Immunology

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Health Affairs: Mental Health Parity
Historically, health insurance covered mental health care differently than other medical care. Recent laws have begun bringing them into balance. ... Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA) in 2008. ... the MHPAEA applied to large group health plans, both fully and self-insured, and included a cost exemption. The MHPAEA prohibited differences in treatment limits, cost sharing, and in- and out-of-network coverage. Importantly, the MHPAEA also applied to the treatment of substance use disorders, which the MHPA did not address. ... Importantly, the ACA defined coverage of mental health and substance use treatment as one of the ten essential health benefits (EHBs) (Goodell, 4/3).

Health Affairs: Adults In The Income Range For The Affordable Care Act's Medicaid Expansion Are Healthier Than Pre-ACA Enrollees
The Affordable Care Act (ACA) has dramatically increased the number of low-income nonelderly adults eligible for Medicaid. ... We used simulation methods and data from the Medical Expenditure Panel Survey to compare nondisabled adults enrolled in Medicaid prior to the ACA with two other groups: adults who were eligible for Medicaid but not enrolled in it, and adults who were in the income range for the ACA's Medicaid expansion and thus newly eligible for coverage. Although differences in health across the groups were not large, both the newly eligible and those eligible before the ACA but not enrolled were healthier on several measures than pre-ACA enrollees (Hill et al., 3/27).

Centers for Disease Control and Prevention: Restaurant Owners' Perspectives On A Voluntary Program To Recognize Restaurants For Offering Reduced-Size Portions, Los Angeles County, 2012
[T]he Los Angeles County Department of Public Health conducted semistructured interviews with restaurant owners to better understand contextual factors that may impede or facilitate participation in a voluntary program to recognize restaurants for offering reduced-size portions. ... Interviews were completed with 18 restaurant owners (representing nearly 350 restaurants). ... 1) perceived customer demand is central to menu planning; 2) multiple portion sizes are already being offered for at least some food items; 3) numerous logistical barriers exist for offering reduced-size portions; 4) restaurant owners have concerns about potential revenue losses from offering reduced-size portions; 5) healthful eating is the responsibility of the customer; and 6) a few owners want to be socially responsible industry leaders (Gase, 3/20).

George Washington University/The Robert Wood Johnson Foundation: Ten Years After Keeping Patients Safe: Have Nurses' Work Environments Been Transformed?
A decade has passed since the Institute of Medicine (IOM) published Keeping Patients Safe: Transforming the Work Environment of Nurses. The report revealed that, "the typical work environment of nurses is characterized by many serious threats to patient safety." To counter these threats and reduce health care errors in hospitals and other settings where nurses care for patients, the 2004 report recommended fundamental transformation in the work environment of nurses .... Despite notable achievements in improving health care quality since that time, patients remain at risk of serious harm. ... Despite notable achievements in improving health care quality since that time, patients remain at risk of serious harm (Kurtzman and Fauteux, 3/31).

The Kaiser Family Foundation: Medicaid Beneficiaries Who Need Home And Community-Based Services: Supporting Independent Living And Community Integration
To provide insight into the unique experiences of Medicaid beneficiaries who need HCBS, this report profiles nine seniors and people with disabilities residing in Florida, Georgia, Kansas, Louisiana, North Carolina, and Tennessee. ... Based on a series of telephone interviews conducted in 2013 by the Kaiser Commission on Medicaid and the Uninsured, these profiles illustrate how beneficiaries' finances, employment status, relationships, well-being, independence, and ability to interact with the communities in which they live â€" in addition to their health care â€" are affected by their Medicaid coverage and the essential role of HCBS in their daily lives. ... Medicaid is a true safety net as it is often the only available source of these essential services to support community living (Musumeci and Reaves, 3/27).

Here is a selection of news coverage of other recent research:

Boston Globe: Benefits Of Mammograms May Have Been Oversold, New Study Finds
Doctors may have oversold the benefits of mammography and underplayed its risks, which has left many women unable to make an informed decision about whether or not to have regular breast cancer screenings beginning at age 40. ... Women in their 40s had just a 15 percent reduction in their breast cancer death risk compared to a 32 percent reduction for older women in their 60s who are far more likely to get breast cancer than younger women, according to the study published Tuesday in the Journal of the American Medical Association (Kotz, 4/1).

Reuters: Most Web-Based Colon-Screening Information Is Lacking: Study
When researchers evaluated a dozen websites meant to inform patients about colon cancer screening, most were written at too high a reading level and lacked important risk and benefit information. This isn't a new problem. Researchers have known for at least 20 years that many materials written for patients, not just those about colonoscopy, are not up to snuff, according to Terry C. Davis [published in Gastrointestinal Endoscopy] (Doyle, 4/1).

Bloomberg: Weight-Loss Surgery Keeps Diabetes At Bay Better Than Medicines
Weight-loss surgery may be a better way to treat diabetes than traditional drug therapy alone, according to a study that found the operation was more likely to keep the chronic condition at bay for at least three years. People who were overweight or mildly obese gained the same benefit from surgery as those who were heavier, a finding that should expand use of the procedure, said Philip Schauer, the lead researcher and director of the Bariatric and Metabolic Institute at the Cleveland Clinic. Most insurance companies limit coverage to those who are morbidly obese or have other medical conditions. ... The study was simultaneously published in the New England Journal of Medicine (Cortez, 3/31).