Published 8/1/2014

Second Look—Advocacy

Bundled payments
An article in The Wall Street Journal (June 9) looks at the issue of bundled payments for healthcare. Under a bundled payment pricing program, a single overall price covers everything involved in a course of treatment. The author states that 350 healthcare organizations are currently participating in pilot bundled-payment programs with Medicare, covering 48 health conditions.

Nearly 6 in 10 ACA enrollees previously uninsured
A report released by the Kaiser Family Foundation finds that 57 percent of enrollees who signed up for insurance through the health insurance exchanges established under the Affordable Care Act (ACA) were previously uninsured. The report also found that ACA enrollees report somewhat worse health than those in pre-ACA plans, that about half are concerned about premium affordability, and that plans trend toward narrow provider networks.

The ACA and ED use
An article published in USA Today (June 8) notes that some hospitals have seen a surge in emergency department (ED) use that may be linked to increased coverage under the ACA. According to information from the American College of Emergency Physicians, nearly half of ED physicians recently polled stated that they’ve seen an uptick in visits since Jan. 1, 2014.

Preventable readmissions?
An article published online in the Journal of Hospital Medicine looks at the strengths and limitations of metrics used by CMS to assess financial penalties for higher-than-expected readmission rates. CMS efforts to reduce readmissions assume that a significant number of those readmissions are “reasonably preventable,” even though “there is no consensus in the medical and policy communities on how to define preventable readmissions, which is essential for taking action to reduce them.” Available research suggests that many readmissions may not be preventable.

These items originally appeared in AAOS Headline News Now, a thrice-weekly enewsletter that keeps AAOS members up to date on clinical, socioeconomic, and political issues, with links to more detailed information. Subscribe at www.aaos.org/news/news.asp (member login required)