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Archive for February, 2012




Helping Consumers Choose Health Plans In Exchanges: Best Practice Recommendations


February 29th, 2012

The Health Insurance Exchanges required under the Patient Protection and Affordable Care Act (ACA) have the potential to create markets that will help millions of Americans get affordable health insurance coverage and access to high-quality care. The exchanges can enhance consumer and employer buying power to improve the overall quality and efficiency of the health […]

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Sustaining and Extending Health Care Reform: Perspectives on the ACA from California


February 28th, 2012

GrantWatch Blog invited E. Richard Brown, a professor at the University of California, Los Angeles, School of Public Health, to report some highlights from a February symposium on health reform. “Health care reform is not self-implementing,” said Peter Long, president and chief executive officer (CEO) of the Blue Shield of California Foundation, as he led […]

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Actuarial Value: Why It Matters And How It Will Work


February 28th, 2012

On February 24, 2012, the Department of Health and Human Services (HHS) released guidance describing a proposed method for estimating the actuarial value of health plan benefit designs in 2014.  The actuarial value measures the percentage of expected medical costs that a health plan will cover. It can be considered a general summary measure of […]

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Media Partnership: AHIP Summit On Payment And Delivery Reform


February 28th, 2012

AHIP’s Summit on Payment Reform and Delivery Transformation, March 5 in Washington, D.C., spotlights efforts across the country to transform the payment system and care delivery. The Summit showcases initiatives where providers and health plans are partnering with success. The sessions will demonstrate the many lessons learned from these partnerships including gaining provider buy-in, governance […]

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FDA’s Draft Biosimilar Guidance: A Good First Step


February 27th, 2012

A key component of the Patient Protection and Affordable Care Act (PPACA) of 2010 has just been released with little fanfare. One of the most significant provisions in the law gives the Food and Drug Administration (FDA) the authority to regulate biosimilars, which are attempts to replicate some of the most complex medicines known as […]

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Dentzer To Moderate PCORI Event; Still Time To Comment On Research Agenda


February 24th, 2012

The Patient-Centered Outcomes Research Institute (PCORI) will hold a National Patient and Stakeholder Dialogue on its first draft National Priorities for Research and Research Agenda on Monday, February 27, 2012, from 9:30 a.m.-5:00 p.m. EST, at the National Press Club in Washington, D.C. The event’s agenda will feature panel discussions moderated by Health Affairs Editor-in-Chief […]

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The Stage 2 Meaningful Use Of EHRs Proposed Rules: No Surprises


February 24th, 2012

Editor’s note: For more on the Stage 2 proposed rules defining meaningful use of electronic health records, see Larry Wolf’s Health Affairs Blog post. Late in the day on February 23, 2012, the Centers for Medicare and Medicaid Services (CMS) released the preliminary rules for Stage 2 Meaningful Use.  For those not deep in the […]

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Saving Medicare Dollars: Moving From The SGR To Bundled Payments


February 24th, 2012

Editor’s note:  The ideas expressed in this post draw on the “IPAB Working Group,” a panel of health care experts supported by Pfizer and charged with identifying strategies the Independent Payment Advisory Board might use to lower Medicare spending. Though many of the ideas that follow stem from that meeting, the authors take sole responsibility […]

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Challenging the Policy of Disdain for Chronically Homeless People


February 24th, 2012

Foundations should provide leadership in programming and advocacy for this population. In the early 1990s, there was a movie entitled Dave. Kevin Kline stars in it as the head of an employment agency who happens to look exactly like the president of the United States. When the president has an incapacitating stroke as he cheats […]

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Implementing Health Reform: State Innovation And Medicaid Waivers


February 23rd, 2012

On February 22, 2012, the Department of Health and Human Services (HHS) issued two final regulations implementing sections of the Affordable Care Act (ACA). The two regulations effectuate 1) an ACA provision that will offer the states flexibility in implementing key ACA requirements beginning in 2017, and 2) an ACA amendment to a section of […]

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Supreme Court Ducks Question Of Right To Sue States On Medicaid Cuts


February 23rd, 2012

Although public and media attention has been focused on the Affordable Care Act litigation pending in the Supreme Court, the Court’s February 22 decision in Douglas v. Independent Living Center is also of great importance.  The decision involved lawsuits brought by Medicaid providers and recipients claiming that California Medicaid payment cuts violated federal law. Medicaid […]

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Meaningful Use Of EHRs Stage 2: What To Expect In The Proposed Rules


February 23rd, 2012

Editor’s note: For more on the Stage 2 proposed rules defining meaningful use of electronic health records, see Ashish Jha’s Health Affairs Blog post. There will be many blogs and news reports, on Health Affairs Blog and elsewhere, about the very-soon-to-be-released Stage 2 proposed rules on the Meaningful Use of electronic health records (EHRs). This […]

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The Graduate Medical Education Debate


February 22nd, 2012

Now that everyone in government is aggressively looking for cost savings, graduate medical education is again in the crosshairs. Just Google “Medicare and GME funding,” and you will see a number of educated (and uneducated) pundits opining on the pros and cons of the current system of financing. Medicare has recognized the costs of training […]

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The Latest Health Wonk Review


February 22nd, 2012

If you haven’t already, take a look at the latest Health Wonk Review posted last week at the Healthcare Economist. Jason Shafrin presents a stellar line-up of health policy blogging. He includes Tim Jost’s Health Affairs Blog post on the Supreme Court briefs filed by the states challenging the Affordable Care Act; Tim examines the […]

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The Melody Of Quality Measures: Harmonize And Standardize


February 21st, 2012

With unsustainably high costs and tremendous gaps in quality and patient safety, the health care system is ripe with opportunities for improvement. For years, many have seen quality measurement as a means to drive needed change. Private and public payers, public health departments, and independent accreditation organizations have asked health care providers to report on […]

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Where Has All the Grant Money Awarded Gone? How Grantors Tell Us Their Post-Grant Stories


February 21st, 2012

In this post, an observer of foundations who writes from Oregon offers some suggestions of how funders could improve their communications about results of grants. Ever wonder who gets grants and what those grants have funded? It is often surprisingly hard to find out. And it is even more surprising, given the importance for grant […]

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Implementing Health Reform: Essential Health Benefits And Medical Loss Ratios


February 18th, 2012

On December 16, 2011, the Department of Health and Human Services issued a bulletin describing the approach that it intended to take to defining the essential health benefits (EHB) that individual (nongroup) and small group plans must cover under the Affordable Care Act.  In that bulletin, HHS indicated that each state will select a benchmark […]

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ACOs And Inequity: Lessons From No Child Left Behind


February 17th, 2012

The Centers for Medicare & Medicaid Services (CMS) recently announced that 32 health care organizations from around the country had signed on to the new Pioneer Accountable Care Organization (ACO) initiative, part of a broader push to incentivize ACOs in the Affordable Care act. ACOs provide financial incentives for healthcare teams—including primary care physicians, specialists, […]

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Assessments Of Community Health Centers As Medical Homes May Be Flawed


February 16th, 2012

One of the initiatives in the Affordable Care Act of 2010 is the expansion of community health centers to provide primary care to millions of newly insured, low-income Americans. The same law promotes the patient-centered medical home model. A community center’s qualifications to be classified as a patient-centered medical home are evaluated through an assessment […]

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A Promising Calorie-Cutting Approach: Would You Like To Downsize That?


February 16th, 2012

How do you get people to eat less? Turns out that, for a significant number of people, the answer may be as simple as asking them. That’s the conclusion of a study in the February issue of Health Affairs, by Janet Schwartz of Tulane’s Freeman School of Business and coauthors, that has been receiving a […]

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