The Robert Wood Johnson Foundation's Changes in Health Care Financing & Organization (HCFO) initiative has proved the value of its diverse research portfolio at this year’s ARM. Throughout the conference, AcademyHealth has followed the presentations of HCFO’s researchers. In the last session of the meeting, “Medication Adherence, Utilization, and Expenditures,” panelists addressed the clinical and financial benefits of policies to improve medication adherence, and the impact of these policies on the larger health care system.
- Will Shrank from Harvard Medical School presented the research of Niteesh Choudhry, which spotlighted the factors that make a successful value-based insurance design program. Matt Maciejewski from the Department of Veteran’s Affairs and Duke University discussed how value-based insurance design can bend the cost curve. Amy Davidoff from the University of Maryland’s School of Pharmacy will outline the impact of medication adherence on Medicare expenditures among beneficiaries with heart failure. Finally, Christine Lu from Harvard Medical School and Harvard Pilgrim Health Care explored the unintended effects of Medicaid prior authorization on access to bipolar medications.
- Scott Ashwood of RAND presented findings from his study on the impact of retail clinics on utilization and cost. Their findings suggest that retail health clinic users exhibit a higher rate of utilization. Therefore, the introduction of retail health clinics into a market was associated with an increase in utilization and an increase in health care costs.
- Ellyn Boukus of the Center for Studying Health System Change shared the findings of her qualitative research on the growing prevalence of workplace health clinics. More employers have opened workplace health clinics to reduce absenteeism and increase productivity in the workplace. According to Dr. Boukus, “Employers are not looking to replace health care for their employees; they are just looking to supplement it.” However, their qualitative interviews outlined some challenges for employers including defining the scope of a workplace health clinic, and therefore the start-up costs, and attracting patients amid concerns about privacy of health information and quality of care.
- Ateev Mehrotra of RAND Corporation presented the findings of a comparison between eVisits and office visits for sinusitis and urinary tract infections at four primary care practices. Looking specifically at concerns associated with the increased use of eVisits for primary care, the research team found that eVisits and office visits had approximately the same rate of follow up visits, but office visits ordered more diagnostic testing, while eVisits prescribed more antibiotics.
- Finally, Tracy Yee of the Center for Studying Health System Change shared the findings of a non-HCFO funded study on Urgent Care Centers and their implications for cost and care coordination. They found that Urgent Care Centers did not significantly improve access to care in areas with low concentrations of primary care providers.