Mochamad Nataliansyah, MD, MPH; Abiodun Salako, PhD; Fred Ullrich, BA; and Keith Mueller, PhD

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 created the Medicare Part D outpatient prescription drug program allowing Medicare beneficiaries to add prescription drugs to their Medicare coverage. Within Medicare, beneficiaries can select either a stand-alone Part D Plan (PDP) or Medicare Advantage plan that provides prescription drug coverage (MA-PD plan). Those plans offer an array of payment options and provided benefits. PDPs must offer the same design throughout the region in which they operate so minimal differences across types of counties were found. MA-PD plans were offered in lower numbers in noncore counties (compared to metropolitan and micropolitan counties), were found to have higher monthly premiums and were less likely to offer enhanced benefits. Of most concern, the brief shows that 10.6 percent of noncore counties have no MA-PD plans available, and 8.7 percent have only one plan offered.

 

Please click here to read the brief.

A paper published in Pediatrics by researchers in HRSA’s Maternal and Child Health Bureau provides a broad new profile of health outcomes and behaviors in the middle childhood population. Middle childhood refers to ages 6 through 11. Using data from the combined 2016 and 2017 National Survey of Children’s Health, the researchers examined sociodemographic, health status, family, and neighborhood characteristics of 21,539 U.S. children in this age range.

Overall, most children were in excellent or very good physical health, and over 20 percent were considered to have special health care needs. Researchers found the prevalence of diagnosed anxiety problems increased as children got older. Also, as children age, the proportion of children obtaining the recommended amount of sleep per night decreased while the amount of reported screen time with television or devices among children increased. Finally, less than one-third of children engaged in the recommended 60 minutes of daily physical activity, with even fewer females participating in daily physical activity as they got older. These findings suggest opportunities for targeted interventions and public health strategies at earlier ages.

View the video and text abstracts in Pediatrics.

Emergency departments may play a surprising role in the reduction of readmission rates following the implementation of Medicare’s Hospital Readmissions Reduction Program, according to a recent analysis.

Charleen Hsuan, assistant professor of health policy and administration at Penn State, led a study that examined what happens to discharged patients when they returned to a hospital’s emergency department. The results were recently published in JAMA Network Open.

For their research, the authors used a retrospective analysis examining hospital data from three states: California, Florida and New York.

The researchers found the Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in the probability of readmission for recently discharged patients presenting to the emergency department, even for conditions for which admission is usually indicated, including congestive heart failure.

The analysis also showed that almost all patients with unplanned readmissions come through the emergency department.

Especially during times such as the COVID-19 pandemic, it is important to reduce the number of unnecessary patients in the hospital. “Medicare’s HRRP aims to do this by reducing unnecessary readmissions for patients hospitalized with key conditions,” said Hsuan. “Our study found that the emergency department is an important gatekeeper for readmission decisions.”

The study was supported by the National Center for Advancing Translation Sciences of the National Institutes of Health (NIH), through Penn State Clinical and Translational Science Institute and the Population Research Institute at Penn State.

In addition to Hsuan, other authors of the paper include Brendan Carr, Icahn School of Medicine at Mount Sinai; Renee Y. Hsia, University of California, San Francisco; and Geoffrey J. Hoffman, University of Michigan School of Nursing, Ann Arbor.

Rural definitions used to direct resources for federal and state policies mostly rely on a combination of population density and economic integration with urbanized areas. This paper from the Rural Policy Research Institute examines the methods that have been used for defining rural areas and presents a number of options for adjustment. Read more here.