Assessing the Impact of Individual Market Reforms in Minnesota.

Starting in 2026, Minnesota could experience disruptions to its health insurance marketplace caused by the anticipated sunset of federal premium subsidy enhancements, made available through the Inflation Reduction Act of 2022, as well as the expiration of state funding for its reinsurance program. With reduced premium subsidies, fewer people might enroll in marketplace plans, which could lead to higher premiums and market instability. The expiration of reinsurance, which partially offsets insurers' claims costs for people with high expenditures, could exacerbate these issues.

Expanding Insurance Coverage to Undocumented Immigrants in Connecticut.

Policymakers in Connecticut are considering various state-funded policy options to improve insurance coverage among undocumented and legally present recent immigrants in the state - almost 60 percent of whom lack health insurance. In particular, they are removing immigration status requirements from Medicaid eligibility. They are also considering whether to provide state-funded subsidies to undocumented immigrants enrolled in individual market plans.

Increasing Subsidies and Expanding Health Insurance Options in Connecticut.

Policymakers in Connecticut are considering various options to increase the affordability of insurance in the state, such as expansions to premium and cost-sharing reduction subsidies on the state's health insurance marketplace, as well as expanded plan offerings, including extending eligibility for the state employee health plan (SEHP) to other groups and a publicly contracted, privately operated plan (the public option plan) offered to individuals on the marketplace. The authors used the RAND Corporation's COMPARE microsimulation model to estimate the impacts of such policy options. For each policy scenario, they calculated enrollment, premiums, consumer spending, and state spending and considered whether the results differed by race, ethnicity, or income group.

Summary of the Current Status of Health Insurance Enrollment in Connecticut.

The state of Connecticut is considering a number of policy options to improve health insurance affordability, access, and equity. To create policies designed to increase insurance coverage and access to care in underserved communities and reduce racial and ethnic disparities, state policymakers need an accurate picture of the current distributions of insurance enrollment across these dimensions. The authors combine data from the American Community Survey Public Use Microdata Sample, which includes demographic characteristics, as well as insurance status, with various data sources from the state to provide a fuller picture of insurance enrollment among those under the age of 65 in Connecticut.

Barriers to Price and Quality Transparency in Health Care Markets.

Consumers of health care in the United States often lack information on the actual prices of the care they receive and can also lack access to information about the quality of their care. RAND researchers gathered information on how health care prices are set, price variation in health care markets, barriers to price and quality transparency for consumers, and the extent to which price and quality information is used in marketing efforts. Public payers typically set prices for physicians and hospitals prospectively, and commercial health plans negotiate with physicians and hospitals to determine prices.

Estimated Savings From International Reference Pricing for Prescription Drugs.

This study estimates what 2020 national US savings would have been using international reference pricing rather than US manufacturer and net prices for insulins and 50 top brand-name drugs.

Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population.

Background: Studies indicate adherence to biologics among patients with psoriasis is low, yet little is known about their use in the Medicare population.

Objective: We sought to investigate real-world utilization patterns in a national sample of Medicare beneficiaries with psoriasis initiating infliximab, etanercept, adalimumab, or ustekinumab.

Methods: We conducted a retrospective claims analysis using 2009 through 2012 100% Medicare Chronic Condition Data Warehouse Part A, B, and D files, with 12-month follow-up after index prescription.

Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use.

Psoriasis is a common chronic inflammatory disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated with biologic use, using a nationally representative sample of Medicare beneficiaries in 2011.

Testosterone and insulin resistance in the metabolic syndrome and T2DM in men.

Obesity, type 2 diabetes mellitus and the metabolic syndrome are major risk factors for cardiovascular disease. Studies have demonstrated an association between low levels of testosterone and the above insulin-resistant states, with a prevalence of hypogonadism of up to 50% in men with type 2 diabetes mellitus. Low levels of testosterone are also associated with an increased risk of all-cause and cardiovascular mortality.

Caregiver assistance among Medicare beneficiaries with atrial fibrillation and factors associated with anticoagulant treatment.

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and disproportionately affects the elderly.

Objective: This study describes patient characteristics and caregiver assistance among Medicare beneficiaries with AF and examines factors associated with receiving anticoagulant treatment.

Methods: Patients with AF and age/gender-matched controls were identified from Medicare Current Beneficiary Survey data from 2001 to 2006.

Clinical and economic outcomes associated with National Kidney Foundation guideline-concordant oral antidiabetic drug treatment among type 2 diabetes patients with chronic kidney disease.

Objective: To assess outcomes associated with oral anti-diabetic drug (OAD) treatment concordant with guidelines from the National Kidney Foundation (NKF) among type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD).

Methods: Electronic health record data between 1/1/2005 and 10/31/2010 provided by an integrated health system were analyzed. T2DM patients were selected based on diagnosis from the health record.

Evaluation of cardiovascular morbidity associated with adherence to atorvastatin therapy.

Long-term adherence to statins is poor. We assessed the relationship between cardiovascular (CV) risk and atorvastatin adherence in primary- and secondary-prevention patients, adjusting for healthy-adherer bias by incorporating preventive service use into the model. Medical and pharmacy claims from employee-based plans from 2002 to 2008 were analyzed for patients who initiated atorvastatin in 2003-2004.

Heat shock protein-containing exosomes in mid-trimester amniotic fluids.

Exosomes are multivesicular bodies formed by inverse membrane budding into the lumen of an endocytic compartment. Fusion with the plasma membrane leads to their release into the external milieu. The incorporation of heat shock proteins into exosomes has been associated with immune regulatory activity.

Bacterial infections associated with blood transfusion: experience and perspective of infectious diseases consultants.

Background: On March 1, 2004, the AABB adopted a new standard that requires member blood banks and transfusion services to implement measures to limit and detect bacterial contamination in all platelet (PLT) components. The AABB has since developed several guidelines to assist blood transfusion services and blood banks in this area, some of which are relevant to clinical practice. Knowledge and experience among clinicians (including infectious disease consultants, who can play an important role in managing patients with sepsis) concerning risk of bacterial infections associated with transfusion, however, are unknown.