This Week in Managed Care: October 17, 2015

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Top managed care stories this week include comparing US healthcare spending and outcomes to other wealthy nations, identifying how many Americans are affected by Medicaid expansion coverage gaps, and a look at adolescents and young patients with cancer.


Transcript (slightly modified for readability)

Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care.

Welcome to This Week in Managed Care, from the Managed Markets News Network.

US Healthcare Spending

High spending on healthcare doesn't guarantee results, at least not in the United States—that's what researchers found in a study this week published by The Commonwealth Fund. Among wealthy nations including Canada, Denmark, Germany, and France, the United States spends more but has some of the worst health outcomes including a lower life expectancy. US healthcare spending per person average $9086 with life expectancy at 78.8 years. Switzerland, meanwhile, spends only $6325 per person and has an average life expectancy of 82.9 years. US rates for cancer, chronic conditions like diabetes, obesity, and infant mortality are all higher than other countries.

Said Commonwealth Fund President Dr David Blumenthal, "Time and again, we see evidence that the amount of money we spend on healthcare in this country is not gaining us comparable health benefits."

Coverage Expansion Gap

As we head into the third open enrollment period under the Affordable Care Act, a new study by the Kaiser Family Foundation shows that about half of the 32 million Americans who remain uninsured are eligble for either Medicaid or tax credits through the marketplace exchanges. But for 10% of the uninsured, about 3.1 million, health insurance could be out of reach. That's because they live in states that have not expanded Medicaid and they fall in the coverage gap. They earn too much for traditional Medicaid, but not enough to qualify for coverage on the exchanges.

States with the highest number of households in the coverage gap are Texas, Florida, Georgia, North Carolina, and Louisiana. However, Louisiana elects a new governor this fall and is expected to expand Medicaid for 2016.

Cancer Survivor Point of View in EBO

The new issue of Evidence-Based Oncology addresses the special needs of adolescent and young patients with cancer. In this issue, we hear from Woody Roseland, a 25-year-old survivor who has had 8 separate bouts with cancer. Roseland's essay, "Picking Up the Pieces," is one of the most read items this week. Read it here.

For the Managed Markets News Network, I’m Justin Gallagher. Thank you for joining us.