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Archive for December, 2011




Media Partnership: Hear Top Policymakers At AcademyHealth’s NHPC


December 30th, 2011

What will the Obama Administration’s health policy priorities be in 2012? What ideas will be highest on the agendas of the two parties in Congress? You can hear the answers to these questions February 13-14 in Washington D.C. at the 2012 National Health Policy Conference. The NHPC will include presentations from Health and Human Services […]

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Pioneer ACOs: Promise And Potential Pitfalls


December 29th, 2011

Editor’s note: See additional posts discussing Pioneer accountable care organizations by Debra Ness and William Kramer and Douglas Hastings. The December 19 announcement by the Centers for Medicare and Medicaid Services (CMS) of 32 Medicare Pioneer ACOs underscores the transition of “shared savings” and “accountable care” from policy concepts to implementation. Perhaps more than any […]

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Holiday Potpourri: Foundation Blog Posts on Health Reform, Use of HIT by Safety-Net Providers, and More


December 28th, 2011

In combing through a number of foundation blogs that I follow (as time permits), I found these recent posts, which you may find relevant to your work. The topics covered by these writings range from oral health to the Gates Foundation’s interactions with grantees and on topics from mental health to HIV/AIDS prevention. Bloggers include […]

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CMS’s Essential Benefits Guidance: Brush-Clearing Or Can-Kicking?


December 28th, 2011

The recent CMS bulletin on the essential benefits package (EBP) required for certain types of coverage under the Affordable Care Act has been described in greater detail in earlier Health Affairs Blog posts by Tim Jost and Kavita Patel.  The bulletin is a pragmatic document, seemingly driven by the overall exigency of implementing the ACA […]

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Essential Health Benefits: Policy Considerations


December 28th, 2011

In the recently released bulletin from HHS on the essential health benefits (EHB), the administration answered a major question on the minds of many critical healthcare stakeholders: Will the administration be specific in their guidance and create a definition of what constitutes “essential?”  The answer, is no, they will leave the bulk of the decision-making […]

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Pioneer ACOs: Moving Toward Needed Transformation In Health Care


December 27th, 2011

Editor’s note: See additional posts discussing Pioneer accountable care organizations by Steven Lieberman and Douglas Hastings. We have commended the Centers for Medicare and Medicaid Services (CMS) on this blog in the past for actions regarding Accountable Care Organizations (ACOs) – but we’ve also noted the need to establish strong enough criteria to ensure that […]

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Health Affairs Request For Abstracts: Payment Reform


December 23rd, 2011

Health Affairs plans a thematic issue in 2012 on trends and developments in payment reform. We will consider papers that cover a variety of perspectives on this topic, including: overview papers that explore historical trends and environmental factors that have shaped these trends; economic, political, and policy analyses that lay out the prospects and motivation […]

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Media Partnership: 2012 Accountable Care & Health IT Summit


December 23rd, 2011

Across the country, competition is emerging to establish leadership around new care delivery systems and the formation of different types of ACOs.  At the center of any accountable care strategy is the requirement to plan and implement the data sharing and analytics platforms that will enable the improved workflow and care coordination as well as support new […]

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Health Affairs Briefing: Confronting The Growing Diabetes Crisis


December 23rd, 2011

On Tuesday, January 10, Health Affairs will release its January 2012 issue, “Confronting the Growing Diabetes Crisis.” The volume explores the challenges that the increase in prevalence of prediabetes and diabetes represents for public health and health care systems in the United States and internationally. A particular focus of the issue is opportunities for diabetes […]

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Pioneer ACOs: Another Step In The Right Direction


December 22nd, 2011

Editor’s note: See additional posts discussing Pioneer accountable care organizations by Steven Lieberman and Debra Ness and William Kramer. With the announcement by the Centers for Medicare and Medicaid Services on December 19 of the Pioneer accountable care organization (ACO) model participants, CMS and its Centers for Medicare and Medicaid Innovation (CMMI) conclude a year […]

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Foundation Efforts to Meet the Demand for Primary Care


December 22nd, 2011

Foundations are funding efforts to inform policy makers and others about the status of primary care, to expand access to primary care, and more. The latest issue of Health Affairs contains a sampling of what philanthropy is doing. In case you missed it, read “Foundation Efforts to Meet Demand for Primary Care,” the GrantWatch column […]

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New Obesity Counseling Coverage Can Help Patients And Taxpayers


December 21st, 2011

With primary care medicine facing ever increasing pressures—fewer doctors to treat more patients and a continual maze of restrictions on reimbursement—primary care practitioners are trying to diagnose and treat obesity with one hand tied behind their backs. The result, unfortunately, is that for what is likely the nation’s costliest disease, strains on coverage have been […]

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Narrative Matters: Drug Company Payments To Physicians


December 20th, 2011

In the December Health Affairs Narrative Matters essay, multiple sclerosis patient Maran Wolston describes how she lost trust in her physician when she found out he was receiving payments from drug companies. Wolston says she was fortunate to be able to look up these payments in a Minnesota state database, and she applauds the establishment of […]

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Patient Medication Adherence: The Next Act


December 19th, 2011

If we’re truly serious about reining in health care costs and improving patient outcomes at the same time, then improving medication adherence is absolutely key. And if we’re serious about improving medication adherence, then the time to strike is now. That’s because there are major opportunities in health reform and major trends in the health […]

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Implementing Health Reform: A Bulletin On Essential Health Benefits


December 16th, 2011

On December 16, 2011, HHS released a “bulletin” describing the approach that it intends to take to establishing the “essential health benefits” under the Affordable Care Act.  A bulletin is a form of guidance that lacks the legal stature of a rule.  HHS believed, however, that the states, insurers, consumer advocates, and the public needed […]

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Ryan-Wyden And The Origins of Premium Support


December 16th, 2011

Yesterday, House Budget Committee chair Paul Ryan (R-WI) and Sen. Ron Wyden (D-OR) introduced a new “premium support” Medicare reform proposal. Among other features of the plan, beginning in 2022, private plans would compete against the traditional fee-for-service Medicare program on a federally regulated Medicare exchange. Premium support levels would be determined by the cost […]

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Health Policy Brief: The Independent Payment Advisory Board


December 16th, 2011

An important and controversial element of the Affordable Care Act is the Independent Payment Advisory Board (IPAB). Beginning in 2013, the panel will have significant authority to recommend ways to put on the brakes if projected increases in Medicare spending exceed target growth rates. The latest health policy brief from Health Affairs and the Robert […]

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Global Financial Crisis Takes Toll On Health Funding


December 15th, 2011

Between 2002 and 2008, financial and in-kind assistance from public and private channels to improve health in developing countries grew rapidly; for instance, assistance grew by 17 percent between 2007 and 2008. However, a new study from Health Affairs finds that the worldwide economic crisis has taken a toll on health funding.Assistance for health grew […]

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Freeing the Data: A Revolution to Improve Health Care


December 15th, 2011

GrantWatch Blog invited Sandra Shewry, the California HealthCare Foundation’s director of state health policy, to report on an event held recently in Sacramento, California. Those working in state health agencies and foundations should be interested in this report.    Like a visiting football coach brought in to invigorate the local team, Todd Park, chief technology officer for […]

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The States’ Medicaid ‘Coercion’ Claim: More Rhetoric Than Fact


December 14th, 2011

Among the issues on which the United States Supreme Court has agreed to hear oral arguments in the Affordable Care Act cases is the question of whether its minimum Medicaid coverage requirements are constitutional. The states have based their appeal on a legal theory known as the “coercion doctrine.”  Citing a long history of precedents, […]

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