number of available plans, premiums for those plans, and benefit designs (Hoadley, Cubanski, Hargrave, Summer and Neuman, Oct. 2009).

Center for Economic and Policy Research: Free Trade in Health Care: The Gains from Globalized Medicare and Medicaid -- This paper examines the potential savings to the U.S. government as well as Medicaid and Medicare beneficiaries if these beneficiaries were to buy into the health care systems of the 26 countries that have lower costs and higher life expectancies (Baker and Rho, Oct. 2009).

Annals of Internal Medicine: Medicare Spending for Previously Uninsured Adults -- An analysis of claims data of patients ages 65 and 74 as reported in the Health and Retirement Study reveals Medicare spending for adults who were uninsured before becoming eligible for the program exceeds that of people who were previously insured ($5,796 compared to $4,773). "Greater spending for previously uninsured adults was largely explained by hospitalizations for complications related to cardiovascular disease or diabetes and for joint replacements. Thus, extending insurance to uninsured adults may result in substantial health gains for many older working-age adults, and subsequent reductions in Medicare spending after age 65 may partially offset increased spending from expanded coverage before age 65" (McWilliams, Meara, Zaslavsky and Ayanian, 10/5).