Elevance Health Public Policy Institute

We're thrilled to share that PPI's own Leah Ramirez and Benjamin Ukert will be presenting this week at #2024APPAM! The APPAM Fall Research Conference is a multi-disciplinary event that allows researchers to share their work on a wide range of pressing policy and management topics. Leah and Ben will present research on the relationship between obstetric care provider incentive levels and birth cost savings from value-based care in Medicaid and arbitration outcomes for out-of-network medical bills under the No Surprises Act, respectively. Read Leah's Abstract ?? https://lnkd.in/eB5DzTrK Read Ben's Abstract ?? https://lnkd.in/ePXnpbgZ

Did you catch PPI researcher Benjamin Ukert on the Managed Care Cast Podcast from AJMC - The American Journal of Managed Care? On it, he discusses his study that?explores prior authorization and whether it is a factor in disparities in cancer care. The study ultimately found no differences in the prior authorization process for Black and Hispanic patients with cancer and higher rates of prior authorization approvals for Asian patients compared with White patients. ???Listen to the Podcast:?https://lnkd.in/eQ53a5FR ??Read the Paper:?https://bit.ly/3A3zPU4

#ICYMI PPI's recent paper on #MedicareAdvantage (MA) growth and lower Medicare spending was featured last week in Fierce Healthcare. As the article notes from our study findings, across counties, 10 percentage point higher MA penetration is associated with 1.9% lower Medicare spending per capita. Using this estimate, cumulative savings resulting from the growth in MA penetration from 2012-2021 are as high as $144 billion. ?? Read the Fierce Healthcare article: https://lnkd.in/eCkUmg3h ?? Read our PPI paper: https://bit.ly/3YHJjxM

In the last decade, growth in total #Medicare program spending has slowed greatly, spurring questions from policymakers and researchers on why this may be. Today, we published important new research demonstrating the significant association between higher Medicare Advantage penetration and lower total Medicare spending per capita, both across counties and year-over-year within a county. This correlation may well be a key driver behind these recent Medicare spending trends. Read more ?? https://bit.ly/3YHJjxM

#ICYMI PPI's recent publication on the role of doulas in improving maternal health and health equity was featured in an article by Science News Magazine earlier this week! The article also quoted PPI associate research director and lead author on the paper, April Falconi. Congrats to April and team! The article summarizes findings from our paper ?–?such as lower risk of having a C-section and preterm birth and higher odds of attending a postpartum visit among those who received doula care –?and offers possible directions for future research. ?? Read the Science News article: https://lnkd.in/d76fk6jg ?? Read our PPI paper: https://bit.ly/3BsF7ce

In a new paper published last week, researchers from Elevance Health and Carelon explore whether the prior authorization process is a factor in racial and ethnic disparities in cancer care. No differences in the prior authorization process were found among Black and Hispanic patients compared with White patients, while Asian patients tended to have lower denial rates than White patients. Read more ?? https://bit.ly/3A3zPU4 Authors: Benjamin Ukert, Stephanie Schauder, Daniel Cullen, david debono, Michael Eleff, Michael Fisch

Surgical site infections (SSIs) are often-preventable infections that can occur in the part of the body where a surgery took place. These infections account for up to 20-31% of all hospital-acquired infections, making them a notable cause of further hospitalization and even death. A new study co-authored by PPI evaluates the impact of SSIs on patient outcomes. The research found that patients who had an SSI following one of several procedures experienced longer lengths of stay in the hospital, higher readmission rates, and higher rates of reoperation, compared to patients who received the same procedure but did not experience an SSI. In some cases, patients also had a higher risk of mortality in the 12 months after surgery. The findings highlight the need to explore strategies to reduce surgical site infections and their long-term adverse consequences for patients. Read more ?? https://bit.ly/4gUFD2W Authors: Sonali Shambhu, Aliza Gordon, Ying Liu, PhD, Maximilian Pany, PhD, Bill Padula, Peter Pronovost MD, PhD, FCCM, Eugene Hsu, MD, MBA

Congratulations to PPI's Benjamin Ukert, as well as our Elevance Health and Carelon colleagues, for their recent publication in the Journal of Clinical Oncology! Their study looks at the Oncology Care Model (OCM)—a value-based payment model directed toward Traditional Medicare beneficiaries—and its impacts on commercially insured and Medicare Advantage members who were not included in the model. The study found evidence of spillover effects from the OCM, as it reduced cancer episode spending by 14% among individuals not included in the model. This suggests the impacts of Medicare alternative payment models may extend to broader treatment groups than the model's intended aim. Read the full study ?? https://lnkd.in/e37U9sU7 #Oncology #ValueBasedCare #HealthcareInnovation

Our latest research paper, published in the American Journal of Public Health, provides evidence that doula care is associated with improved health outcomes among all women enrolled in Medicaid managed care plans, lowering the risk of cesarean delivery and preterm birth, while increasing the likelihood of a postpartum checkup. This in-depth examination of a geographically diverse population examined the impact of doula care on maternal health disparities, stratifying results by race as well as an area’s rate of infant mortality. This research offers pivotal insights as policymakers consider strategies to address maternal health in the U.S. Read the full paper ?? https://bit.ly/3BsF7ce Authors: April Falconi, Leah Ramirez, Rebecca Cobb, Carrie Levin, Michelle Nguyen, MPH, Tiffany (Davis) Inglis, MD #Doulas #MaternalHealth

#ICYMI Earlier this month, we published a paper written in partnership with CarelonRx and CPESN Networks that examines outcomes for Medicaid health plan members engaged in a unique collaboration between the health plan, pharmacy benefit manager, and community pharmacies. The results found that engagement in these collaborations was associated with a favorable change in medical services utilization, higher rate of improvement in quality of care HEDIS gap closures, and reduction in medical costs for members with chronic conditions. Read our full report ?? https://bit.ly/4g7oH97