The state’s Health Policy Commission (HPC) on Wednesday introduced “DataPoints” – described as online briefs that will spotlight data findings relevant to HPC’s mission of driving down healthcare costs.
The data was released at a joint meeting of two HPC committees – Community Health Care Investment and Consumer Involvement (CHICI) and Cost Trends and Market Performance (CTMP).
Avoidable Emergency Department Use
The HPC says “avoidable” ED use includes two types of visit categories: visits that could have been treated by a primary care provider (for example, an ear infection) and visits that did not require any immediate medical care (sore throat with no fever).
The HPC found that such visits occur equally across the state and that about 31% of them occur between 8 p.m. and 8 a.m. The 69% of visits that occur during daytime hours led the HPC to opine that access problems exist, adding that some solutions may involve the increased use of telemedicine and granting nurse practitioners full practice authority.
Oral Health ED Visits
HPC found that ED visits for oral health complaints continue in Massachusetts even though hospital EDs are not really equipped to handle such visits and result in higher costs than having care provided in a dentist’s office.
Elderly patients (65 to 74) showed the greatest increase in ED visits (15%) along with children ages 5 to 10 (also 15%). The 25% of Massachusetts residents residing in the lowest-income areas of the state accounted for 45.3% of oral health ED visits in 2015, HPC found. In 2014, just 35% of dentists in Massachusetts treated a MassHealth patient.
Contraceptives
The Affordable Care Act (ACA) mandated that insurers cover certain preventive services with no patient cost-share, and the regulations subsequently drawn up to enforce the ACA included the full range of contraceptive devices under preventive services.
The HPC found that decreases in out-of-pocket spending for all prescription claims were greater for women than men in Massachusetts. The reason for the decrease in women’s spending “was almost entirely due to a significant decrease in cost sharing for contraception.” While prescription contraception claims remained relatively constant from 2011 to 2014, the claims with any patient cost sharing decreased from 98% to 6.5%; average out-of-pocket spending per contraception claim dropped from $16 in 2011 to $1.73 in 2014.
While prescription contraception claims remained static, IUD claims between 2011 and 2014 rose 34%, from 13,800 to 18,500. Patient cost sharing for IUDs also plummeted during this period.
HPC’s detailed DataPoints are here.