Brief: Health care consolidation kills competition, raises costs

The average hospital admission costs $2,000 more in areas where just one or two large hospitals systems dominate, and insurance premiums are higher where there is less competition. In an opinion piece published in Forbes, authors say consolidation among providers and insurers kills the competitive forces that keep prices in check. Worse, patient health outcomes aren’t as good in areas without enough hospital competition. In a related policy brief, the authors propose three steps to promote competition. ( Forbes; policy brief)

Medicaid's role in behavioral health may be underestimated
Medicaid plays a bigger role in covering behavioral health than most realize; in 2015; it covered 21 percent of adults with mental illness, 26 percent of adults with serious mental illness and 17 percent of adults with substance use disorders. Average Medicaid spending for those with behavioral health diagnoses is almost four times greater than for enrollees without these diagnoses. The Senate’s Better Care Reconciliation Act allows states to significantly change who receives behavioral health benefits and change payment structures for providers. ( Kaiser Family Foundation brief)

Technology partnership yields big win

When New York-based Services for the Underserved partnered with VirtualHealth to improve patient tracking, its patients with intellectual or developmental disabilities were the winners. Six months after moving paper-based assessments and tracking to a technology dashboard, SUS saw tangible outcomes: a 70 percent drop in challenging behavior, 30 percent drop in use of psychotic drugs and a 15 percent decrease in required caregivers per case. ( Managed Healthcare Executive)

MACRA pushing ACO trend
Passage of MACRA may be responsible for some of the growth in ACOs in the past year with its charge to identify new alternative payment models to CMS. More than 32 million Americans—greater than 10 percent—are now covered by an accountable care contract. The rate of organizations creating ACOs is 11 percent over last year, but the field is hardly stabilizing: Since the first quarter of 2016, 138 new ACOs began operation while 46 dropped their contracts. A majority of contracts and covered lives are in commercial ACOs. ( Healthcare Finance; Health Affairs blog)

Social problems heart of 80 percent of health use
Solving problems with food insecurity, housing and unemployment would address their downstream effect on health, according to experts at a briefing sponsored by Politico last week. About 80 percent of what causes lower-income people to enter the health care system is related to social determinants , said Joseph Wright of Howard University. Former Department of Health and Human Services official Karen DeSalvo said digging into environmental triggers to poor health behaviors can uncover social factors and reduce hospital readmissions and ER use. ( MedPageToday )

Merck, Penn. hospital system hit by latest cyberattack
A new ransomware attack, Petya, claimed Merck and Pennsylvania-based Heritage Valley Health System among its victims last week. A HITRUST bulletin cited multiple reports of health care entities involved, and saw similarities in approach to May’s WannaCry attack. Heritage Valley canceled surgeries and closed lab and diagnostic services across three states, but kept hospital services operational; Merck said its computer network was compromised. ( FierceHealthcare; Pittsburgh Post-Gazette)