Health Affairs

Note: This post was edited on September 2 to include descriptions of two Internal Revenue Service (IRS) notices issued on Friday, August 31. The late summer doldrums and the impending election seem to have dampened federal Affordable Care Act regulatory activities.   In late August, HHS announced additional funding for consumer assistance, exchange establishment, and COOP... Read the rest of this entry »

A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation looks at so-called risk adjustment—an approach that will be needed in insurance exchanges scheduled to open in 2014. When the exchanges created under the Affordable Care Act are up and running and millions of Americans are buying coverage through them, some... Read the rest of this entry »

As a former state legislator and foundation CEO, I worry about how the majority opinion of Chief Justice John Roberts on the constitutionality of the Affordable Care Act of 2010 (National Federation of Independent Business v. Sebelius) may affect our approach to prevention programs. Funding environmental health may be the best way to go. In... Read the rest of this entry »

Amenable mortality—deaths that could have been avoided with timely and appropriate health care—accounts for 21 percent of deaths among men and 30 percent among women under the age of 75 in several high-income countries. A Health Affairs Web First study released yesterday compares mortality rates in the Unites States, France, the United Kingdom, and Germany... Read the rest of this entry »

Editor’s note: The post below explains why Maryland has chosen to implement the Affordable Care Act’s Medicaid expansion. Watch Health Affairs Blog for an upcoming post explaining why South Carolina has decided not to implement the expansion. On June 28, 2012, the U.S. Supreme Court upheld virtually all of the coverage provisions of the Affordable... Read the rest of this entry »

Medication use vividly illustrates the paradox of overuse, underuse, and misuse of health care in America. While a growing segment of the population overuses certain medicines — including opioids, central nervous system depressants, and stimulants — other medicines known to deliver clinical value are substantially underutilized by people who could benefit. In one recent study,... Read the rest of this entry »

An August 22 Health Affairs Web First traces the evolution of the health policies of the US Department of Housing and Urban Development (HUD) from the Johnson administration to the Obama administration. The article, by Raphael Bostic of the University of Southern California’s Sol Price School of Public Policy and coauthors, also looks at the... Read the rest of this entry »

Six months to the day after the Centers for Medicare and Medicaid Services (CMS) released the “preliminary rules” for Meaningful Use, the final rules are in.  For clinicians and policymakers who want to see Electronic Health Records (EHRs) play a key role in driving improvements in the healthcare system, there’s a lot to like here.... Read the rest of this entry »

Health care in the United States is changing at a pace not seen since the launch of Medicare. The changes are largely a response to runaway medical costs in our health care delivery system. Our nation spends nearly twice as much per person on health care services than most industrialized countries. Yet, by almost any... Read the rest of this entry »

In July, 2012, the US economy produced roughly the same volume of goods and services as it did five years earlier with five million fewer workers.  Yet, during the first four years of the recession (May 2007 to May 2011), the US health system, despite slowing or declining utilization, added 1.149 million workers.  Key sectors,... Read the rest of this entry »

My GrantWatch column in the August 2012 issue contains a selected sampling of foundation funding on the topic of the health care safety net. Grants awarded include efforts to help safety-net providers, as well as populations who turn to the safety net for their health care. The column is but a small part of the... Read the rest of this entry »

On Friday, September 7, Health Affairs will hold a briefing to unveil its September 2012 issue, “Payment Reform To Achieve Better Health Care.” The volume contains a thorough examination of the present state of and future challenges for payment reform, and includes profiles of current initiatives whose early results indicate some success in achieving the... Read the rest of this entry »

Patient registries collect data for the scientific assessment of patient outcomes for particular conditions, devices, and treatment protocols. The Agency for Healthcare Research and Quality is currently developing a catalog of all such registries around the country. In his August Health Affairs Narrative Matters essay, Kerry O’Connell observes: “I often wonder why, in a country... Read the rest of this entry »

Jaan Sidorov has “A Brainy Health Wonk Review on Health Reform, the Affordable Care Act and Lots More!” over at Disease Management Care Blog. Check out Jaan’s collection of great health policy blogging, including a Health Affairs Blog debate over whether the Affordable Care Act does or does not allow for premium tax credits on... Read the rest of this entry »

A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation analyzes the debate over financing of graduate medical education (GME). In the United States, approximately 115,000 medical school graduates are being trained each year through residencies at more than 1,000 teaching hospitals—with much of the financial support coming from the Centers... Read the rest of this entry »

Two staffers at a Kentucky foundation report on a webinar held in July to address this important question. Today, grantmakers and some government agencies are encouraging public health departments and nonprofit health promotion organizations to “advocate for policy change,” but the line between permitted advocacy and prohibited lobbying is often unclear. The Centers for Disease... Read the rest of this entry »

Twentieth Century Medicare. Medicare, the federal medical and hospital insurance program for seniors and disabled, reflects the popular understanding of medical care 50 years ago:  primarily treatment by doctors of acute episodes such as pneumonia.  Medicare’s design was based on the historical demands of the medical profession for “fee-for-service” (FFS) payment: “free choice of treatment”... Read the rest of this entry »

Since they began in 2000, retail clinics have become a regular fixture in many American pharmacies, supermarkets, and shopping malls. Although some professional medical organizations have spoken out against them, consumers have appreciated the convenience they offer. A new study by Ateev Mehrotra and Judith Lave, released yesterday by Health Affairs as a Web First... Read the rest of this entry »

On August 14, 2012, the Department of Health and Human Services took one step closer to implementation of the Affordable Care Act health insurance exchanges by releasing the final version of its Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges. This document includes the declaration letter and application form which must be... Read the rest of this entry »

Upon receiving the news “you have cancer,” there are many questions that run through a patient’s mind, key among them: Where can I get the best care?  Today, meaningful information to help patients answer this question is lacking.This post is based on remarks that the author made on July 12, in Los Angeles, at the... Read the rest of this entry »