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Four times as many counties as last year have only one insurer
In 2017 open enrollment, nearly 1,000 counties across the county only have one health care insurer available, quadruple the number from last year. Sarah Killf and Sarah Frostenson of Vox explain counties with only one plan provider are experiencing the largest premium hikes. Further withdrawals from these counties could leave residents without any insurance options, and there are no contingency plans for counties in this position.
Millions of Americans forgo health coverage despite penalty
More than 8 million people paid the Affordable Care Act penalty for not having health insurance in 2014, the first year the law required most Americans to be covered. For individuals who do not qualify for tax credits, the penalty is lower than the cost of insurance. The average penalty starts at $700. Many young people believe they are healthy enough to forgo coverage, reports Robert Pear of The New York Times.
First state moves to all-payer ACO
Vermont is set to become the first state to implement a voluntary, all-payer accountable care organization (ACO). The ACO, which will begin in January and last five years, will cover Medicare, Medicaid and commercial payers. The Centers for Medicare and Medicaid Services is giving the state $9.5 million to help transition to the model. Shannon Muchmore at Modern Healthcare has the story.
Groups shift liability for high drug prices
The Biotechnology Innovation Organization, a trade association serving the biotech industry, released an advertisement yesterday showing the large portion of drug profits that goes to the middleman, not the pharmaceutical company. Anna Edney and Robert Langreth of Bloomberg report the health care industry is shifting responsibility for high drug prices among various stakeholders as Congress gears up to take action on the issue.
Political climate presents challenges to expanding ACA
A contentious political environment is increasing pressure for the next president to change the Affordable Care Act (ACA) and will make expanding coverage more difficult. Democratic presidential candidate Hillary Clinton proposes modifying the health care law, while Republican candidate Donald Trump wants to immediately repeal it. Amy Goldstein of The Washington Post shares insurers are hopeful enough healthy people will enroll to help stabilize the program.
Studies of Note
In this feature, the Media Monitoring Report shares a selection of notable research studies within the health care industry.
Media Attention and Cost
Despite Being Shamed for Overcharging Patients, Hospitals Raised Their Prices, Again
The Washington Post
University of Miami researchers find hospital prices increased significantly after negative media attention over facility charges. The authors of the study, published in the Journal of Health Care Finance, compared the total amount of charges from 20 hospitals before and after negative publicity about the facilities’ prices from 2010 to 2015. Reporter Lena Sun has the story.
Premiums On, Off Exchanges
New Data Expose Mysterious World of Off-Exchange Health Plans
The Robert Wood Johnson Foundation finds the cost of an average silver plan premium sold on the exchanges is a little under $300, while a similar plan sold on the off-exchange market costs more than that figure. The data offer an in-depth look at how prices compare on and off the exchanges, according to Senior Reporter Harris Meyer.
Treatment for Broken Bones
Re-Evaluation of Low-Intensity Pulsed Ultrasound in Treatment of Tibial Fractures (TRUST): Randomized Clinical Trial
Researchers from McMaster University and colleagues find an ultrasound, often used to help heal broken bones quickly, is not effective treatment. The researchers report no difference in the amount of time to return back to work without limitations for participants assigned to the ultrasound treatment versus the sham treatment.
Impact of Vaccines
Modeling the Economic Burden of Adult Vaccine-Preventable Diseases in the United States
A model designed to measure the effect of vaccines finds adults who do not get vaccinated cost the American economy about $9 billion. The estimate includes expenses from treatment and loss in productivity. University of North Carolina Eshelman School of Pharmacy Associate Professor Sachiko Ozawa, MHS, PhD, led the research team that created the model.
Mandatory Provider Review and Pain Clinic Laws Reduce the Amounts of Opioids Prescribed and Overdose Death Rates
A study exploring the effects of prescription drug monitoring programs (PDMP) finds states implementing mandatory programs saw fewer opioid prescriptions and more than a 10 percent drop in opioid-related deaths. The programs allow state officials, doctors and pharmacists to identify and track trends in prescriptions and provide an opportunity to catch potential abuse. Centers for Disease Control and Prevention Senior Medical Advisor Deborah Dowell, M.D., MPH, led the study (subscriber’s content).