Research roundup: Best health care for homeless, new business model for pharma

Published on June 16, 2012 at 8:04 AM · No Comments

Each week reporter Christian Torres compiles a selection of recently-released health policy studies and briefs.

Center for Health Care Strategies/Robert Wood Johnson Foundation: Medicaid-Financed Services In Supportive Housing For High-Need Homeless Beneficiaries: The Business Case -- The cost and coordination of health care for homeless individuals can be a challenge for states. But as this brief describes, establishing supportive housing - which provides social services, usually on site - "can help improve health, increase survival rates, foster mental health recovery, and reduce alcohol and drug use." The authors note funding opportunities under the 2010 health law. While such programs require lots of planning and targeted outreach, they also "could represent a good investment opportunity for states" (Nardone, Cho and Moses, 6/8).

Health Affairs: Acute Care For Elders Units Produced Shorter Hospital Stays At Lower Cost While Maintaining Patients' Functional Status -- In the 1990s, clinicians at the University Hospitals of Cleveland developed a program called "Acute Care for Elders," which puts an emphasis on senior-friendly facilities within the hospital and coordinated, "team" care. This randomized, controlled trial found that patients in the program had shorter hospital stays than the control group, 6.7 vs. 7.3 days, on average. Costs were also significantly lower -- $9,477 versus $10,451 per patient. The researchers suggest that "more widespread implementation of Acute Care for Elders Units could result in major systemwide cost savings while preserving quality of care" (Barnes et al., 6/5).

Rand Corporation: Medicines As A Service -- A New Commercial Model For Big Pharma In The Postblockbuster World -- The pharmaceutical industry is facing an uncertain future as many of its "blockbuster" drugs go off patent. The authors of this paper propose a new business model in which the industry places a greater emphasis on chronic conditions and quality of care. They recommend companies "add patient engagement solutions to medicines, which would promote adherence," and point to some examples, e.g. packaging for birth control pills so users can recall if they have taken the day's dose. The authors encourage tying financial reward to quality of patient care, such as in accountable care organizations, and advocate moving "from selling pills to selling outcomes. The opportunity is clearly there because prescription drugs are underused, and better adherence to evidence-based treatment regimens could both save lives and reduce cost," they write (Mattke, Klautzer and Mengistu, 6/6).

State Health Access Data Assistance Center/Robert Wood Johnson Foundation: The Rural Implications Of Geographic Rating Of Health Insurance Premiums
Beginning in 2014, the health law will allow insurers to vary their premiums based on only a few factors. Among those is the location for a plan, because regions can vary widely on the cost of care. This brief looks at current "geographic rating" practices and finds no clear pattern in pricing, which "suggests that health plans may [currently] use geographic rating for business purposes other than adjusting for underlying cost/price differences." The authors conclude that rating practices "could undermine the intent of the ACA to distribute risk broadly" and ensure affordable coverage (Coburn et al., 6/8).

Here is a selection of excerpts from news coverage of other recent research:

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