HCAO News

Surge in Prescription Costs Hit Medicare in 2014

The Wall Street Journal, December 21, 2015
by Peter Loftus

Hefty price increases for a number of prescription drugs contributed to higher spending by the U.S. Medicare program in 2014, according to new government data released Monday.

The Centers for Medicare and Medicaid Services identified at least five drugs that were covered under Medicare’s Part D drug benefit and had increases of 100% or more in cost per unit from 2013 to 2014. At the top of the list was Vimovo, a pain reliever whose cost-per-unit rose more than 500% after Horizon Pharma PLC purchased rights to the drug from AstraZeneca.

Vimovo was one of the drugs highlighted in an April article in The Wall Street Journal about drug makers buying old products and substantially raising prices. Medicare Part D spending on Vimovo rose to $38.9 million in 2014 from $7.3 million in 2013, CMS said.

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Research Confirms Racial Inequities in Mental Health Treatments

The Lund Report, Jan 6, 2016
by CPSE Secretary [Center for Public Safety Excellence]

  • Asian Americans were 51% less likely than Whites to access mental health services.
  • Experiences of racism were associated with lower emotional well-being.
  • Stronger levels of ethnic identification were associated with higher overall well-being.
  • Racial issues impact the effectiveness of psychotherapy.
  • Public payment for health services eliminated racial inequities for economically disadvantaged individuals.

Millions of Americans suffer from mental illness. Many seek therapy, but racial background influences availability and quality of treatment.  In 1999 and 2001, the U.S. Surgeon General’s Office issued reports highlighting racial inequities: Racial minorities have less access to mental health services than Whites.

A new summary of research representing over 4.7 million individuals has provided data on the severity of the racial inequities: Asian Americans were less than half as likely as Whites to use mental health services, Hispanic/Latino(a) Americans were 25% less likely, and African Americans were 21% less likely.  In a finding that is particularly troubling, African Americans suffering from mental illness were found in mental health services less often when they most needed help.

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Health Is Where the Home Is

Truthout, 16 January 2016 00:00
by Susan Sered, Susan Sered's Blog | Op-Ed

Maybe it's because of the bitterly cold temperatures at night this week, or maybe it's my own visceral response to overdosing on television shows with happy family Christmas scenes and neighborhood holiday lighting competitions, but I've been giving a lot of thought recently to how housing and homes impact health.

About a decade ago I traveled to the Mississippi Delta, Texas's Rio Grande Valley, south-central Illinois, the mountains of northern Idaho and the cities of eastern Massachusetts to speak with individuals and families scraping by without health insurance. Most of these people worked in construction, retail, agricultural or service jobs. The details varied, but across the country I heard about spiraling poor health, declining employability and growing poverty. In 2015 I made return trips to check in with the people I'd met ten years earlier.[i]While I was able to locate nearly all of the original interviewees who owned their homes (including very modest homes of immigrants in colonias in the Rio Grande Valley), I only located a minority of the renters. Typically, their original phone numbers were disconnected and original addresses belonged to subsequent tenants. When I knocked on neighbors' doors the most common response was, "I don't know [so-and-so]. I've only lived here for a few months myself."

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Greenlick Opens Controversial Debate on Future of CCO System

Rep. Greenlick

Rep. Greenlick

Rep. Mitch Greenlick seeks major changes that will ensure that the local Medicaid health management companies operate in the public interest, and he wants legislation passed before the new contracts come out. Sen. Bates seeks more transparency from the Oregon Health Authority to avoid another heated battle with CCOs over payment.

The Lund Report, January 15, 2015
by Chris Gray

Rep. Mitch Greenlick, D-Portland, has unveiled some major changes to the structure of the state’s coordinated care organizations that are designed to create more transparent rules for their operation that will ensure they will be run in the public interest and have clearer expectations that might prevent further rows with the Oregon Health Authority.

“It creates a blueprint of what CCOs should look like,” Greenlick said.

All CCOs would become non-profit, community-based organizations by 2023; their board of directors would have meetings open to the public, and 50 percent of their directors would represent the general public. Of the remaining board members, only 25 percent could represent the risk-bearing CCO stakeholders, and 25 percent could be healthcare providers.

Reserve funds, now kept in vaguely defined accounts by the CCOs, would instead be placed in a global escrow account housed in the state treasury starting in 2018. The Oregon Health Policy Board would need to develop new health metrics that CCOs would be required to meet or else forfeit their contracts.

Greenlick’s proposals could put an end to the relentless infighting between the Oregon Health Authority and some of the CCOs, diminishing the opportunity for some stakeholders to get rich from the Medicaid system and reducing the perception that the state might be playing favorites when it sets rates.

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