Center for Studying Health System Change

Health Affairs Studies Examine Medicaid/SCHIP Cuts and Emergency Department Use; Hospital Payment Systems

Media Advisory
Jan. 12, 2006

FURTHER INFORMATION, CONTACT:
Alwyn Cassil (202) 264-3484 or acassil@hschange.org

WASHINGTON, DC—Two studies by Center for Studying Health System Change researchers (HSC)—one on the impact of Medicaid/SCHIP cuts on emergency department use, and the other on hospital payment issues-—were published in the January/February edition of the journal Health Affairs.

"Medicaid/SCHIP Cuts and Hospital Emergency Department Use," by Peter J. Cunningham, HSC senior researcher

This study, commissioned by the Kaiser Family Foundation (KFF) with additional support from The Robert Wood Johnson Foundation, examines how decreases in Medicaid and State Children’s Health Insurance Program (SCHIP) enrollment would affect the volume and distribution of emergency department (ED) use among low-income people. A decrease in Medicaid/SCHIP enrollment would lead to an increase in ED visits by uninsured people but little change in overall ED volume. The results suggest that cost containment efforts that reduce eligibility and enrollment will achieve cost savings largely by reducing access and shifting costs away from Medicaid/SCHIP.

The article is available on the KFF Web site at http://www.kff.org/medicaid/kcmu011006pkg.cfm. In a From the Journals audio interview, KFF’s Jackie Judd discusses the research with Cunningham. The interview is available at http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1627. From the Journals highlights current research on health policy published in major professional journals and is part of the special interview series "A Closer Look."

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"Hospital Payment Systems: Will Payers Like the Future Better Than the Past?" by Len M. Nichols of the New America Foundation and HSC Senior Researcher Ann S. O’Malley

Unsustainable health care cost growth has forced payers to re-examine goals for hospital payment systems. Employers want simplicity and transparency, with comparative performance data available in the public domain. Insurers favor simplicity but prefer to keep the analysis of comparative performance data and pricing private. Thirty-five pay-for performance experiments have been devised in the private sector, to reward hospitals for higher quality and move toward more effective payment systems. Definitive results are not yet known, and caveats remain, but early signs are promising. The authors develop three scenarios for future hospital payment systems and identify policy actions to improve outcomes.

Reporters can e-mail Alwyn Cassil at acassil@hschange.org to obtain a copy of the article.

The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org.