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Over a 10-year period, spending for Medicaid-enrolled patients with depression increased substantially but only minimal improvements in quality of care were observed, according to a report in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals. The study was carried out by Catherine A. Fullerton, M.D., M.P.H., of Harvard Medical School and Cambridge Health Alliance, Boston, and colleagues.

As we [American Psychological Association Practice Organization] reported last week, the situation on Capitol Hill has once again shifted dramatically with the failure of the Joint Select Committee on Deficit Reduction to reach agreement on $1.2 trillion in debt savings. Legislative leaders have begun to discuss options to address critical, time-sensitive issues by the end of the year, including the expiration of unemployment benefits, the Alternative Minimum Tax patch, tax extenders and Medicare extenders.

As you know, the APA Practice Organization has been hard at work on Capitol Hill to avert steep cuts to Medicare reimbursement for psychologists. The Joint Select Committee on Deficit Reduction, which faces a November 23 deadline to identify at least $1.2 trillion in debt savings, has clearly indicated that the future of Medicare is on the table.

Researchers from Harvard School of Public Health (HSPH), Massachusetts Institute of Technology (MIT), the National Bureau of Economic Research (NBER), and Providence Health & Services have found that expanding low income adults’ access to Medicaid substantially increases health care use, reduces financial strain on covered individuals, and improves their self-reported health and well-being. This is the first study to evaluate the impact of insuring the uninsured in the United States using a randomized controlled trial, the gold standard in medical and scientific studies.

As required under the Patient Protection and Affordable Care Act of 2010, millions of people will soon be added to the ranks of the insured. However, this rapid expansion of coverage is colliding with a different, potentially problematic trend that could end up hampering access to health care. Since 2005, doctors have been accepting fewer and fewer patients with health insurance, according to a new study published in the June 27th issue of Archives of Internal Medicine.

Roughly 1 of every 6 Americans age 18 to 64 reported using more than 10 percent of their total family income to pay for health insurance premiums and out-of-pocket medical expenses in 2007, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. Check the end of this report to download the “2010 National Healthcare Disparities Report” and “2010 National Healthcare Quality Report” for a complete summary of the findings.

Most hospitals follow established practice guidelines for surgery involving Medicare beneficiaries with cancer, but in some cases their practice patterns diverge from the guidelines, according to a report published Online First today by Archives of Surgery, one of the JAMA/Archives journals. According to background information in the article, health care quality has emerged as an important concern in the United States. However, the right care is not always delivered to the right patient at the right time, the authors remark.

Employees of private-sector companies contributed up to 121 percent more in 2009 for their yearly share of their employer-sponsored health insurance coverage than they did in 2001, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. By comparison, the total average annual premium for employer-sponsored health plans, which includes both the cost to the worker and to his or her employer, rose at a slower pace during the same period. Included in this report is a link to download the original statistical brief.

Sixty-six percent of publicly-insured children were unable to get a doctor’s appointment for medical conditions requiring outpatient specialty care including diabetes and seizures, while children with identical symptoms and private insurance were turned away only 11 percent of the time, according to an audit study of 273 specialty physician practices in Cook County, Ill. conducted by researchers from the Perelman School of Medicine and the School of Social Policy and Practice at the University of Pennsylvania. The findings are published in the June 16 issue of the New England Journal of Medicine.

During the debate over health care reform, American Psychological Association (APA) and the APA Practice Organization (APAPO) focused significant energy and resources to ensure the inclusion of provisions promoting psychologist involvement in integrated care in the Affordable Care Act. The Department of Health and Human Services (HHS) has begun to develop regulations to implement the law, including its recent publishing of a proposed rule to encourage the development of coordinated care by establishing Accountable Care Organizations (ACOs) in Medicare as part of the Medicare Shared Saving Program. Included in this report is a link to the original comment letter.