AHRQ News Now: insurer participation in ACA marketplaces; addressing climate change and health equity; funding for diagnostic safety centers of excellence

AHRQ News Now

April 12, 2022, Issue #810

AHRQ Stats: seniors’ use of opioids


Access more data on this topic in the associated statistical brief, plus additional AHRQ data infographics.

Today's Headlines:

More Health Insurers Offering Coverage on Individual Market in 2021 Than 2018

Since the implementation of the Affordable Care Act (ACA) in 2010, levels of insurer participation in the individual health insurance marketplace have varied, reaching a low in 2018. But a new study in Health Affairs co-authored by an AHRQ-supported scholar has found that nearly 2,000 counties—which account for two-thirds of the U.S. population under 65—had more insurers offering coverage on the individual marketplace in 2021 than in 2018. At the same time, the number of counties with monopolistic marketplace insurers declined from 1,616 in 2018 to 294 in 2021. Fewer insurers participated in ACA marketplaces in 2021 than during peak participation in 2015 because of increased insurer competition that reduces premium differences between various types of plans. In light of the Biden administration’s support for the ACA marketplaces, researchers speculated that the individual insurance market will remain stable and profitable for the next several years. Access the abstract.

Federal Health Officials Call for Action Linking Climate Change, Health Equity

In a New England Journal of Medicine Perspective calling for direct action on climate change and health equity, Admiral Rachel Levine, M.D., Assistant Secretary for Health, C. Joseph McCannon, Senior Advisor on Climate Health and Equity, and other officials from the U.S. Department of Health and Human Services (HHS) noted that healthcare accounts for 8.5 percent of overall U.S. carbon emissions with a disproportionate impact on at-risk communities. “In government health agencies, hospital boardrooms, and the executive offices of major insurers, manufacturers, and suppliers, leaders must fully understand the catastrophic human and financial costs of delayed action and lead the nation in addressing the crisis,” the authors wrote. They identified four policy areas they believe will lead to progress: public reporting on aims such as greenhouse gas emissions, broad support for learning and innovation, HHS-level incentives including payment, and updates to HHS regulations. Access the Perspective.

AHRQ Seeks Applications for Funding To Develop Diagnostic Centers of Excellence

Dx centers

A new Notice of Funding Opportunity invites applications for the development of Diagnostic Centers of Excellence to perfect a component of diagnostic care in an integrated cross-disciplinary health system. Each center will develop an expertise in at least one of the four areas of focus: error detection and prevention, resilience for safe practice, improving diagnostic precision through consensus and improving “truth” or diagnostic reference standards. Learn more and apply by June 9.

Unnecessary Use of Antibiotics in Dental Visits Remains Common

antibiotics, dentistry

 Antibiotics are commonly prescribed for use before dental procedures for patients with a number of underlying medical conditions even though their use is not necessary in most cases. In an AHRQ-supported study in the American Journal of Preventive Medicine, researchers reviewed data from more than 60,000 dental visits that included procedures involving manipulations from 2016 to 2018 and found that more than three-quarters of them involved the prescription of a prophylactic antibiotic that was considered unnecessary according to guidelines. Dentists prescribe antibiotics at a higher rate than medical providers and prescribe up to 10 percent of antibiotics in the United States. Unnecessary use of antibiotic medications is considered a major public health issue because overprescribing can lead to antibiotic resistance. Access the abstract.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Featured Impact Case Study: American College of Physicians Uses AHRQ Research To Create Clinical Guidelines

A new AHRQ Impact Case Study describes how the American College of Physicians (ACP) relies on AHRQ resources to develop clinical recommendations on a variety of topics, including COVID-19. ACP has been using AHRQ’s evidence reviews since 2003 to create practice guidelines for internal medicine physicians about the best care for patients. “AHRQ’s work is methodologically sound, evidence-based, high quality, and unbiased,” said Amir Qaseem, M.D., ACP’s chief science officer. With 161,000 members worldwide, ACP and its physician members work to advance the science and practice of internal medicine. ACP clinical policies based on AHRQ systematic reviews have been published in ACP’s Annals of Internal Medicine.

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Lessons learned from the historical trends on thrombolysis use for acute ischemic stroke among Medicare beneficiaries in the United States. Meng T, Trickey AW, Harris AHS, et al. Front Neurol. 2022 Mar 4;13:827965. Access the abstract on PubMed®.

Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States. Remigio RV, He H, Raimann JG, et al. Sci Total Environ. 2022 Mar 15;812:152481. Epub 2021 Dec 16. Access the abstract on PubMed®.

Real-world considerations for implementing pediatric quality measures: insights from key stakeholders. Schur C, Johnson M, Doherty J, et al. Acad Pediatr. 2022 Apr;22(3S):S76-S80. Access the abstract on PubMed®.

Increasing capacity for treatment of opioid use disorder in rural primary care practices. Zittleman L, Curcija K, Nease DE, Jr., et al. Ann Fam Med. 2022 Jan-Feb;20(1):18-23. Access the abstract on PubMed®.

Do high-deductible health plans affect price paid for childbirth? Cliff BQ. Health Serv Res. 2022 Feb;57(1):27-36. Epub 2021 Jul 12. Access the abstract on PubMed®.

Effect of an eHealth intervention on older adults' quality of life and health-related outcomes: a randomized clinical trial. Gustafson DH, Sr., Kornfield R, Mares ML, et al. J Gen Intern Med. 2022 Feb;37(3):521-30. Epub 2021 Jun 7. Access the abstract on PubMed®.

Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit. Huang J, Graetz I, Millman A, et al. JAMIA Open. 2022 Apr;5(1):ooac002.  Access the abstract on PubMed®.

Effectiveness of pharmacist intervention to reduce medication errors and health-care resources utilization after transitions of care: a meta-analysis of randomized controlled trials. De Oliveira GS, Jr., Castro-Alves LJ, Kendall MC, et al. J Patient Saf. 2021 Aug 1;17(5):375-80. Access the abstract on PubMed®.

Contact Information

For comments or questions about AHRQ News Now, contact Bruce Seeman, (301) 427-1998 or Bruce.Seeman@ahrq.hhs.gov.