For First Time in Modern Era, Living With Parents Edges Out Other Living Arrangements for 18- to 34-Year-Olds
by Richard Fry
Share living with spouse or partner continues to fall
Broad demographic shifts in marital status, educational attainment and employment have transformed the way young adults in the U.S. are living, and a new Pew Research Center analysis of census data highlights the implications of these changes for the most basic element of their lives – where they call home. In 2014, for the first time in more than 130 years, adults ages 18 to 34 were slightly more likely to be living in their parents’ home than they were to be living with a spouse or partner in their own household.
Study: U.S. spends more on mental disorders than any other condition
by AHA News Now
U.S. health expenditures for mental disorders exceeded spending for every other medical condition in 2013 at $201 billion, according to a study published online this week by Health Affairs. Spending for heart conditions and trauma were the next highest, at $147 billion and $143 billion, respectively, followed by cancer and pulmonary conditions, at $122 billion and $95 billion. About 40% of spending for mental disorders was for institutionalized populations. “Spending on mental disorders tends to be underestimated in other sources because institutionalized populations are excluded,” the authors said.
Five Health Issues Presidential Candidates Aren’t Talking About — But Should Be
by Julie Rovner via Kaiser Health News
References to the Affordable Care Act — sometimes called Obamacare — have been a regular feature of the current presidential campaign season.
For months, Republican candidates have pledged to repeal it, while Democrat Hillary Clinton wants to build on it and Democrat Bernie Sanders wants to replace it with a government-funded “Medicare for All” program.
GAO Audit: Feds Failed To Rein In Medicare Advantage Overbilling
by Fred Schulte
Private Medicare Advantage plans treating the elderly have overbilled the government by billions of dollars, but rarely been forced to repay the money or face other consequences for their actions, according to a congressional audit released Monday.
In a sharply critical report, the Government Accountability Office called for "fundamental improvements" to curb overbilling by the health plans, which are paid more than $160 billion annually. The privately run health plans, an alternative to traditional fee-for-service Medicare, have proven popular with seniors and have enrolled more than 17 million people. The plans, which were the subject of a Center for Public Integrity investigation, also enjoy strong support in Congress.
Researchers Target the 7 Deadliest and Most Expensive Emergency Surgeries
by Jim Burger
Together, they account for more than 80% of deaths and inpatient costs.
Seven procedures collectively account for 80% of emergency surgeries, deaths, complications and costs related to emergency surgeries in the United States, a new study published in JAMA Surgery finds.
The 7 — partial colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy and laparotomy — represent a cross-section of surgeries that are either extremely common (appendectomy and cholecystectomy, for example) and/or that have relatively high mortality rates (laparotomy and management of peptic ulcer).
The study was based on more than 400,000 cases between 2008 and 2011. Mortality rates ranged from 0.08% for appendectomies to 23.8% for laparotomies. So while the mortality rate for appendectomies (about 1 of every 1,250 patients) is extremely low compared with most other emergency procedures, its high incidence boosts its importance. In contrast, laparotomies are performed only about 1.4% as often as appendectomies, but have a mortality rate approximately 300 times higher.
Complication rates ranged from 7.3% for appendectomies to 46.9% for small-bowel resections; and mean inpatient costs ranged from $9664.30 for appendectomies to $28,450.72 for small-bowel resections.
The 7 surgeries warrant special attention when it comes to establishing quality standards and reducing costs, say the authors. "National quality benchmarks and cost-reduction efforts should focus on these common, complicated and costly procedures," the authors conclude.
News Item - 04/27/2016
Administration takes first step to implement legislation modernizing how Medicare pays physicians for quality
The Department of Health and Human Services today issued a proposal to align and modernize how Medicare payments are tied to the cost and quality of patient care for hundreds of thousands of doctors and other clinicians. The Notice of Proposed Rulemaking is a first step in implementing certain provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This legislation – supported by a bipartisan majority and stakeholders such as patient groups and medical associations – ended more than a decade of last-minute fixes and potential payment cliffs for Medicare doctors and clinicians, while making numerous improvements to America’s health care system.
Increase in Suicide in the United States, 1999–2014
by Sally C. Curtin, M.A., Margaret Warner, Ph.D., and Holly Hedegaard, M.D., M.S.P.H.
Suicide is an important public health issue involving psychological, biological, and societal factors. After a period of nearly consistent decline in suicide rates in the United States from 1986 through 1999, suicide rates have increased almost steadily from 1999 through 2014. While suicide among adolescents and young adults is increasing and among the leading causes of death for those demographic groups, suicide among middle-aged adults is also rising. This report presents an overview of suicide mortality in the United States from 1999 through 2014. Suicide rates in 1999 are compared with 2014 for both females and males across age groups, and percentages are compared by method (firearms, poisoning, suffocation, and other means).
Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Proposed Rule Issues for Fiscal Year (FY) 2017
On April 18, 2016 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update fiscal year (FY) 2017 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The proposed rule, which would apply to approximately 3,330 acute care hospitals and approximately 430 LTCHs, would affect discharges occurring on or after October 1, 2016.
IMS Health Study: U.S. Drug Spending Growth Reaches 8.5 Percent in 2015
by Tor Constantino
Specialty Medicine Innovation Drives Growth, Partially Offset by Price Concessions from Manufacturers
Total spending on medicines in the U.S. reached $310 billion in 2015 on an estimated net price basis, up 8.5 percent from the previous year, according to a new report issued today by the IMS Institute for Healthcare Informatics. The surge of new medicines remained strong last year and demand for recently launched brands maintained historically high levels. The savings from branded medicines facing generic competition were relatively low in 2015, and the impact of price increases on brands was limited due to higher rebates and price concessions from manufacturers. Specialty dug spending reached $121 billion on a net price basis, up more than 15 percent from 2014.
CMS launches largest-ever multi-payer initiative to improve primary care in America
CMS launches largest-ever multi-payer initiative to improve primary care in America New Affordable Care Act initiative, designed to improve quality and cost, gives doctors and patients more control over health care delivery
The Centers for Medicare & Medicaid Services (CMS) today announced its largest-ever initiative to transform and improve how primary care is delivered and paid for in America. The effort, the Comprehensive Primary Care Plus (CPC+) model, will be implemented in up to 20 regions and can accommodate up to 5,000 practices, which would encompass more than 20,000 doctors and clinicians and the 25 million people they serve. The initiative is designed to provide doctors the freedom to care for their patients the way they think will deliver the best outcomes and to pay them for achieving results and improving care.
Now that ICD-10 is in full swing, we are seeing a lot of activity with providers, payers, consultants and regulators who need to understand how Acute Inpatient and Long Term Care Hospital claims "behave" when the claim is coded in ICD-10. This includes both prospective and retrospective review of claims scenarios to understand MS-DRG grouping. This article offers a basic primer on MS-DRG grouping logic, and research techniques for using related MediRegs Coding Suite tools. If you'd like a personalized training on these tools, or a demonstration of them in action to see if they are a good fit for your research scenarios, please let us know!
OVERVIEW OF THE FY 2016 IPPS FINAL RULE: SUMMARY OF CALCULATION ELEMENTS
New Health Analytics, a national healthcare software developer and data analytics firm, is pleased to announce that it has released a special report with an concise review of the FY 2016 Hospital Inpatient Prospective Payment System (IPPS) Final Rule recently posted by the Centers for Medicare & Medicaid Services.