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Publication Detecting BS in Health Care(2018-11-27) Burns, Lawton R.; Pauly, Mark V.In the past several months, we have observed several notable signs of deceptive, misleading, unsubstantiated, and foolish statements — what we will call “BS” — in the health care industry. Here we present our Top 10 BS candidates, in both pictures and words. First we present each picture, untitled and without text, thereby inviting readers to discern what the BS message is and engage them in the BS detection process. Then we offer an explanation of what the picture conveys. This will help the reader become a more skilled “BS Hunter.” We reserve the option to expound further as we step in more BS in the future.Publication Marketplace Plans With Narrow Physician Networks Feature Lower Monthly Premiums Than Plans With Larger Networks(2016-10-04) Polsky, Daniel; Cidav, Zuleyha; Swanson, AshleyKey Findings: Narrow network plans on the health insurance marketplaces allow consumers to trade-off lower premiums for a more restricted choice of providers. This study finds that, all else being equal, an individual consumer is saving 6.7 percent of premiums, or between $212 and $339 a year, on a typical plan.Publication Could a Public Health Insurance Option Lead to More Competitive Markets?(2019-12-10) Pauly, Mark V.Calls for the establishment of a “public option,” which emerged during the debate on the Affordable Care Act, have reemerged in this election season. Some proposals base the public option on Medicare, while others on Medicaid. In this article, Wharton professor and LDI Senior Fellow Mark Pauly discusses the likely effects of a public option on private markets, using experience in Medicare Advantage as a guide. Will the public option become the preferred one, sweeping away the private market? Or can the public and private options peacefully coexist?Publication Expanding Access to Naloxone: A Review of Distribution Strategies(2019-05-29) Weiner, Janet; Murphy, Sean M; Behrends, CzarinaAmidst an ongoing opioid crisis that claimed 47,600 lives in 2017, increasing the availability of the rescue medication naloxone is a high priority. Naloxone reverses an opioid overdose when given intranasally or intramuscularly. But to be effective, naloxone must be available at the time of overdose. Naloxone distribution to laypeople can save a life when first responders are not immediately available, or when people witnessing overdoses are unwilling or unable to call 911. Naloxone is increasingly available through some pharmacies under a standing order; however, even when available, cost and stigma barriers persist. This Issue Brief reviews recent evidence on the outcomes and cost-effectiveness of naloxone distribution strategies in community, pharmacy, and other health care settings.Publication From Hospital to Drugstore: Insurance and the Shift to Outpatient Care(2001-10-23) Danzon, Patricia. M; Pauly, Mark VAs policymakers consider whether and how to add prescription drug coverage to Medicare, they need to understand the relationship between insurance coverage and the adoption of new medical technologies, including drugs. Even the direction of these relationships is not always so clear. In this Issue Brief, Drs. Danzon and Pauly examine the shift from inpatient to outpatient care in the last 20 years, and ask two broad questions: to what extent was this shift encouraged by changes in insurance, and to what extent was insurance coverage influenced by this shift?Publication Window Shopping on Healthcare.gov and the State-Based Marketplaces: More Consumer Support Needed(2014-12-17) Baker, Tom; Beatty, Adrienne; Nirenburg, Gabbie; Weiner, JanetThis data brief examines the window-shopping experience that consumers encountered on each health insurance marketplace website during the first two weeks of the Affordable Care Act's second open enrollment period. The marketplaces have made some progress toward adopting the recommended "Top 5 Rules for Decision Support." Shoppers found plenty of sorting and filtering options, but insufficient information about providers and little true decision support. Although there is still a long way to go, there are grounds for optimism about further progress for the next open enrollment period.Publication Accommodating Medical School Faculty with Disabilities(2003-01-06) Steinberg, Annie G; Iezzoni, Lisa I; Conill, Alicia; Stineman, MargaretMore than ten years have passed since the Americans with Disabilities Act (ADA) mandated that all employers provide “reasonable accommodations” for employees with disabilities. This mandate applies to medical schools, but no systematic information is available to assess the accommodations provided to medical school faculty with disabilities. This Issue Brief summarizes anecdotal evidence from several medical schools about the experiences of faculty with disabilities, and the barriers they face in establishing and maintaining their careers. It also recommends practical steps medical schools can take to provide a welcoming and accessible academic medical environment.Publication State Firearm Laws and Interstate Firearm Deaths From Homicide and Suicide in the United States: A Cross-Sectional Analysis of Data by County(2018-03-15) Kaufman, Elinore J; Morrison, Christopher N; Branas, Charles C; Wiebe, Douglas J.In a cross-sectional analysis of deaths from 2010 through 2014, states with strong gun laws had lower rates of firearm-related homicide and suicide than states with less regulation. Counties in states with less restrictive firearms laws had relatively lower rates of firearm-related homicide when they bordered states with strict gun laws. In contrast, rates of gun violence in areas with strong gun laws were unaffected by lenient laws in neighboring states. Restrictions on the sale and ownership of firearms may have measurable effects on rates of firearm deaths, with potential spillover across state lines.Publication Reducing Firearm Injury: Lessons from Brazil(2007-06-01) Macinko, James; Marinho de Souza, Maria de FátimaFor the second straight year, large cities in the U.S. are experiencing an alarming increased in homicides, mostly committed with firearms. Philadelphia reported 406 homicides in 2006, giving it the highest rate of homicides among the ten largest cities (27.8 per 100,000 people). This trend has renewed interest in policies to limit the availability of firearms. However, the effectiveness of such policies at reducing injury remains controversial, often creating political deadlock. To inform this debate, we look at evidence from Brazil, a country with even greater levels of violence than the U.S. This Issue Brief analyzes recent gun legislation and other violence reduction policies in Brazil and their effects on firearm violence.Publication Show Me the Money: Economic Evaluations of Opioid Use Disorder Interventions(2016-05-25) Murphy, Sean; Polsky, Daniel; Meisel, Zachary; Mitchell, JuliaThis brief summarizes a new systematic review of economic evaluations of treatments for substance use disorders. The review reveals strong evidence that methadone maintenance therapy is an economically advantageous form of treatment; the economic evidence for buprenorphine and naltrexone treatments is more limited.