Gun violence survivors and witnesses could face lifetime of trauma and bad health

http://www.modernhealthcare.com/article/20161105/MAGAZINE/311059989

Gun violence survivors

Chicago has been pummeled with near constant gun violence this year. An estimated 3,600 shootings have taken place, on average—that’s about 10 shootings a day.

During the recent Halloween weekend alone, 17 people died and 41 were wounded.

And while politicians and policy makers struggle to find ways to create policies to address America’s violence, another related crisis is slowing growing.

Most of the shootings are concentrated in impoverished communities. The virtual war zones are home to people who suffer from poor health and lower rates of insurance coverage, leaving them at a disadvantage when they are injured, either physically or tangentially, by gun violence. And oftentimes, the most vulnerable victims are young people who have a lifetime ahead.

f you grow up in a world where you’re not feeling safe, then you feel as though you’re under attack whether or not you actually are,” said Dr. David Soglin, chief medical officer at La Rabida Children’s Hospital, an acute-care pediatric center on Chicago’s South Side that specializes in treating children who have been victims of abuse and trauma. “For some kids in our communities, they really are under attack.”

The trauma surrounding exposure to gun violence is not disputed, especially among children. In 1995, the Centers of Disease Control and Prevention reported that children who had four or more adverse childhood experiences, such as experiencing or witnessing a shooting, were more likely to smoke, drink, abuse drugs and engage in unsafe sex. Those behaviors often lead to chronic conditions such as cancer, heart disease, stroke, liver disease, diabetes and sexually transmitted diseases.

The growing number of people who survive living in the country’s most violent neighborhoods is causing public health officials to respond by creating comprehensive violence prevention efforts.

Your Health Insurance Will Cost More Next Year: Here’s What’s Driving Prices Higher

http://www.thefiscaltimes.com/2016/08/10/Your-Health-Insurance-Will-Cost-More-Next-Year-Here-s-What-s-Driving-Prices-Higher

The cost of getting your health insurance through work will go up an average of 5 percent next year, according to a new survey of large employers by the National Business Group on Health.

The cost for employers will go up 6 percent. This is the third consecutive year that employers’ health costs have risen by 6 percent. While that’s still more six times the current rate of inflation, it’s likely a smaller increase than will be experienced by consumers who purchase insurance through the public exchanges.

While those plans vary widely by state, the average plan is expected to cost 10 percent more in 2017, according to Kaiser. Last year, the price of the average silver level plan on public exchanges increased 12 percent.

For employers, the biggest driver of the cost increases is the price of specialty drugs. Other factors included high-cost claims and long-term conditions, according to the NGBH survey.

Nondiscrimination And Chronic Conditions — The Final Section 1557 Regulation

http://healthaffairs.org/blog/2016/07/20/nondiscrimination-and-chronic-conditions-the-final-section-1557-regulation/

Blog_Burwell2

Before the Affordable Care Act (ACA), those with serious or chronic health conditions were often denied health insurance coverage or paid high prices for substandard plans with coverage exclusions. Many went uninsured and untreated. For them, the ACA’s new coverage opportunities and protections against discriminatory practices by health insurers serve as an essential lifeline.

Under the ACA, insurers can no longer charge higher premiums or deny coverage for people with pre-existing conditions. However, some insurers have tried to circumvent ACA protections by designing benefits that discourage enrollment by persons with significant health needs.

NHeLP and The AIDS Institute filed a landmark complaint with the Department of Health and Human Services’ Office for Civil Rights after four Florida insurers placed all HIV medicines, including generic drugs, on the highest cost sharing tiers. Researchers found that this practice—called “adverse tiering”—is widespread. A New England Journal of Medicine study found that one-in-four insurers placed all drugs to treat HIV in the highest tiers. Another study in Journal of the American Medical Association found that up to 15 percent of plans in the federal marketplace lack in-network physicians for at least one specialty, making access to care significantly more expensive for those with specialized care needs.

The Department of Health and Human Services (HHS) recently finalized regulations for the cornerstone non-discrimination provision of the ACA — Section 1557. For the first time, the provision applies civil rights protections against discrimination on the basis of race, ethnicity, national origin, sex, age, and disability specifically to health programs and activities administered by or receiving federal funding.

Health advocates and patient advocacy organizations lauded the final regulations for Section 1557, which expressly prohibit insurers from employing plan benefit designs or marketing practices that discriminate.

U.S. Health Care from a Global Perspective

http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective

Cross-national comparisons allow us to track the performance of the U.S. health care system, highlight areas of strength and weakness, and identify factors that may impede or accelerate improvement. This analysis is the latest in a series of Commonwealth Fund cross-national comparisons that use health data from the Organization for Economic Cooperation and Development (OECD), as well as from other sources, to assess U.S. health care system spending, supply, utilization, and prices relative to other countries, as well as a limited set of health outcomes.1,2 Thirteen high-income countries are included: Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. On measures where data are widely available, the value for the median OECD country is also shown. Almost all data are for years prior to the major insurance provisions of the Affordable Care Act; most are for 2013.

Health care spending in the U.S. far exceeds that of other high-income countries, though spending growth has slowed in the U.S. and in most other countries in recent years.3 Even though the U.S. is the only country without a publicly financed universal health system, it still spends more public dollars on health care than all but two of the other countries. Americans have relatively few hospital admissions and physician visits, but are greater users of expensive technologies like magnetic resonance imaging (MRI) machines. Available cross-national pricing data suggest that prices for health care are notably higher in the U.S., potentially explaining a large part of the higher health spending. In contrast, the U.S. devotes a relatively small share of its economy to social services, such as housing assistance, employment programs, disability benefits, and food security.4 Finally, despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions. Mortality rates from cancer are low and have fallen more quickly in the U.S. than in other countries, but the reverse is true for mortality from ischemic heart disease.

Three drug trends impacting specialty pharmacy

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/three-drug-trends-impacting-specialty-pharmacy?cfcache=true

Specialty Drugs

High-Deductible Health Plans

http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=152

Recurring Topic Image - Health Policy Brief (640 x 360 at 72 PPI)