Public and Private Insurance Payment Gap Narrowed Between 2012 and 2016
January 7, 2020
AHRQ Stats: Highest Healthcare Premiums in the Nation
Average annual healthcare premiums for single coverage in employer-sponsored plans in 2018 were significantly higher than the national average in nine states: Alaska, Connecticut, District of Columbia (treated as a state in this analysis), Illinois, Massachusetts, New Hampshire, New Jersey, New York and Rhode Island. (Source: AHRQ, Medical Expenditure Panel Survey—Insurance Component 2018 Chartbook).
- Public and Private Insurance Payment Gap Narrowed Between 2012 and 2016.
- New AHRQ Grantee Profile Highlights How Work of Anthony Harris, M.D., M.P.H., Tailors Infection-Control Practices .
- Study Provides Recommendations for Detecting and Removing Unnecessary Catheters.
- Highlights From AHRQ’s Patient Safety Network.
- Rural Residents More Likely To Have Usual Source of Care, Less Likely To Get Care From Physician.
- AHRQ in the Professional Literature.
While payments for hospital stays, outpatient hospital care and emergency department (ED) visits grew much faster for privately insured patients than for Medicare and Medicaid patients from 2000 to 2012, that trend of a widening private-public payment gap slowed or even reversed itself from 2012 to 2016, according to a new study published in the journal Health Affairs. The analysis, based on data from AHRQ’s Medical Expenditure Panel Survey (MEPS), found that private insurers’ payment rates for hospital stays were 66 percent greater than Medicare’s payment rates in 2013, yet had narrowed to only 50 percent greater in 2016. The study also showed that since 2000, hospital charges grew at a faster rate than private insurance payments. Hospital charges, when measured as a percent of Medicare payment rates, grew most rapidly for ED care. Access the abstract.
New AHRQ Grantee Profile Highlights How Work of Anthony Harris, M.D., M.P.H., Tailors Infection-Control Practices
Our latest grantee profile examines how AHRQ-funded research by Anthony Harris, M.D., M.P.H., professor of public health and epidemiology at the University of Maryland, Baltimore, is developing more tailored infection-control practices for hospitals. By understanding the behavior of organisms that cause healthcare-associated infections, hospitals can tailor their infection-control practices in the most medically effective and cost-effective manner. Check out his profile and others that show how AHRQ grantees have made major advances in health services research.
An AHRQ-funded study identified potential actions medical facilities can take to ensure the timely removal of urinary and vascular catheters, including providing clinicians with ready access to accurate catheter data, clearly defining staff responsibilities, utilizing effective tools to facilitate discussions and establishing standardized removal protocols. Observations and in-person interviews with physicians and nurses at a large, academically affiliated tertiary-care hospital provided a deeper understanding of the current challenges to timely catheter removal, allowing for recommendations to address barriers. Access the abstract of the article, published in the Joint Commission Journal on Quality and Patient Safety.
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Potentially inappropriate medications according to STOPP-J criteria and risks of hospitalization and mortality in elderly patients receiving home-based medical services.
- Prioritizing patient safety efforts in office practice settings.
- Design of a safety dashboard for patients.
While their health is poorer, rural Americans are more likely to have a usual source of care than people living in metropolitan areas, according to an AHRQ-funded study in the American Journal of Preventive Medicine. However, usual sources of care in rural areas are less likely to be physicians and are less likely to be available at night and on weekends. Researchers examined MEPS data on about 52,000 rural and metropolitan patients. Respondents in rural areas were 5 percentage points more likely to have a usual source of care than residents in metropolitan areas, but were 13 percentage points less likely to have a usual source of care who was a physician and 11 percentage points less likely to have an individual provider as a usual source of care, relying instead on a clinic or other facility. Usual sources of care in rural areas were 18 percentage points less likely to offer night and weekend hours. Researchers concluded future studies should look beyond having a usual source of care as the sole indicator of primary care access. Access the abstract.
Health literacy in the inpatient setting: implications for patient care and patient safety. Glick AF, Brach C, Yin HS, et al. Pediatr Clin North Am 2019 Aug;66(4):805-26. Epub 2019 May 23. Access the abstract on PubMed®.
The association between self-declared acute care surgery services and operating room access: results from a national survey. Ricci KB, Rushing AP, Ingraham AM, et al. J Trauma Acute Care Surg 2019 Oct;87(4):898-906. Access the abstract on PubMed®.
Association between androgen deprivation therapy use and diagnosis of dementia in men with prostate cancer. Jayadevappa R, Chhatre S, Malkowicz SB, et al. JAMA Netw Open 2019 Jul 3;2(7):e196562. Access the abstract on PubMed®.
Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation. Snyder ME, Jaynes H, Gernant SA, et al. BMC Med Inform Decis Mak 2019 Jul 16;19(1):135. Access the abstract on PubMed®.
Development and validation of a pragmatic natural language processing approach to identifying falls in older adults in the emergency department. Patterson BW, Jacobsohn GC, Shah MN, et al. BMC Med Inform Decis Mak 2019 Jul 22;19(1):138. Access the abstract on PubMed®.
The team, the team, the team: what critical care research can learn from football teams. Costa DK. Ann Am Thorac Soc 2019 Dec;16(12):1492-4. Access the abstract on PubMed®.
Use of a preventive index to examine clinic-level factors associated with delivery of preventive care. Hatch BA, Tillotson CJ, Huguet N, et al. Am J Prev Med 2019 Aug;57(2):241-9. Access the abstract on PubMed®.
Factors associated with comprehensive medication review completion rates: a national survey of community pharmacists. Snyder ME, Jaynes HA, Gernant SA, et al. Res Social Adm Pharm 2019 Aug 2. [Epub ahead of print.] Access the abstract on PubMed®.