Health and Medical News and Resources

General interest items edited by Janice Flahiff

Potential Effects of the Affordable Care Act on Income Inequality | Brookings Institution

Potential Effects of the Affordable Care Act on Income Inequality | Brookings Institution.

From the 27 January 2014 Brookings Institute post
The Affordable Care Act (aka “Obamacare”) was designed to expand health insurance coverage and hold down the cost of insurance, but it will also change incomes of many Americans according to initial projections of Brookings Senior Fellows Henry Aaron and Gary Burtless.

In their new, preliminary paper “Potential Effects of the Affordable Care Act on Income Inequality,” Aaron and Burtless find sizeable income gains in the bottom quarter of the income distribution offset by small losses spread across higher income groups. Their estimates are highly sensitive to the definition of income. They discussed their paper in a recent event, joined by three other economists in a panel discussion.

The Affordable Care Act (aka “Obamacare”) was designed to expand health insurance coverage and hold down the cost of insurance, but it will also change incomes of many Americans according to initial projections of Brookings Senior Fellows Henry Aaron and Gary Burtless.

In their new, preliminary paper “Potential Effects of the Affordable Care Act on Income Inequality,” Aaron and Burtless find sizeable income gains in the bottom quarter of the income distribution offset by small losses spread across higher income groups. Their estimates are highly sensitive to the definition of income. They discussed their paper in a recent event, joined by three other economists in a panel discussion.

January 30, 2014 Posted by | health care | , , , , | Leave a comment

Study quantitatively evaluates factors underlying Medicare decisions on medical technology

From the 6 February posting at the CEA Registry blog

Our new study, recently published online in Medical Care (“Factors Predicting Medicare National Coverage: An Empirical Analysis” (1)), highlights factors underlying Medicare decisions on medical technology.

Interventions considered to be particularly controversial or expected to significantly impact the Medicare program in the United States are considered in National Coverage Determinations (NCDs).  Medicare coverage for interventions is limited to eligible items and services deemed “reasonable and necessary” for the diagnosis or treatment of an illness or injury.  What constitutes reasonable and necessary has not, however, been clearly defined.

This study is the first of its kind to quantitatively evaluate the factors associated with positive NCDs…

…Key findings include:
•    CMS favors proven interventions. Compared to interventions with clinical evidence deemed “insufficient”, interventions with good or fair quality supporting evidence were approximately six times more likely to receive a positive decision (p<0.01).
•    Interventions with available alternatives are less likely to be covered. Compared with interventions with no available alternative, those for which an alternative was available were approximately eight times less likely to receive a positive decision (p<0.01).
•    CMS accounts for value in coverage decisions. Compared with technologies estimated to be dominant, i.e., more effective and less costly than the competing intervention considered, those with no published estimate of cost-effectiveness were approximately five times less likely to receive a positive coverage decision (p<0.05).
•    Coverage decisions have become more restrictive over time. Compared with coverage decisions made in the years 1999 to 2001, decisions made from 2002 to 2003 were more than three times less likely to be positive (p<0.05).  Decisions made from 2004 to 2005 were also more than three times less likely to be positive (p<0.1), and from 2006 to 2007 decisions were almost ten times less likely to be positive (p<0.01).

This analysis can help the medical community better understand the type of evidence that Medicare considers in NCDs.  CMS and other payers may also benefit from this kind of external review of coverage decisions as it can help ensure the consistency of decisions and the integrity and accountability of the coverage process.

 

February 20, 2012 Posted by | health care | , , , | Leave a comment

   

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