Research roundup: Patient satisfaction, community health centers as medical homes, analyzing controversial Medicare coverage

Every week, KHN reporter Shefali S. Kulkarni compiles a selection of recently-released health policy studies and briefs.

Archives Of Internal Medicine: The Cost Of Satisfaction: A National Study Of Patient Satisfaction, Health Care Utilization, Expenditures, And Mortality -- Using the Medical Expenditure Panel Survey from 2000 -2007, researchers conducted a "prospective cohort study of adult respondents (N = 51,946)" and found that "higher patient satisfaction was associated with less emergency department use, but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality" (Fenton et al., 2/13).

Center For Studying Health System Change/National Institute For Health Reform: Health Status And Hospital Prices Key To Regional Variation In Private Health Care Spending -- The author analyzed claims from 218,000 autoworkers to understand health care spending patterns. "Although autoworkers' health benefits essentially are uniform nationally, health spending per enrollee in 2009 varied widely across 19 communities within a large concentration of autoworkers, from a low of $4,500 in Buffalo, N.Y. to a high of $9,000 in Lake County, Ill." The study suggests that the variation in health care spending is a quality and price problem. "Restraining hospital prices and improving people's health status," will push purchasers to create new cost-effective strategies (White, February 2012).

Related KHN story: Autoworkers' Health Claims Offer Clues To Regional Spending Variation (Rau, 2/15)

Health Affairs: Tool Used To Assess How Well Community Health Centers Function As Medical Homes May Be Flawed -- The Health Resources and Services Administration (HRSA) and CMS are trying to promote and test the adoption of a patient-centered medical home model within community health centers. However, after looking at 30 community health centers in the Los Angeles area, researchers found "that there was no significant relationship between how well these centers performed on the assessment and whether they achieved a range of process or outcome measures for diabetes care. ... Therefore, additional methods are required for measuring and improving the capabilities of community health centers to function as medical homes and to deliver the scope of services that impoverished patients genuinely need" (Clarke, Tseng, Brook and Brown, 2/15).

Medical Care Journal: Factors Predicting Medicare National Coverage: An Empirical Analysis --"Interventions considered to be particularly controversial or expected to significantly impact the Medicare program in the United States are considered in National Coverage Determinations," the authors of this analytical review write. They looked at coverage decisions from 1999 to 2007 and concluded that "good or fair quality supporting evidence is a strong predictor of positive coverage. Availability of alternative interventions, more recent decisions, and lack of an associated estimate of cost-effectiveness are associated with a decreased likelihood of positive coverage. The findings highlight Medicare's move to evidence-based coverage decisions, and suggest that coverage decisions are influenced by the availability of cost-effectiveness evidence" (Chambers, Morris, Neumann and Buxton, 2/13).