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Sunday, September 10, 2023 | The Latest Research, Commentary, And News
From Health Affairs

Dear John,

This week on The Other 80 podcast
<[link removed]"favorable selection into MA led to underpayments for counties with
lower MA penetration
<[link removed]"

Meanwhile, MA enrollment has shifted to counties with higher MA
penetration. The net result is overpayments to MA plans of nearly $10
billion per year between 2017 and 2020.

Rapid growth in MA enrollment is largely due to enrollees switching from
traditional Medicare to MA
<[link removed]"the share of MA enrollment growth due to switching was 80
percent or more each year from 2020 to 2022 compared with 61-79
percent in the ten years before then."

In addition, enrollees who switch into MA from traditional Medicare are
disproportionately healthy, whereas those who switch out of MA are
disproportionately less healthy.

In a DataWatch, Jeffrey Marr and coauthors find that MA enrollees were
almost 25 percent less likely than traditional Medicare enrollees
<[link removed]"an increasingly bifurcated society for the middle-resourced
future elderly population along nearly all dimensions examined."

Although life expectancy and resources increased for the upper-middle
economic status group, they remained stagnant for the lower-middle
group.

Aditi Sen and colleagues compare the prices negotiated by self-insured
and fully insured employers for commonly used services
<[link removed]"prices were found to be moderately
higher in self-insured plans for most services."

Read More
<[link removed]"people with dementia living in the community who used
hospice incurred significantly lower total health care costs
<[link removed]" primarily as a
result of lower inpatient care costs.

Cost differences were not as large for people living in nursing homes.

Adam Dean and coauthors examine the relationship between unionization
and nursing homes' compliance with the Occupational Safety and Health
Administration
<[link removed]'t already, join Health Affairs Unlimited to access our
current and past issues
<[link removed]' Impact on Prenatal
Care
<[link removed]' Editor-in-Chief Alan Weil interviews the University of
Maryland's Rebecca Gourevitch on her recent paper examining the impact
on prenatal care of home visits with a registered nurse.

Health Affairs This Week: Audit of Nursing Home Staffing Standards in
Progress by Biden Administration
<[link removed]' Michael Gerber and Chris Fleming discuss the Biden
administration's proposal to increase minimum staffing levels at nursing
homes.

To Advance Interoperability, Look To Market-Based Strategies
<[link removed]'s "Moonshot," The Task Force Misses The Aim
<[link removed]'s Time For A New Season Of Episode-Based Payment
<[link removed]