MHA Press Room

Report: More Americans taking multiple prescription drugs

The percentage of Americans taking five or more prescription drugs increased 70% between 1999 and 2008, according to a new report from the Centers for Disease Control and Prevention. One-half of Americans used at least one prescription drug in 2007-2008, and one in 10 used five or more.

The most common prescriptions were asthma medicines for children, central nervous system stimulants for adolescents, antidepressants for middle-aged adults, and cholesterol and blood pressure drugs for older Americans. Those without health insurance or a regular place for health care were less likely to use prescription medications than their counterparts.

CDC: About one in five adults smoked cigarettes in 2009

An estimated 20.6% of U.S. adults were cigarette smokers in 2009, about the same proportion as in 2005, according to a report released Sept. 7 by the Centers for Disease Control and Prevention. Smoking prevalence was higher among men (23.5%) than women (17.9%), and among people living below the federal poverty level (31.1%).

Asian (12.0%) and Hispanic (14.5%) Americans had the lowest smoking rates among racial and ethnic groups, while multiple-race (29.5%) and Indian/Alaska Native (23.2%) Americans had the highest. Smoking rates generally declined with increasing education.

State smoking rates ranged from 9.8% in Utah to 25.6% in Kentucky and West Virginia. The estimates are based on data from the 2009 National Health Interview Survey and Behavioral Risk Factor Surveillance System.

The Patient Protection and Affordable Care Act is expected to expand access to evidence-based smoking-cessation services and treatments, which will likely reduce smoking and its adverse effects among U.S. adults, CDC said.

Study: Medical liability/defensive medicine cost about $55.6 billion a year

The medical liability system costs the nation an estimated $55.6 billion annually, according to a study published Sept. 7 in Health Affairs. Based on 2008 dollars, the estimate represents about 2.4% of national health care spending that year.

The estimate includes economic, non-economic and punitive damages paid to claimants; administrative expenses such as attorneys' fees and other legal expenses; the cost of defensive medicine, or medical services ordered primarily to minimize a physician's liability risk; and other costs such as lost clinician work time.

"Our estimates should be interpreted cautiously, with recognition that some system cost elements were excluded and others - particularly the defensive medicine figures - were estimated based on substantial assumptions and extrapolations," the authors state. "…Although our estimates are imperfect, they are more comprehensive, transparent, and firmly grounded in the best available data than previous estimates of liability system costs."

Firms Shifting Burden To Workers For Family Coverage

Workers on average are paying nearly $4,000 this year toward the cost of family health coverage — an increase of 14 percent, or $482, above what they paid last year, according to the benchmark 2010 Employer Health Benefits Survey released Sept. 3 by the Kaiser Family Foundation and the Health Research & Educational Trust (HRET). Selected findings were also published as a Health Affairs Web First article.

Read more here.

Which Children Are Uninsured And How Can We Insure Them?

At the beginning of this year, the U.S. Department of Health and Human Services (HHS) launched an initiative called Connecting Kids to Coverage, designed to identify (and subsequently enroll) the nearly five million uninsured children thought to be eligible for Medicaid or the Children’s Health Insurance Program (CHIP). In the past it had been difficult to produce accurate estimates on the number of uninsured children in each state. However, the authors of a paper released today by Health Affairs succeeded by creating a new model, using data from the American Community Survey, an annual sample of some 700,000 children nationwide collected by the U.S. Census Bureau. This technique enabled the Urban Institute’s Genevieve Kenney and coauthors to produce meaningful national and state estimates of Medicaid/CHIP participation rates, which ranged from 55 percent to 95 percent enrollment, with ten states having participation rates close to or above 90 percent.

On Sept. 3, Health Affairs also released a commentary by HHS Secretary Kathleen Sebelius discussing efforts to increase health coverage among children. Read more here.

Study: Medicaid/CHIP participation rates vary widely by state

An estimated 81.8% of eligible children participated in Medicaid or the Children's Health Insurance Program in 2008, according to a study published online Sept. 3 by Health Affairs. Based on data from the Census Bureau's 2008 American Community Survey, which began asking about health coverage that year, an estimated 4.7 million children were eligible for the programs but not enrolled.

Participation in the programs varied widely across states, from 55.4% in Nevada to 95.4% and 95.2% in the District of Columbia and Massachusetts, respectively. Eleven states had participation rates of 88% or more, while 13 states had participation rates under 80%.

The study precedes the Children's Health Insurance Program Reauthorization Act of 2009, which included grants and bonus payments to states that adopt enrollment and retention strategies or exceed enrollment targets. The economy also has worsened since 2008, which is likely to have increased the number of children eligible for Medicaid and CHIP, the authors note.

Study: More young athletes visiting EDs with concussions

Emergency department visits for concussions sustained during organized team sports doubled among 8- to 13-year-olds between 1997 and 2007, and nearly tripled among older youth, according to a report published online today by the journal Pediatrics. U.S. children aged 8-19 had an estimated 502,000 ED visits for concussion between 2001 and 2005, about half of which were sports-related. During the study period, about 1 in 1,000 children aged 8-13 and 3 in 1,000 aged 14-19 had an ED visit for concussion during one of the top five organized team sports: ice hockey, football, soccer, basketball and baseball.

Study: Nearly one-fourth of children underinsured

More than 14 million U.S. children (22.7%) were underinsured in 2007, according to a survey of parents by the federal Health Resources and Services Administration. The 2007 National Survey of Children’s Health asked parents whether their child’s health insurance covered needed services and providers, and whether the out-of-pocket costs (excluding premiums) were reasonable; the child was considered underinsured if the parent did not answer “usually” or “always.”

Older children, children in fair or poor health, and those with special health care needs were more likely to be underinsured. The most common reason cited for underinsurance was unreasonable costs.

The study appears in the Aug. 25 New England Journal of Medicine.

Study: Economic crisis reducing health care use

More than 26% of U.S. residents report reducing their use of routine medical care since the economic crisis, according to a new study by the National Bureau of Economic Research. That's more than twice the proportion who report reducing such care in France, Germany, Canada or Great Britain, countries that have lower out-of-pocket costs for care.

The findings are based on a survey administered in the five countries in June and July 2009. "The greater the reported loss in wealth, the larger the net reductions in routine care across all countries," the report states. "Similarly, net care reductions were more pronounced among the unemployed."

Hospital EDs increasingly serving as safety net

U.S. hospital emergency departments are increasingly serving as the safety net for medically underserved patients, according to a study in the Aug. 11 Journal of the American Medical Association. Annual ED visits increased by an estimated 21.9 million between 1997 and 2007, or 23%, with Medicaid-covered adults accounting for most of the increase.

"Our findings suggest that increased enrollments in Medicaid between 1999 and 2007 have had substantial effects on ED volume and crowding, and that at least part of this may reflect limited access to primary care services for Medicaid enrollees," the authors state. While the study includes the latest available data, the authors say a critical concern is what has happened in more recent years.

"One of the nation's most severe recessions started in 2008, and with record job losses in 2008 and 2009, an estimated additional 5.8 million Americans became uninsured and an estimated 5.4 million enrolled in Medicaid and SCHIP [State Children's Health insurance Program]."