Dan Gorenstein: As the pandemic recedes and summer arrives, many of us are eager to get away from work and finally take a vacation.

How are health economists celebrating the start of summer?

Clip: Good morning, and welcome to the 2021 Annual Research Meeting.

DG: With back-to-back health policy conferences.

SFX: Party noise maker

DG: Today, get your fanny packs and T-shirts ready because we’re hopping on the tour bus for a behind-the-scenes look at what happens when a few thousand health policy experts get together.

From the studio at the Leonard Davis Institute at the University of Pennsylvania, I’m Dan Gorenstein, and this is Tradeoffs.

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DG (on CB radio): Hello and welcome to Tradeoffs Tours, your number one choice for all your health policy vacation, road trips, day trips and overnight excursions. 

Today’s tour is our Classic Conferences Tour. If you’re here for the All Night Aducanumab Tour, that’s next week.

I’m your guide, Dan the Driver. I’ve attended my fair share of health policy conferences, but to help me out and offer you a true insider’s view, we have a very special guest tour guide today. And I’ll let her introduce herself.

Kosali Simon: Hi, I am Kosali Simon, I’m a health economist at Indiana University. I really enjoy these conferences, and I am excited to go on this bus tour with you guys.

DG (on CB radio): You know what…

DG (off CB radio): Can y’all hear me in the back if I don’t use this thing?

Rider: Yeah! … (whisper) unfortunately. 

DG: Okay, great.

Do you know, Kosali, what was the first year you attended a conference, a health policy conference?

KS: It was in the mid-to-late ’90s, as a graduate student. It’s very scary to go and feeling like, well, I don’t really belong here. I’m just kind of looking from outside. Gradually, you know, it becomes like a venue of friends meeting often because you’ve gotten to know people. It becomes a lot more fun over time.

DG: Okay, it looks like we’ve got everybody on board, so we’re going to roll out now.

SFX: Horn

DG: I love that goofy horn.

Today we’re going to be visiting AcademyHealth’s Annual Research Meeting and the American Society of Health Economists Conference, better known as ASHEcon.

AcademyHealth is the biggie. It covers everything health policy, and you’re just as likely to see doctors, nurses, legislative staffers and regulators as you are academics.

ASHEcon on the other hand is a little smaller because it’s much more focused on health economics. But still a hot ticket.

The bread and butter of both conferences is researchers sharing early versions of their work.

Rider: Excuse me, excuse me, Driver Dan?

DG: Yes?

Rider: Do you know how many papers are going to be presented at the two conferences?

DG: 2,121.

Rider: Woah, that’s so many!

DG: Close your mouth, kid. But I am with you, that is a lot of papers.

Thankfully, Kosali, you’ve helped chart a course taking us past a few of the abstracts you’re most excited about.

And look, we’re here, pulling up to our first cite — c-i-t-e. Little research humor for you there.

RL: Don’t quit your day job, Driver Dan!

DG: Anyway, this first one is from AcademyHealth, and it’s about assisted living residents during COVID. Tell us more about it, Kosali. 

KS: There’s been a lot written about nursing homes, but not about assisted living facilities, even though they’re very similar in many regards. What this research shows is that there has been in 2020 much higher rates of mortality there, too. So every policy that has targeted nursing homes should have been thinking about assisted living facilities, too. And this is good to know for anything that happens in the future.

DG: Alrighty, back on the road we go. 

SFX: Horn

DG: Now, Kosali, I get why these conferences are exciting and useful for health policy people like you.

But why should people who will probably never set foot in a health policy conference care about what happens at these events?

KS: We are often asked to weigh in on health policy questions by industry, by lawmakers, regulators, state agencies. And we’re not just going to talk about studies we’ve done. We want to talk about things we’ve heard, and conference venues give us a sense of what is the consensus in this area. So it really helps in this policy translation work we do. Also, great ideas get developed initially at these conferences. You know, there have been so many of those types of conversations when I think about how did that paper start, it’s because of a discussion at a conference.

DG: When we come back, Kosali talks dorm rooms, boats and babies, plus more research she’s excited for at this year’s conferences.

BREAK

DG: Welcome back to our Classic Conferences Tour.

I’m Driver Dan here with our special guest guide Kosali Simon, and one of the things that we’re known for here are Tradeoffs Tours, Kosali, is our behind-the-scenes stories that you will not find on our competitors’ tours. What’s something about these conferences that only insiders like you know about and would surprise the rest of us?

KS: Well, here’s something people might not know. Some of these conferences, like the ASHEcon conference tries to stay low budget by having venues sometimes at universities. So that means the housing options include dorms.

DG: Shared bathrooms and the whole thing? 

KS: Yeah, just like the good old days.

DG: Keg parties?

KS: Well, you know, the rules on campuses. 

DG: [Laugh]

KS: But after the receptions, things don’t end. There’s an economist who’s known to sometimes come by on a boat to conferences.

DG: Yeah, I’ve heard about that boat and some pretty ridiculous stories. 

You know, Kosali, the Classic Conferences tour is an annual thing we do, and each year there’s a different theme. My personal favorite was the Death Panel Ghost Tour we did a few years ago. 

Obviously COVID, this time around, is a big theme at these conferences, but I’ve also heard that there are a lot of papers about health equity and racial disparities this year. 

And that’s actually our next stop. If everybody looks out the right hand window, Kosali can you describe this ASHEcon abstract you’ve picked out for us?

KS: Yeah, so this paper looks at whether increasing access to SNAP, which is also known as the food stamp program, had an impact on racial health disparities among older Americans. We do know that access to quality food can improve health, and food insecurity is much more common among minority households. But what these researchers found is that while SNAP does improve people’s health among older minorities, it did not lead to a reduction in the disparities in self-reported health. 

DG: So this abstract suggests, and it is just one abstract, that we may need to tweak SNAP if we want SNAP to better address health disparities.

KS: Yes.

DG: Alright we’ve got time for one more stop.

SFX: Horn

DG: Kosali, where do we go?

KS: Let’s go to one of the AcademyHealth sessions, which has a paper on cost reform in Medicare.

DG: That’s going to be coming up on the left hand side of the bus.

Tell us about this one, Kosali.

KS: In 2013, to try to cut health care costs, Medicare rolled out what’s called a two night minimum stay policy that said hospitals will get reimbursed for a patient that’s inpatient only if they are severe enough to need two nights. If you’re not, you should really be seen in a less intensive setting. So researchers look at what happened before and after this policy went into effect. What they find is that hospitals certainly saw a reduction in patients who are admitted inpatient for less than two days. But there is this increase in patients who are in the hospital but are in what’s called observational status.

DG: I remember when this rule came out and there was a lot of hope that this would lead to improving care and lowering costs, and it sounds like you’re saying this paper gets us closer but not quite all the way to figuring out if it’s delivered on that promise. 

KS: Yes, and it’s one of the reasons that attending a session is important because there may be things not just in the abstract, but you want to find out. So tell me, what does this mean bottom line? Is this what will reduce costs or was this only just a cosmetic change and costs are really high? What about patient health? Maybe that’s the next step on these researchers’ agenda.

DG: As we wrap up the tour, Kosali, you told us before that when you first started going to these conferences in the ‘90s, you kind of hid in them back and tried to blend in. After going to these for a couple decades now, what advice would you give to someone who’s going to their first conference this year or next year?

KS: First, you might look at what sessions you want to go to. Also, have a question ready to ask in the Q&A. I also think it’s important to be social. Make plans to meet up with people after the receptions. I also know for a lot of parents with young kids, it’s a tradeoff — do you want to leave your kid home and be at a conference? Some of my fondest memories are actually of bringing my infants to the conference because it made it easier to have that relaxed conversation, right? Everybody wants to come over and say hi when you’re carrying an infant, so, I really encourage people to not be too intimidated by these conferences. People are there to meet new people, hear new ideas, and you’re very much part of it.

DG: Let’s everybody on the bus give a big round of applause for our incredible tour guide, Kosali Simon. Thank you so much, Kosali. 

KS: Thank you very much.

DG: You can find links to both conferences’ full agendas with all 2,121 abstracts on our website, tradeoffs.org.

While you’re there, subscribe to our weekly newsletter where our Research Council will share which abstracts they’re most excited about too.

I’m Driver Dan, and this is Tradeoffs Tours. And remember to watch those moral hazards out there!