Research Roundup: Long-Term Support For Older Americans; Outpatient Care; And Heart Health

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

Commonwealth Fund: Are Older Americans Getting Long-Term Services Supports They Need? 
Older adults’ needs have evolved and are no longer met by the Medicare program. With the recent passage of the Bipartisan Budget Act of 2018 (BBA), Medicare Advantage (MA) plans can now provide beneficiaries with nonmedical benefits, such as long-term services and supports (LTSS), which Medicare does not cover. (Willink, 1/24)

JAMA Internal Medicine: Quality And Experience Of Outpatient Care In The United States For Adults With Or Without Primary Care.
In this nationally representative survey study of 49 286 adults with and 21 133 adults without primary care, Americans with primary care received significantly more high-value care (4 of 5 composites), received slightly more low-value care (3 of 4 composites), and reported significantly better health care access and experience. These differences were stable from 2002 to 2014. (Levine et al, 1/28)

The Henry J. Kaiser Family Foundation: Medicare Part D Enrollees With Serious Health Conditions Can Face Thousands Of Dollars In Out-Of-Pocket Costs Annually For Specialty Drugs
Despite Medicare’s protections, Part D enrollees with serious health conditions can face thousands of dollars in annual out-of-pocket costs for expensive specialty drugs, a new KFF anaylsis finds. The analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 costs for more than two dozen specialty tier drugs used to treat four health conditions — cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis – based on coverage and costs in national and near-national stand-alone drug plans, using a pharmacy in Baltimore, MD. It found that expected median out-of-pocket costs for Part D enrollees not receiving low-income subsidies would range from $2,622 for Zepatier (for hepatitis C) to $16,551 for Idhifa (for leukemia) in 2019. (1/29)

JAMA Cardiology: Association Of All-Cause And Cardiovascular Mortality With High Levels Of Physical Activity And Concurrent Coronary Artery Calcification.
In this observational study of 21 758 men with varying levels of physical activity, the presence of elevated levels of coronary artery calcification (≥100 Agatston units) was more prevalent among highly active men. However, no increase in all-cause or cardiovascular disease mortality was evident in this group when compared with men who were less active. (DeFina et al, 1/30)

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