With the holiday season here, it’s time for one of the many annual arguments in the Burda household: Lots of little presents or one big present? I’m a lots-of-little-presents kind of guy, so in keeping with that spirit, I’m using this month’s space to give you as many updates as can fit on the page. Here goes:

Study finds no evidence hospital acquisitions of physician practices improves care 
In June 2015, we urged employers to question proposed mergers and acquisitions involving hospitals and doctors because they can result in higher prices without any noticeable improvement in quality or service (bit.ly/1QggeMN). A study in the Annals of Internal Medicine examined changes in four patient outcomes at 803 hospitals that acquired physician practices in recent years. The researchers did not find any greater improvements in mortality rates, readmission rates, length of stay or patient satisfaction than at a comparable group of peer hospitals that didn’t employ doctors over that same period (bit.ly/2cKmjHd). “Although many advocates have suggested that hospital employment of physicians will likely result in much better care, we have found no substantive evidence to date to support this notion,” the researchers concluded.

Employers express skepticism over benefits from hospital mergers
This past June, the Midwest Business Group on Health asked 85 employers what they thought about the impact of hospital mergers (bit.ly/1jizAqu). Most think hospital mergers reduce the hospitals’ operating costs but don’t see that benefit accruing to them or their employees. Some 64 percent of the employers said hospital mergers would improve administrative efficiencies, but only 41 percent said mergers would lead to better health outcomes. Even fewer foresaw higher-quality care (21 percent) or better customer service (14 percent), though 39 percent said they anticipate higher medical costs, premiums and fees.

Cancer is the leading cause of death in Minnesota and 21 other states, according to the CDC 
In September 2015, we suggested employers support population health management programs in their communities to keep their local labor pools as healthy as possible and on the job (bit.ly/2dq1GQq). For many programs and employers, that focus should be on cancer prevention and screening. Here’s why. From 2000 to 2014, cancer overtook cardiovascular disease as the leading cause of death in 20 states, according to a data brief from the Centers for Disease Control and Prevention’s National Center for Health Statistics (bit.ly/2dq2ip8). That brings to 22 the number of states where cancer is the leading cause of death. Cancer claimed the most lives in Alaska and Minnesota both in 2000 and 2014.

Private insurance payments to treat opioid dependence and abuse topped $400 million last year
This past September, we recommended that employers take an active role in prescription drug take-back programs to reduce the risk that unused opioid pain medications will be misused by employees or their dependents. (bit.ly/2cO999k). If employers don’t want to do it for altruistic reasons, they should consider doing it for financial reasons. It will save businesses money. A group called FAIR Health released a study that said private health insurers paid $445.7 million in medical claims last year to treat opioid dependence and abuse. That’s up nearly 14-fold from the $32.4 million in medical claims paid by private carriers in 2011 for the same diagnoses (bit.ly/2dCTOtd).

Hospital readmission rates for Medicare patients dropped in 49 states last year, including Minnesota
In May 2015, we directed employers to a number of publicly available resources that disclose the quality and safety records of hospitals and doctors that treat their workers, hoping they will use the resources to avoid sending employees to unsafe settings for their care (bit.ly/1OAg872). One number used by the government to measure quality and safety is hospitals’ 30-day readmission rate—that is, after discharge, how many patients have to come back in less than a month for more care. New government data show hospitals are getting a little better at it. The Centers for Medicare & Medicaid Services said hospitals’ readmission rate for Medicare patients dropped in 49 states and the District of Columbia from 2010 to 2015 and was statistically unchanged in one state (bit.ly/2cCoFcx). In Minnesota, the rate slid from 15.7 percent in 2010 to 14.6 percent in 2015.

More employers embracing telemedicine as low-cost alternative to in-person physician office visits
In November 2014, we discussed the potential of telemedicine—online medical consultations between patients and doctors—to lower employers’ health care costs and improve their workers’ productivity (bit.ly/1rKQhyy). A number of employer surveys have documented a big upswing in the percentage of businesses now offering a telemedicine benefit. According to a survey of nearly 2,000 employers by the Kaiser Family Foundation and the Health Research & Education Trust, 39 percent cover telemedicine and 33 percent offer a financial incentive to workers to use telemedicine instead of an in-person physician office visit (kaiserf.am/2dEzWGH). And 70 percent of the 133 large employers surveyed by the National Business Group on Health said they currently have a telemedicine benefit, with that percentage jumping to 90 percent in 2017 (bit.ly/2aD3hzc).

David Burda (twitter.com/@davidrburda, dburda@msp-c.com) is editorial director, health care strategies, for MSP-C, where he serves as the chief health care content strategist and health care subject matter expert.

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