Health Affairs looks at economic trends & quality trade-offs

(Press-News.org) Bethesda, MD – Articles in Health Affairs' October issue examine the pursuit of improved physical and mental health. Featured articles include:

Providing More Home-Delivered Meals Is One Way To Keep Older Adults With Low Care Needs Out Of Nursing Homes. Expanding programs that deliver meals to Medicaid-receiving seniors would save 26 of 48 states money, in addition to allowing more seniors to stay in their own homes, according to a new study in the October issue of Health Affairs. The study by Kali Thomas and Vincent Mor of Brown University projects that if every U.S. state in the lower 48 expanded the number of seniors receiving meals by just 1 percent, 1,722 more Medicaid recipients avoid living in a nursing home and most states would experience a net annual savings from implementing the expansion. Every state would enable more seniors, who could live independently except for meals, to remain in their homes regardless of whether they are on Medicaid.

Biosimilars May Save Billions of Dollars. In Europe, biosimilars (the "second generation" of medicines derived from a biological source) have been available since 2006 within the European Union and are expected to save $15-$44 billion by 2020. The situation in the United States is different: although the Biologics Price Competition and Innovation Act is a key provision of the Affordable Care Act, the Food and Drug Administration has yet to finalize the necessary regulatory processes for their approval. A new study in the October issue of Health Affairs by Francis Megerlin of Université Paris Descartes and co-authors examines the European experience and explains how the U.S. market can learn from it—and eventually realize dramatic discounts to help "bend the cost curve."

The Health and Economic Benefits of "Delayed Aging." Although most medical research focuses on managing or eradicating individual diseases, Dana Goldman of the University of Southern California and co-authors demonstrate the value of an alternative approach to address the underlying biological mechanisms of disease. Using the Future Elderly Model—a simulation of future health and spending of older Americans—the authors compared such an approach with optimistic "disease specific" scenarios, evaluating impact on longevity, disability, and major entitlement program costs. The authors estimate that delayed aging could increase life expectancy by an additional 2.2 years and generate more than $5 trillion in social value. When aging is delayed, say the authors, all fatal and disabling disease risks are also lowered. Although delayed aging would also greatly increase entitlement outlays, the authors demonstrate that these costs can be managed through modest policy changes, such as indexing the eligibility ages for Social Security and Medicare.

On a related topic, an article by Ankur Pandya of Weill Cornell Medical College and co-authors looked at the impact of some of the future risk factors for cardiovascular disease. Using nine National Health and Nutrition Examination Survey waves from 1973 to 2010, the authors forecast disease risk and prevalence from 2015 to 2030. They found that despite continued improvements in the disease's treatment and declining smoking rates, increasing obesity rates, the aging population, and declining mortality from the disease should cause a rise in health care costs, disability, and reductions in the quality of life associated with increased disease prevalence. "Prevention efforts should be intensified," the authors urge, to curb the imminent spike in cardiovascular disease forecasted by their model.

### ABOUT HEALTH AFFAIRS Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at www.healthaffairs.org. The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on END