Recent Prescription Drug Spending Trends

Spending on prescription drugs has risen, and is projected to continue to rise more rapidly than overall health care spending. According to the U.S. Department of Health and Human Services1, several factors contributing to THE increase from 2010-2014 can be roughly allocated in these proportions: 10 percent due to population growth; 30 percent due to...

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Insurance Merger Would Multiply Already Excessive Market Concentration

Recent months have brought forth formal announcements from several major health insurers – specifically, Aetna Inc. and Humana Inc., and Anthem Inc. and Cigna Corporation – of proposed mergers. These mergers are being scrutinized by the Department of Justice due to the scope of the proposed consolidations. A key factor in determining insurance market concentration...

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Identifying Hospital Care High Utilizers

In the coming years, VHHA’s Center for Healthcare Excellence will expand its works with members on addressing high utilizers of hospital care. High utilizers are patients who have four or more hospital admissions within a 12-month period. These patients are frequently younger than 65 and have multiple chronic diseases, such as diabetes and hypertension, that...

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A Picture of COPD Readmitted Patients

Virginia’s hospitals admitted 54,477 patients for chronic obstructive lung disease (COPD) between the fourth quarter of 2013 and the third quarter of 2015. Of those patients, 8,265 (or 15 percent of COPD patients) people returned to the hospital within 30 days. Among COPD patients who return to the hospital, 90 percent return through the emergency...

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Risk Adjusted Readmission Rates Have Fallen in Virginia

To encourage efforts to reduce readmissions, Congress created within the Affordable Care Act (ACA) the Hospital Readmissions Reduction Program (HRRP), which instructs the U.S. Centers for Medicare & Medicaid Services (CMS) to penalize hospitals with higher-than-expected readmissions for specific clinical conditions such as heart attack, pneumonia, and heart failure. Nationally, hospitals are making significant progress....

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The Relationship Between Readmission and Age

The existence of CMS readmission penalties compels hospitals to better prepare Medicare patients for post-hospital care at home or in the community. However, focusing readmission prevention strategies only on those 65 and older is shortsighted. As illustrated in Table 1 below, 47% of patients who returned to the hospital more than one time are under...

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