Map of Opioid Prescriptions to Part-D Medicare Beneficiaries in 2013 by Zip Code. Continue reading “Part-D Medicare Prescriptions For Opioids in KY By Zip Code – 2013 (Test)”
Big-Change or No-Change in Post-Election Kentucky Healthcare?
I have been out of the country these last two weeks and am trying to catch up. Perhaps the biggest news item while I was away happened just as I left town – the election of Matt Bevin as our next Governor. I had only just learned of this fact when I was contacted by an out-of-state reporter who asked whether people in Kentucky who gained coverage through Medicaid expansion or through our KYNECT state insurance exchange should be concerned. If so, why would people who only so recently obtained healthcare coverage vote for Mr. Bevin – as they obviously must have in winning fashion?
Of course they should be concerned!
I responded that based on Mr. Bevin’s campaign promises and comments alone, as reported by our local press, current KYNECT and Medicaid expansion recipients have every reason to worry about their future coverage and access to healthcare. I would certainly worry if I were in their shoes and not the satisfied Medicare beneficiary that I am. In the heat of the campaign, and to appeal to virulent anti-Obama haters, Tea-Partiers, and other conservative voters; Mr. Bevin unequivocally promised to undo as much as possible of the Affordable Care Act (ACA) implemented in Kentucky by Governor Steve Beshear. At least that is what I heard.
Real promises or campaign maybes?
Campaign promises included unwinding Kentucky’s successful KYNECT insurance plan, or switching it from a state-run plan to a federal plan. It also seemed clear to me that Mr. Bevin promised to end or roll back the Medicaid expansions that have numerically provided the most coverage to previously uninsured Kentuckians. (Mr. Bevin later apparently hedged his promise to something short of a full roll-back.) Much was made during the campaign of Mr. Bevin’s possible confusion of Medicare and Medicaid, and statements about whether beneficiaries of publicly-financed healthcare should be required to submit urine tests for illegal drugs. I took some of this to be red-meat stuff thrown Trump-style by both parties to their admiring crowds. I would rather see Governor-elect Bevin improve what we have rather than walk away from it solely to satisfy his political base. Continue reading “Big-Change or No-Change in Post-Election Kentucky Healthcare?”
Free Bound Medical Journals.
Prepare yourself for medicine in the post-apocalyptic world!
The evolving interface with the medical literature.
They were once one of my most prized possessions, but now I can’t even give them away. Beginning in 1967 with the New England Journal of Medicine (NEJM), I began to bind my medical journals. The fact that the practice was begun for me by my late father-in-law only increased my emotional attachment to these physically and intellectually handsome books. As my career progressed, I added all the major general internal medicine and rheumatology journals to my collection. I was on the editorial board of two of these, wrote articles appearing in them, and reviewed countless articles submitted for publication by others. I carried these books from one institution to another for over 40 years until, following my active medical retirement, they ended up in a Stor-All facility. As I attempt to further downsize now because I no longer physically have room for them, I discover to my naive surprise and disappointment that no one else wants them. My current dilemma stems from the fact that I cannot bring myself to throw them away. Perhaps one of my readers can help me. Details about the collection can be found at the end of this article. Continue reading “Free Bound Medical Journals.”
Medicare Releases On-Line Application To Map Opioid Prescriptions.
Summary.
Both “hot- and cold-spots” of opioid prescription are easily found. The business address and volume of opioid prescriptions written by Medicare prescribers correlates very well with the volume of opioids consumed by non-Medicare patients and predicts where where they live. The Medicare Part-D Prescription Drug Database can be a useful instrument for medical professional, public health, and law enforcement organizations in dealing with America’s exploding prescription drug and opioid drug epidemic.
Background.
In its efforts to make our healthcare system more transparent, affordable, and accountable, the Cabinet for Medicare and Medicaid Services (CMS) has just released an on-line website tool map Medicare Opioids that allows anyone to create maps showing the distribution of prescribing for opioids at the state, county or 5-digit ZIP Code level. The underlying data comes from the same initial release of 2013 Part-D Medicare prescription data and is therefore geographically organized by the business address of each individual prescriber but is limited to the subset of patients covered by Part-D Medicare.
However, data accompanying the mapping application includes information not available in the earlier release including the number of prescribers in a given geographic area, and the percentage of all prescriptions written that were for opioids. (Who else could do this!) With this additional information, the number of opioid prescriptions per-prescriber within a given geographic region can be calculated. A few minutes of browsing easily demonstrates major geographic variation and “hot-spots” of both high- and low opioid prescribing at the five-digit ZIP Code level. Continue reading “Medicare Releases On-Line Application To Map Opioid Prescriptions.”