More Nonelderly Americans Face Problems Affording Prescription Drugs

Analyzes 2003-07 trends in unmet prescription drug needs among Americans under age 65 by insurance status and type of coverage, income level, and the presence of chronic conditions. Explores implications of the economic downturn and changes to Medicaid

Paying More for Primary Care: Can It Help Bend the Medicare Cost Curve?

Estimates how a permanent 10 percent increase in Medicare fees for primary care ambulatory visits would affect the number and cost of visits and spending for inpatient and post-acute care. Considers primary care's role in bending the Medicare cost curve

Enhanced Magnetic Trap Loading for Atomic Strontium

We report on a technique to improve the continuous loading of atomic strontium into a magnetic trap from a Magneto-Optical Trap (MOT). This is achieved by adding a depumping laser tuned to the 3P1 to 3S1 (688-nm) transition. The depumping laser increases atom number in the magnetic trap and subsequent cooling stages by up to 65 % for the bosonic isotopes and up to 30 % for the fermionic isotope of strontium. We optimize this trap loading strategy with respect to the 688-nm laser detuning, intensity, and beam size. To understand the results, we develop a one-dimensional rate equation model of the system, which is in good agreement with the data. We discuss the use of other transitions in strontium for accelerated trap loading and the application of the technique to other alkaline-earth-like atoms.Comment: 8 pages, 8 figure

Employment Changes Play Major Role in Access to Employer Health Coverage

Highlights findings on the factors that drive short-term changes in employer-sponsored health insurance coverage, including the rising cost of health insurance and changes in employment rates and availability of better jobs during macroeconomic cycles

Healthcare Price Transparency: Policy Approaches and Estimated Impacts on Spending

Healthcare price transparency discussions typically focus on increasing patients' access to information about their out-of-pocket costs, but that focus is too narrow and should include other audiences -- physicians, employers, health plans and policymakers -- each with distinct needs and uses for healthcare price information. Greater price transparency can reduce U.S. healthcare spending.For example, an estimated $100 billion could be saved over the next 10 years if three select interventions were undertaken. However, most of the projected savings come from making price information available to employers and physicians, according to an analysis by researchers at the former Center for Studying Health System Change (HSC). Based on the current availability and modest impact of plan-based transparency tools, requiring all private plans to provide personalized out-of-pocket price data to enrollees would reduce total health spending by an estimated$18 billion over the next decade. While $18 billion is a substantial dollar amount, it is less than a tenth of a percent of the$40 trillionin total projected health spending over the same period. In contrast, using state all-payer claims databases to gather and report hospital-specific prices might reduce spending by an estimated $61 billion over 10 years.The effects of price transparency depend critically on the intended audience, the decision-making context and how prices are presented. And the impact of price transparency can be greatly amplified if target audiences are able and motivated to act on the information. Simply providing prices is insufficient to control spending without other shifts in healthcare financing, including changes in benefit design to make patients more sensitive to price differences among providers and alternative treatments. Other reforms that can amplify the impact of price transparency include shifting from fee-for-service payments that reward providers for volume to payment methods that put providers at risk for spending for episodes of care or defined patient populations. While price transparency alone seems unlikely to transform the healthcare system, it can play a needed role in enabling effective reforms in value-based benefit design and provider payment

Factors associated with geographic variation in cost per episode of care for three medical conditions

Objective: To identify associations between market factors, especially relative reimbursement rates, and the probability of surgery and cost per episode for three medical conditions (cataract, benign prostatic neoplasm, and knee degeneration) with multiple treatment options. Methods: We use 2004–2006 Medicare claims data for elderly beneficiaries from sixty nationally representative communities to estimate multivariate models for the probability of surgery and cost per episode of care as a function local market factors, including Medicare physician reimbursement for surgical versus non-surgical treatment and the availability of primary care and specialty physicians. We used Symmetry’s Episode Treatment Groups (ETG) software to group claims into episodes for the three conditions (n = 540,874 episodes). Results: Higher Medicare reimbursement for surgical episodes and greater availability of the relevant specialists are significantly associated with more surgery and higher cost per episode for all three conditions, while greater availability of primary care physicians is significantly associated with less frequent surgery and lower cost per episode. Conclusion: Relative Medicare reimbursement rates for surgical vs. non-surgical treatments and the availability of both primary care physicians and relevant specialists are associated with the likelihood of surgery and cost per episode