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Commonwealth Fund International Health News Brief: 2019, No. 1

International Health News Brief Australia

Lowest Rate of Out-of-Pocket Payments as Bulk Billing Hits Historic Levels in Australia

0 min read

Corespondent:  Sonĵ Hall

The latest figures released by the Australian Institute of Health and Welfare show that record numbers of Australians did not have to pay anything out of pocket when visiting their doctor last year. In 2017–18, 86 percent of patients were bulk-billed, meaning that Australia’s universal health coverage, Medicare, paid the bill in full. The remaining 14 percent faced out-of-pocket costs as their doctors charged rates that were higher than the Medicare bulk-billing rate. The bulk-billing coverage rate rose in all states and territories, with 133 million primary care visits fully covered, 5.6 percent higher than in 2016–17.

Australia Newsletter Article

The latest figures released by the Australian Institute of Health and Welfare show that record numbers of Australians did not have to pay anything out of pocket when visiting their doctor last year. In 2017–18, 86 percent of patients were bulk-billed, meaning that Australia’s universal health coverage, Medicare, paid the bill in full.

Show Link Controlling Health Care Costs

Guide Offers Path to Better Care for Aboriginal and Torres Strait Islander Australians

0 min read

Country Correspondent: Sonĵ Hall

The start of 2019 marks a turning point for Australian hospitals in delivering better and more appropriate care for Indigenous Australians, who have a 10-year-lower life expectancy compared with non-Indigenous Australians. Developed in collaboration with Indigenous leaders, the newly launched National Safety and Quality Health Service Standards User Guide for Aboriginal and Torres Strait Islander Health provides advice and case studies to assist health services in meeting the new standards required to maintain accreditation starting January 1, 2019. The guide identifies six essential actions to close the gap, including Indigenous representation in governance structures and improved cultural competency in the workforce.

Australia Newsletter Article

The start of 2019 marks a turning point for Australian hospitals in delivering better and more appropriate care for Indigenous Australians, who have a 10-year-lower life expectancy compared with non-Indigenous Australians. Developed in collaboration with Indigenous leaders, the newly launched National Safety and Quality Health Service Standards User Guide for Aboriginal and Torres Strait Islander Health provides advice and case studies to assist health services in meeting the new standards required to maintain accreditation.

Show Link Improving Health Care Quality
Canada

British Columbia First to Sue Pharmaceutical Companies for Opioid Crisis

0 min read

Correspondent: Danielle Rodin

British Columbia is the first among Canadian provinces to hold more than 40 pharmaceutical companies accountable for their role in the opioid crisis that is crippling the province. A lawsuit filed by Attorney General David Eby alleges that companies were negligent in pushing opioids to physicians while downplaying the risk of addiction. The province is now seeking retribution for costs incurred by the public health care system. Pharmaceutical companies have pushed back, claiming that the complexity of legal and illegally produced opioids is the cause of the spike in overdoses, and that the companies operate within Canadian and international laws. Some critics of the lawsuit say resources should instead be directed at responding to the urgent crisis of illegal opioids and providing clean drugs at injection sites, since a lawsuit could take up to decades to resolve. Other provinces are carefully watching the suit unfold before launching their own legal charges against Big Pharma.

Canada Newsletter Article

British Columbia is the first among Canadian provinces to hold more than 40 pharmaceutical companies accountable for their role in the opioid crisis that is crippling the province. A lawsuit filed by Attorney General David Eby alleges that companies were negligent in pushing opioids to physicians while downplaying the risk of addiction. The province is now seeking retribution for costs incurred by the public health care system.

Show Link Improving Health Care Quality
Europe/European Union

Strengthening Cooperation on Health Technology Assessment in Europe

0 min read

Health technology assessment (HTA) is the process of evaluating the added value of new medicines and technologies relative to existing therapies. Now, the European Commission is strengthening cross-border cooperation and making it possible for EU countries to use common HTA methodologies and procedures. The goal is to ensure quicker access to innovative health technologies, increase the transparency of value assessments, avoid duplication of work for national HTA bodies, and improve business predictability for manufacturers. In July, more than 300 stakeholders met in Brussels to discuss future HTA cooperation, including the importance of engaging patients and clinicians early and the potential of the EU’s Digital Single Market to enable sharing of disease registry and real-world data across country borders.

Newsletter Article

Health technology assessment (HTA) is the process of evaluating the added value of new medicines and technologies relative to existing therapies. Now, the European Commission is strengthening cross-border cooperation and making it possible for EU countries to use common HTA methodologies and procedures. The goal is to ensure quicker access to innovative health technologies, increase the transparency of value assessments, avoid duplication of work for national HTA bodies, and improve business predictability for manufacturers.

Show Link Improving Health Care Quality
France

Telemedicine Visits in France Will Be Reimbursed by Public Health Insurance

0 min read

Country Correspondent: Paul Dourgnon

To date, a number of reports have pointed to problems in access to medical care in rural and semiurban areas of France. To improve access, the public health insurance agency (L’assurance maladie) announced that telemedicine visits will be reimbursed starting in September 2018. In addition, “tele-expertise” — seeking advice from other medical professionals using telemedicine technology — also will be reimbursed. The move is expected to improve access in particular for older adults who often face physical difficulties accessing medical facilities.

France Newsletter Article

To date, a number of reports have pointed to problems in access to medical care in rural and semiurban areas of France. To improve access, the public health insurance agency (L’assurance maladie) announced that telemedicine visits will be reimbursed starting in September 2018. In addition, “tele-expertise” — seeking advice from other medical professionals using telemedicine technology — also will be reimbursed.

Show Link Improving Health Care Quality
Germany

Heart Disease Mortality on the Rise in Germany

0 min read

Country Correspondent: Michael Laxy

Mortality from heart disease in Germany increased in 2015 for the first time after more than 20 years of steady decline. With more than one-third (38%) of all deaths now attributable to heart disease, it remains one of the leading causes of death. Experts see this as a sign that new technologies for prevention and treatment of heart disease have reached a saturation point. While the increasing prevalence of heart disease might be partially explained by increased life expectancy, clinicians have called for strengthened prevention measures addressing risk factors such as smoking, physical inactivity, hypertension, obesity, and alcohol use.

Germany Newsletter Article

Mortality from heart disease in Germany increased in 2015 for the first time after more than 20 years of steady decline. With more than one-third (38%) of all deaths now attributable to heart disease, it remains one of the leading causes of death. Experts see this as a sign that new technologies for prevention and treatment of heart disease have reached a saturation point.

Show Link Controlling Health Care Costs
Netherlands

Netherlands Not Immune to the Dangers of Opioid Misuse

0 min read

Country Corespondent: Marthe Haverkamp

In August, the Dutch National Information Center on Poisoning published its annual report, which included recent statistics for opioid overdoses in 2017. The number of people using oxycodone in the Netherlands has risen fivefold, from 75,000 in 2007 to 372,000 in 2016, and opioid overdoses rose nearly sevenfold — from 43 in 2008 to 280 in 2017. In the first half of 2018 alone, 215 overdoses were recorded. Fentanyl use, although on the rise, does not play an important role in the Dutch drug scene. The growing problem has not yet resulted in an orchestrated response from the Ministry of Health.

Netherlands Newsletter Article

In August, the Dutch National Information Center on Poisoning published its annual report, which included recent statistics for opioid overdoses in 2017. The number of people using oxycodone in the Netherlands has risen fivefold, from 75,000 in 2007 to 372,000 in 2016, and opioid overdoses rose nearly sevenfold — from 43 in 2008 to 280 in 2017.

Show Link Improving Health Care Quality

First Steps Toward Pay-for-Performance in Behavioral Health in the Netherlands

0 min read

The Dutch health insurance company Menzis, one of the four largest insurance companies operating in the Netherlands, has decided to move away from fee-for-service for selected behavioral health conditions. Starting in 2019, it will no longer pay providers for depression and anxiety lasting less than one year, based on the number of treatment sessions. Instead, remuneration will depend on the level of improvement in symptoms and quality of life of the patient as indicated by patient questionnaires and other data sources. The Dutch Association of Psychiatrists disagreed with the move, arguing that the recovery path for behavioral health is highly unpredictable and not necessarily linked to treatment.

Netherlands Newsletter Article

The Dutch health insurance company Menzis, one of the four largest insurance companies operating in the Netherlands, has decided to move away from fee-for-service for selected behavioral health conditions. Starting in 2019, it will no longer pay providers for depression and anxiety lasting less than one year, based on the number of treatment sessions.

Show Link Improving Health Care Quality
Norway

Providers in Norway Mandated to Offer Reconciliation Meeting with Patients and Family After Major Adverse Events

0 min read

Correspondent: Marianne Storm

The Patient Rights Act of 2001 states that patients have a right to receive information about their own health condition and the health services that are provided. If patients experience a serious adverse event, they must be informed of the event, their right to seek compensation from the Norwegian System of Patient Injury Compensation, and their right to contact the Patient and User Ombudsman to request a legal inquiry. Since July 2018, Norwegian health and care providers are legally mandated to offer a meeting with patients or their relatives after a serious adverse event has caused injury or complications. The meeting must take place within 10 days of the incident. The primary goal is to ensure transparency and offer the patient or relative an opportunity to ask questions and hold the provider accountable.

Norway Newsletter Article

The Patient Rights Act of 2001 states that patients have a right to receive information about their own health condition and the health services that are provided. If patients experience a serious adverse event, they must be informed of the event, their right to seek compensation from the Norwegian System of Patient Injury Compensation, and their right to contact the Patient and User Ombudsman to request a legal inquiry.

Show Link Improving Health Care Quality

Norwegian Intensive Obsessive-Compulsive Disorder Treatment Receives International Attention

0 min read

Correspondent: Marianne Storm

An intensive treatment protocol for treating psychiatric disorders, developed in Norway, has increased in popularity among therapists in the United States. Professors from Bergen developed an intensive four-day treatment protocol for obsessive-compulsive disorder, panic disorder, and social anxiety disorder. The protocol involves patients actively approaching fearful situations with their therapist and avoiding behavior that would alleviate their anxiety. In Norway, more than 700 patients have been treated with the protocol, with 90 percent of participants experiencing significant recovery. What’s more, the majority of patients remain symptom-free for up to four years. Last year, the researchers received a NOK 20 million (USD 2.3 million) research grant to study the application of the four-day protocol to other types of anxiety disorders.

Norway Newsletter Article

An intensive treatment protocol for treating psychiatric disorders, developed in Norway, has increased in popularity among therapists in the United States. Professors from Bergen developed an intensive four-day treatment protocol for obsessive-compulsive disorder, panic disorder, and social anxiety disorder.

Show Link Improving Health Care Quality
New Zealand

New Zealand Launches Initiative to Improve Care Transitions for Patients with Behavioral Health Conditions

0 min read

Correspondent: Jennifer Moore

A new initiative by the New Zealand Health Quality and Safety Commission, “Connecting Care,” aims to improve transitions between health and social care for patients with behavioral health conditions. In August, teams of providers from New Zealand’s 20 district health boards, nongovernmental organizations (NGOs), and primary care providers began partnering with patients and their families to identify pathways that would improve transitions. The project focuses on transitions from specialist services to community teams, from specialist care to primary care or NGO services, and from youth to adult services. The initiative is the second national project introduced under a five-year mental health and addiction quality improvement program.

New Zealand Newsletter Article

A new initiative by the New Zealand Health Quality and Safety Commission, “Connecting Care,” aims to improve transitions between health and social care for patients with behavioral health conditions. In August, teams of providers from New Zealand’s 20 district health boards, nongovernmental organizations (NGOs), and primary care providers began partnering with patients and their families to identify pathways that would improve transitions.

Show Link Improving Health Care Quality

Ten-Year Study on Older New Zealanders Reveals Good Health for Most, but Social Inequalities Remain Unsolved

0 min read

Correspondent: Jennifer Moore

A new report summarizing findings from the 2006 to 2016 New Zealand Health, Work and Retirement Longitudinal Study was released in August. The report showed that in 2016, two-thirds of adults age 55 and older enjoyed good physical, mental, and social health. Approximately one in five were caregivers, and these individuals were more likely to be in poorer health. The study also indicated that older adults who rent their home are at greater risk of mental health deterioration than older adults who are homeowners, and the gap in mental health outcomes between these two groups has increased over time. The study was carried out using six biennial surveys and was led by the Health and Ageing Research Team at Massey University.

New Zealand Newsletter Article

A new report summarizing findings from the 2006 to 2016 New Zealand Health, Work and Retirement Longitudinal Study was released in August. The report showed that in 2016, two-thirds of adults age 55 and older enjoyed good physical, mental, and social health. Approximately one in five were caregivers, and these individuals were more likely to be in poorer health.

Show Link Improving Health Care Quality
Sweden

Consumer Comparison Website for Dental Care Prices Being Developed in Sweden

0 min read

Country Correspondent: Ulrika Winblad

Dental services are only partly subsidized by the Swedish state and are often very expensive to access. To address this, the Swedish government recently commissioned the Dental and Pharmaceutical Benefits Agency (TLV) to develop a comparative website for dental care prices. TLV is working with several national agencies, as well as private and public organizations, as part of the project. The website aims to be an objective, nondiscriminatory, noncommercial, and competition-neutral platform that will allow individuals to compare prices among different dental providers. Participation is mandatory for any dental care provider that receives public funding. The website will, according to the government, contribute to increased competition among providers.

Sweden Newsletter Article

Dental services are only partly subsidized by the Swedish state and are often very expensive to access. To address this, the Swedish government recently commissioned the Dental and Pharmaceutical Benefits Agency (TLV) to develop a comparative website for dental care prices. TLV is working with several national agencies, as well as private and public organizations, as part of the project.

Show Link Improving Health Care Quality

Sweden Adds Incentives to Improve Care Coordination for Elderly People with Dementia and Multimorbidity

0 min read

Correspondent:  Ulrika Winblad

Provider compliance with the so-called coordination law adopted by the Swedish Parliament in 2018 has so far been inconsistent. The law stipulates that a “coordinating care plan” must be arranged for patients with health and social care needs. The Swedish government has now put in place financial incentives to encourage adherence to the law. SEK 10 million (USD 1.1 million) has been awarded to the Swedish Association of Local Authorities and Regions to facilitate implementation among providers. The additional funding will be used to develop a quality registry on care coordination for the elderly and to disseminate information on how to design coordinating care plans.

Sweden Newsletter Article

Provider compliance with the so-called coordination law adopted by the Swedish Parliament in 2018 has so far been inconsistent. The law stipulates that a “coordinating care plan” must be arranged for patients with health and social care needs.

Show Link Improving Health Care Quality
Switzerland

Switzerland Moves Forward with Electronic Patient Records

0 min read

Country Correspondent:  Lars Hemkens

The Electronic Patient Dossier (EPD) is a personal health record that collates treatment-related documents, including information on prescriptions, vaccinations, and hospital discharge reports. In August, the University Hospital in Basel was the first in the German-speaking part of the country to open its first EPD. Starting in 2020, all hospitals in Switzerland will be required to offer EPDs to their patients. Information on patient visits and treatments can be registered in the EPD only by approved health care providers and patients themselves. Patients must grant each provider access to their EPD, at one of three access levels.

Switzerland Newsletter Article

The Electronic Patient Dossier (EPD) is a personal health record that collates treatment-related documents, including information on prescriptions, vaccinations, and hospital discharge reports. In August, the University Hospital in Basel was the first in the German-speaking part of the country to open its first EPD.

Show Link Improving Health Care Quality

Swiss Federal Council Seeks Easier Access to Medical Cannabis and Research on Recreational Drug Use

0 min read

The Swiss Federal Council aims to adapt current regulations on cannabis use to better address opportunities and risks. The council aims to facilitate access to medicinal cannabis for patients in need — for example, in palliative care situations — and intends to reduce barriers to further research on recreational use.

Switzerland Newsletter Article

The Swiss Federal Council aims to adapt current regulations on cannabis use to better address opportunities and risks. The council aims to facilitate access to medicinal cannabis for patients in need — for example, in palliative care situations — and intends to reduce barriers to further research on recreational use.

Show Link Improving Health Care Quality
United Kingdom

Hancock Replaces Hunt as Health and Social Care Secretary, Pledges to Focus on Health Technology

0 min read

Matt Hancock has replaced Jeremy Hunt as Secretary of Health and Social Care. The previous culture secretary took on the role following Hunt’s move to the Foreign Office. Hancock has pledged to accelerate digital transformation within the National Health Service (NHS). Acknowledging his passion for technology, Hancock believes that more strategic and prolific use of health technology will enable the NHS to deliver more timely care that is better tailored to patients’ needs.

Newsletter Article

Matt Hancock has replaced Jeremy Hunt as Secretary of Health and Social Care. The previous culture secretary took on the role following Hunt’s move to the Foreign Office. Hancock has pledged to accelerate digital transformation within the National Health Service.

Show Link Controlling Health Care Costs

NHS England Review of the NHS Quality and Outcomes Framework Suggests Need for Change

0 min read

Launched in 2004, the National Health Service (NHS) Quality and Outcomes Framework (QOF) is one of the world’s longest-running and most extensive pay-for-performance reimbursement mechanisms. As part of the 2017–18 contract negotiations with the General Practitioners Committee of the British Medical Association, a review was agreed upon and included in a report titled Next Steps on the NHS Five Year Forward View. The report states that while the QOF’s impact on patient outcomes has been limited, there have been many gains in the organization of long-term care management and the development of the data infrastructure across primary care. The review identifies ways in which the QOF program needs to evolve to provide more holistic patient-centered care to meet the needs of increasingly complex patients and primary care physicians going forward.

Newsletter Article

Launched in 2004, the National Health Service Quality and Outcomes Framework is one of the world’s longest-running and most extensive pay-for-performance reimbursement mechanisms. As part of the 2017–18 contract negotiations with the General Practitioners Committee of the British Medical Association, a review was agreed upon and included in a report titled Next Steps on the NHS Five Year Forward View.

Show Link Improving Health Care Quality

Newsletter Editorial Team and Country Correspondents for 2019, No. 1

0 min read

Editorial Team

Roosa Tikkanen, Editor

Aisha Gomez, Project Manager

Molly FitzGerald, Coeditor

Country Correspondents

Australia — Sonĵ Hall

Canada — Danielle Rodin

France — Paul Dourgnon

Germany — Michael Laxy

Netherlands — Marthe Haverkamp

New Zealand — Jennifer Moore

Norway — Marianne Storm

Sweden — Ulrika Winblad

Switzerland — Lars Hemkens

United Kingdom — Partha Das

Newsletter Article

Editorial Team

Roosa Tikkanen: Editor, Aisha Gomez: Project Manager, Molly FitzGerald: Coeditor

Country Correspondents

Australia: Sonĵ Hall, Canada: Danielle Rodin, France: Paul Dourgnon, Germany: Michael Laxy, Netherlands: Marthe Haverkamp, New Zealand: Jennifer Moore, Norway: Marianne Storm, Sweden: Ulrika Winblad, Switzerland: Lars Hemkens, United Kingdom: Partha Das

Show Link Improving Health Care Quality
Contributors

International Health News Brief Contributors

0 min read

Editor: Roosa Tikkanen

Co-editor: Molly Fitzgerald

Project manager: Aisha Gomez

Country Correspondents: Sonĵ Hall (Australia), Danielle Rodin (Canada), Paul Dourgnon (France), Michael Laxy (Germany), Marthe Haverkamp (Netherlands), Marianne Storm (Norway), Lars Hemkens (Switzerland), Jennifer Schulz Moore (New Zealand), Partha Das (United Kingdom), Roosa Tikkanen (Europe/International

Newsletter Article Show Link Improving Health Care Quality
Commonwealth Fund International Health News Brief: 2019, No. 1