Research Headlines

Last month, the Centers for Medicare and Medicaid Services (CMS) released data showing that total national health spending increased by less than 4 percent in 2009 and 2010, the slowest annual pace in five decades. Writing in the New York Times (“In Hopeful Sign, Health Spending is Flattening Out [2]”), Annie Lowrey discusses factors contributing to this trend. Many experts point to the weak economy as a chief cause.There is consensus among experts, however, that there are other contributors besides the economic downturn, including the growth in recent years in high-deductible health plans (HDHPs). HCFO-funded research offers insights into the features of HDHPs and their unintended consequences.

Recently the Chicago Sun-Times reported on Mayor Rahm Emanuel’s effort to bring down high health care costs among Chicago city employees. The article, “10,000 Additional Employees Join Emanuel’s Wellness Plan [4],” details Emanuel’s decision to raise monthly health insurance premiums by $50 for employees who do not participate in a wellness plan to manage chronic conditions. This is one example of increasing employer interest in workplace wellness initiatives as a means to control costs, as well as potentially improve worker health and productivity. HCFO-funded research offers insights into the value of different initiatives to improve employee health and lower costs for employers.

Interest in reducing costly and dangerous medical mistakes made in hospitals has grown in recent years, especially with new advances in health information technology (HIT). Journalist Ted Burnham, recently noted on the NPR: Health Blog [6] that an estimated one in seven hospital patients will suffer some form of error in their care. Approximately one-third of those are prescription drug related. A specific innovation in HIT, Computerized Physician Order Entry (CPOE), including e-prescribing, addresses this problem. In addition to being able to prevent harmful drug interactions, electronic prescriptions also reduce mistakes from misread handwriting, miscalculated dosages, and incomplete forms. HCFO has funded research on the impact of computerized physician order entry (CPOE) systems on the quality and cost of health care. 

Recently, the Agency for Healthcare Research and Quality (AHRQ) released a study showing the concentraton of health care costs among a relatively small proportion of the population. Writing in The Atlantic Monthly and describing the study results [8], Jordan Weissmann notes that the top 5 percent of spenders acconted for approximately half of all health care spending in the United States. This concentration of spending in a relatively small number of individuals presents both challenges and opportunities for policymakers. HCFO research offers additional insights into the nature of health care costs and the challenge of controlling their increase and improving value for money spent. 

Among recent developments in the implementation of the Patient Protection and Affordable Care Act (ACA), the Secretary of Health and Human Service’s decision to give states significant discretion in prescribing which benefits insurers must offer generated significant media attention. As described by Robert Pear in the New York Times [10], the ACA requires that insurance include “essential health benefits” in ten categories. For public and private policymakers faced with decisions about health insurance benefit design, HCFO’s portfolio of funded research includes several relevant studies.