Health Affairs

One of the more creative provisions in the American Recovery and Reinvestment Act’s $19 billion health information technology (IT) initiative calls for the creation of “regional extension centers” to “provide technical assistance and disseminate best practices . . . to support and accelerate efforts to adopt, implement, and effectively utilize” health IT. Simply put, the... Read the rest of this entry »

The tea leaves say President Barack Obama will do more than pay lip service to bipartisanship, but they don’t say whether others will follow his example. Health reformers typically genuflect at this altar, and have placed rich offerings on it in anticipation of impending deliberations. Comparative effectiveness research, health information technology (IT), and value-based purchasing... Read the rest of this entry »

We’ll never know what would have happened if Tom Daschle had kept his books in order and become Health and Human Services secretary. He was widely regarded as a promising choice for the secretary’s job and a role as point man on health reform for the Obama administration. What is clearer is the likelihood that... Read the rest of this entry »

No doubt that Teddy Kennedy’s dramatic return to the Capitol on Wednesday and the senatorial smackdown on Medicare that ensued were the stuff of legend. With Kennedy’s vote putting the Senate Democrats over the hump on cloture on S. 3101, nine Republicans who had voted against cloture last week pivoted to produce a potentially veto-proof... Read the rest of this entry »

For the second time in as many weeks, a respected research organization has reported sharp increases in reported difficulties with access to care for insured as well as uninsured patients. Earlier this month, in a study on underinsurance widely reported by national media, Cathy Schoen and colleagues at the Commonwealth Fund found that the share... Read the rest of this entry »

It is no great stretch to allow that “consumers” may have an important role to play in health economics. After all, it was a market response by premium payers that forced the insurance industry to back away from tightly managed care in the late 1990s. Nor is the idea of patient-centered care merely an idealistic... Read the rest of this entry »

From its inception, the Medicare Modernization Act has simmered with the contradictions implicit in its mixed parentage. It is at once the most ambitious new U.S. human welfare program of the millenium; and at the same time a great ragbag of absurdities, from the loopy benefit structure to a wilderness of obscure and convoluted arrangements... Read the rest of this entry »

If you’re just reading the headlines, jobs and the economy have displaced access to affordable health insurance as the electorate’s top domestic concern with six months to go until Election Day. But digging a little deeper into the results of a new poll from the Robert Wood Johnson Foundation, it appears that voters also believe... Read the rest of this entry »

UnitedHealth Group officials may have been laying protective cover for themselves when they attributed poor first-quarter earnings to a sagging economy last week. But that doesn’t mean it isn’t also true, as United said, that business is bad because the company’s products are getting too expensive for a growing number of workers and companies. Coming within... Read the rest of this entry »

It’s been nearly five years since the President’s New Freedom Commission on Mental Health issued its final report. The report affirmed the possibility of recovery and the effectiveness of available treatments for many conditions. But it also warned that many patients never find their way to care and that providers are often unaware of therapies... Read the rest of this entry »

Because the most glaring geographic variations in health care use have been observed in specialty and end-of-life care, policymakers have had trouble coming to terms with the work of John Wennberg and his Dartmouth colleagues. The questions the Dartmouth researchers raise about spending and quality are too disruptive, too threatening. Specialty and end-of-life care are... Read the rest of this entry »

A lot of pipe dreams have been stoked by the seductive notion of “aligning incentives” — a catchphrase of the managed care era that promised better quality and lower costs in one magical bubble. But the divergent interests of patients, payers, and providers are in reality more likely to collide than align, a circumstance that... Read the rest of this entry »

Like a recurring illness, stalemate looms again over the prospects for settling the issue of payment levels to private plans in Medicare, which now exceed the average per beneficiary cost of traditional fee-for-service Medicare by 13 percent, according to the Medicare Payment Advisory Commission. MedPAC recommends eliminating the differential, which funds extra benefits for private-plan... Read the rest of this entry »

The good people in the Office of the Actuary (OA) at the Centers for Medicare and Medicaid Services (CMS) take great pains every year to summarize and explain their health spending forecast without spin or exaggeration. The editors of Health Affairs are perennially grateful to them for taking an approach that helps the journal fulfill... Read the rest of this entry »

A report highlighting the failure of many regional health information exchanges was Health Affairs’ most-read article in December. Then in January, the California HealthCare Foundation (CHCF) published another discouraging assessment on the progress of these collaboratives and of the national infrastructure envisaged in the 2004 presidential order that called for wiring the health system in... Read the rest of this entry »

Two trillion dollars is a lot of money. So when Health Affairs published earlier this week an official estimate of health spending in 2006 that exceeded that amount, it was big news. Media outlets all over the planet picked it up. The journal tallied a record number of pageviews for a single day – more than... Read the rest of this entry »

Galaxies ago, in a decade far, far away, genius entrepreneur Jim Clark launched Healtheon on the premise that one giant Internet portal could unscramble all of health care’s tangled lines of communication, rectify its inefficiencies, and soothe its troubled soul in one brilliant masterstroke. It sounded good. The Internet was young, and people believe what... Read the rest of this entry »

Congressional Budget Office (CBO) director Peter Orszag today continued his assault on the elephant in health policy’s living room, the 2.1 percent “excess cost growth” by which the nation’s total health spending growth has exceeded the growth in gross domestic product (GDP) since 1975. At a reporters’ briefing sponsored by Health Affairs, Orszag unveiled a... Read the rest of this entry »

Just when it looked as if the debate over the State Children’s Health Insurance Program (SCHIP) couldn’t get any more agonizing, some of the same folks who brought us the devastating RAND 55 percent study four years ago are back with the dismal news that children, on average, receive recommended treatment in only 46.5 percent... Read the rest of this entry »

House Democratic leaders last week quietly compromised away the Medicare provisions in their State Children’s Health Insurance Program (SCHIP) reauthorization bill as they hunkered down for a veto fight. Prudently set aside for the moment is the Dems’ aggressive attack on Medicare Advantage (MA) insurance subsidies. Gone also is an intriguing and widely overlooked package... Read the rest of this entry »