Archive for August, 2016


NIH Launches Research on Health Disparities for Disadvantaged Communities

The National Institutes of Health is launching a new Transdisciplinary Collaboratives Centers for Health Disparities Research on Chronic Disease Prevention program that seeks to respond to

…the need for more robust, ecological approaches to address chronic diseases among racial and ethnic minority groups, under-served rural populations, people of less privileged socio-economic status, along with groups subject to discrimination who have poorer health outcomes often attributed to being socially disadvantaged. Two centers will focus their research efforts on development, implementation, and dissemination of community-based, multilevel interventions to combat chronic diseases such as heart disease, cancer and diabetes.

Anticipated funding over the first five years is approximately $20 million.

To learn more about what the program seeks to accomplish and the health challenges it anticipates addressing, see this NIH news release.…

Pennsylvania Launches Prescription Drug Monitoring Program

The Pennsylvania Department of Health has launched its much-anticipated prescription drug monitoring program.

Previously operated by the state’s office of the attorney general but assigned to the state’s Health Department through 2014 legislation, the program requires those authorized to prescribe controlled substance prescription drugs to collect and submit information to the PDMP each time they do so within 72 hours. That information is then stored in a database that is available to health care professionals to help them identify patients who may have problems with controlled substances or may even be going from provider to provider to gain additional prescriptions.

The state Health Department has created a web site for the program that includes FAQs about how the PDMP works for those who prescribe and dispense controlled substances. Visit that web site here.…

CMS Questions Steering of Patients to Higher-Paying Insurers

Concerned that health care providers may be steering patients to health insurers that pay providers better, the Centers for Medicare & Medicaid Services has issued a request for information seeking input on

inappropriate steering of people eligible for or receiving Medicare and/or Medicaid benefits into an individual market plan.

According to CMS,

…we believe there is potential for harm when a healthcare provider or provider-affiliated organization steers people eligible for Medicare and/or Medicaid benefits to enroll in an individual market plan for the healthcare provider’s financial gain through higher payment rates without taking into account the needs of these individuals. People who are steered away from Medicare and/or Medicaid and to an individual market plan may experience a disruption in the coordination of their care, changes in prescription drug benefits, loss of dental care for certain Medicaid beneficiaries, and changes in the network of providers. Enrollment decisions should be made, without influence, by the consumer and based on their individual circumstances and health and financial needs.

Based on the input it receives, CMS may take steps to address such practices – including using its

…existing authorities to impose civil monetary penalties on health care providers who induce Medicare eligible

Who’s Still Uninsured?


Young people between the ages of 19 and 34.


Low-income people, especially those living in states that have not expanded their Medicaid programs.

People in the South – again, especially those living in states that have not expanded their Medicaid programs.

Those who work for small companies.

The uninsured rate in the U.S., 20 percent before the Affordable Care Act took effect, is now 13 percent.

Learn more about how the Affordable Care Act has changed the rate at which different groups of Americans are insured in this Commonwealth Fund survey.…

Medicaid Expansion Did Not Increase ER Visits

Contrary to the expectations of many, the increase in Medicaid enrollment spurred by the Affordable Care Act did not lead to an increase in overall hospital emergency room use across the country.

According to a new study in the journal Health Affairs, ER visits among Medicaid patients rose 27.1 percent in Medicaid expansion states in 2014 but were offset by a 31.3 percent decline in ER visits by the uninsured and a 6.7 percent decline in the number of privately insured patients visiting ERs. Overall, the number of ER visits in 2014 rose less than three percent.

Thus, while ER payer mix certainly changed, utilization of ER services did not.

Learn more about how Medicaid expansion affected hospital ER utilization here, in the August 2016 Health Affairs article “Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix.”…