Wednesday, December 21, 2016

The Top 10 Health Affairs Articles Of 2016

Man reading Health Affairs journal

Here they are! The 10 most read Health Affairs articles of 2016. It's no surprise that, like the journal, this list covers a lot of territory.

Coming in at number one is a July 2016 article by Ashley C. Bradford and W. David Bradford examining the relationship between state medical marijuana laws and prescription drug use under Medicare Part D. Next up is Ge Bai and Gerard F. Anderson's study identifying key characteristics of the most profitable hospitals in the United States.

From there, the list ranges across topics as varied as childhood immunization, retail clinics, and physician quality reporting. And of course, the challenges of measuring and containing costs is a common thread that runs through many of the papers our readers found most interesting.

We are pleased to offer the number one article on this top 10 list free to all for two weeks (through January 4, 2017). And number eight on the list is made available as free access courtesy of the author. (If you are not a subscriber, but want to read the other Health Affairs articles on this list, we are offering them on sale for $5 each (one-third the usual price). To purchase, either go directly to the Storefront and choose 2016 Top 10 Most Read under the Featured Categories. Or, when on the article abstract, click on PDF, follow the instructions to purchase an article, and once on the Storefront, click on Home Page to find this Featured Category.)

1. Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D

Ashley C. Bradford and W. David Bradford, July 2016

Twenty-four states and the District of Columbia have laws allowing marijuana use for medical purposes. Most research to date has focused on the indirect effects of the laws rather than the impact on clinical care. Ashley and W. David Bradford examine substitution of medical marijuana for other prescription drugs. They find a significant impact on prescriptions and spending in Medicare Part D, adding a new dimension to the policy debate surrounding these laws.

2. A More Detailed Understanding Of Factors Associated With Hospital Profitability

Ge Bai and Gerard F. Anderson, May 2016

Some nonprofit hospitals in the US earn substantial profits on patient care services, while most have deficits. In order to better understand why some hospitals are able to earn substantial profits, the authors used fiscal year 2013 Medicare Cost Reports from the Centers for Medicare and Medicaid Services, examining profitability from patient care services for some 3,000 US acute care hospitals. The authors found that market forces and price markup appear to play a substantial role in determining which hospitals earn substantial profits.

3. National Health Expenditure Projections, 2015–25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment

Sean P. Keehan et al., WEB FIRST July 2015/August 2016

Estimates from the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) project an average rate of national health spending growth of 5.8 percent for 2015–25, exceeding the expected average growth in gross domestic product (GDP) by 1.3 percentage points per year. As a result, the health share of the economy is projected to be 20.1 percent at the end of this period, up from 17.5 percent in 2014.

4. US Physician Practices Spend More Than $15.4 Billion Annually To Report Quality Measures

Lawrence Casalino et al., DATAWATCH, March 2016

Physicians spend $15.4 billion annually compiling quality data. Notably, the burden on primary care practices was almost twice that for cardiology and orthopedics practices.

5. Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000–09

Elizabeth Bradley et al., May 2016

The authors extend their prior work on the balance between health and social service spending at the country level to examine the same issue at the level of states. They find that people living in states that spend more on public health and social programs such as education, income support, recreational programs, and housing fare significantly better on a range of health outcomes, compared to states with less spending on those areas.

6. Return On Investment From Childhood Immunization In Low- And Middle-Income Countries, 2011–20

Sachiko Ozawa et al., February 2016

What are the costs and economic benefits associated with broad vaccination coverage in the world's ninety-four low- and middle-income countries? The authors find an average sixteenfold return on investment when considering only health-related costs and benefits, with much higher returns when they include broader economic effects.

7. Mental Disorders Top The List Of The Most Costly Conditions In The United States: $201 Billion

Charles Roehrig, DATAWATCH and WEB FIRST, May 2016/June 2016

In 2013, $201 billion were spent on mental disorders–more than on any other medical condition.

8. Modeling The Economic Burden Of Adult Vaccine-Preventable Diseases In The United States

Sachiko Ozawa et al., WEB FIRST, October 2016/November 2016

According to the Centers for Disease Control and Prevention (CDC), only 42 percent of US adults ages 18 and older received the flu vaccine in the 2015–16 flu season. This is just one example of US adults' not receiving vaccinations at recommended levels, which can lead to avoidable costs of doctor visits, hospitalizations, and lost productivity. Authors calculate the annual economic burden of diseases associated with vaccines that are recommended by the CDC for adults.

9. Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending

J. Scott Ashwood et al., March 2016

Because they are cheaper than physician office and emergency department (ED) visits, retail clinics have been seen as saving money for patients and health plans. To understand whether the use of retail clinics cuts health care costs, authors assessed data from a large health plan to understand what fraction of visits to retail clinics replace office or ED visits versus those that represent new utilization.

10. An Insurer's Care Transition Program Emphasizes Medication Reconciliation, Reduces Readmissions And Costs

Jennifer Polinski et al., July 2016

Medication nonadherence is a top contributor to unnecessary hospital readmissions. While most efforts to reduce readmissions have focused on the transition from hospital to home, the authors look at a care transition program focused on medication reconciliation. Their findings indicate that a pharmacist-led transition program, independent of provider programs, can reduce readmissions and costs.



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