News & Commentary

Briefly Noted February 2017

Frank Diamond

A Medicare bundled payment program for hip and knee replacement seems to be saving money, according to a study in JAMA Internal Medicine. Researchers looked at Medicare claims data for 3,942 patients receiving joint replacement surgery from 2008 to mid-2015. They found a decrease of $5,577 (20.8%) in total spending per episode. “Most of the hospital savings came from implants and supplies and most of the post-acute care savings came from decreased use of institutional care,” the study states.

San Antonio is one of the communities around the country working to keep patients with mental illness out of the expensive emergency department. The root of the problem is that there are too few psychiatrists in the country to meet demand, and patients sometimes have to wait months for an appointment, Kaiser Health News reports. In response, San Antonio sends such patients to a transitional care clinic. In this case it’s at the University of Texas Health Science Center, which treats about 1,500 mentally ill patients until they can get regular care.

It was expected that Medicare Advantage enrollment would decline from 10.9 million enrollees (or 24% of all Medicare enrollment) to 8.2 million (15% of Medicare’s total enrollment). Instead, enrollment has continued to climb. In 2016, 17.6 million Medicare beneficiaries—or 31% of all beneficiaries—were in MA plans.

A push by some employers for telemedicine is running into a wall: Many workers know it’s available but don’t really trust remote health care consultations, reports the Chicago Tribune. The newspaper cites a report by the National Business Group on Health that says that 70% of large employers offered the service but only 3% of employees at those companies used it during the first half of 2016.

Transfers from the hospital to a nursing home can be sprung on older adults without enough notice, reports Kaiser Health News. What families often don’t know is that they can challenge the discharge if they think the patient isn’t ready with what is known as a “fast appeal” to a Medicare Quality Improvement Organization. All it takes is a phone call. Once a fast appeal has been lodged, the patient can’t be transferred until it’s resolved.

Veterans who seek help for mental health issues often have to wait for months. Help is on the way from an unlikely source: Steven A. Cohen, the former head of a hedge fund that pleaded guilty to insider trading charges. Cohen is opening up a chain of mental health clinics that will give free service to veterans.

Under the ACA’s Medicaid expansion, prisoners can sign up for Medicaid benefits so that they are covered upon release. But many prisons have not created a program to help the inmates sign up, so many leave without having any coverage.

Donald Trump’s ascendancy to the presidency has given anti-vaccine activists new hope that their cause will be heard, STAT reports. The movement’s leader, Andrew Wakefield, found Trump to be a very sympathetic audience when they met this summer. “For the first time in a long time, I feel very positive about this, because Donald Trump is not beholden to the pharmaceutical industry,” Wakefield tells STAT. Wakefield is a controversial messenger. His paper suggesting the connection between vaccination and autism had to be retracted.

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