Health Affairs

Last Thursday’s Republican Presidential Debate in Florida included a lively, but not always accurate, exchange on health reform in Massachusetts.  In particular, Senator Santorum reported that one in four Massachusetts residents were going without needed care because of high costs; he also implied that the share of residents choosing to pay the fine for failing [...]

Massachusetts’s health reform bill, which provided the template for the federal Affordable Care Act, went into effect in 2006. In a statewide survey taken in 2010, 94.2 percent of the state’s nonelderly (19–64) residents reported being covered, a significant increase over the 86.6 percent estimate of 2006. The survey is reported in a Health Affairs [...]

It was recently reported that a study in the Annals of Internal Medicine found, contrary to expectations, that demands on safety-net providers in Massachusetts have actually increased as a result of moving to a full coverage model.  While the study concludes that patients choose to use safety-net providers because of affordability and convenience, the underlying [...]

Provisions of the Affordable Care Act and other recent legislative changes will transform public substance abuse treatment in the United States, substantially increasing the funding, expanding access to care, and better integrating it with other health services. That’s the conclusion of an article by Jeffrey Buck, senior advisor for behavioral health in the Center for [...]

The women recounted how their lives had been saved as they pleaded for the Food and Drug Administration not to withdraw approval for Avastin as a treatment for advanced breast cancer. They did so even without evidence that it provides benefit and with evidence that it confers risks. Their efforts were ultimately not successful: the [...]

Editor’s note: In addition to Autumn Kieber-Emmons (photo and bio above), this post is coauthored by Tom Bodenheimer and Kevin Grumbach. Bodenheimer is Professor of Family and Community Medicine at University of California, San Francisco. Grumbach is Professor and Chair of the Department of Family and Community Medicine at UCSF and Chief of Family and [...]

Four papers in the newly released July 2011 issue of Health Affairs examine key topics for hospitals, including the extent to which hospitals “cost shift” to private payers; the success of efforts to reduce avoidable rehospitalizations; new responsibilities for hospital boards of trustees as a consequence of the Affordable Care Act; and expanding access to [...]

A new national study of small and medium-size physician practices shows that this group is not using many of the organized care processes of the patient-centered medical home model of health system reform included in the Affordable Care Act of 2010. The study by Diane Rittenhouse of the University of California-San Francisco and coauthors was [...]

With cardiac services contributing 25 to 40 percent of a hospital’s net revenues, do new cardiac surgery programs improve access or exacerbate the duplication of services? To answer this question, the authors of a new Health Affairs Web First article published June 23 examined Medicare claims data to identify where new cardiac surgery programs were [...]

While President Barack Obama and congressional leaders continue to tussle over what to do about the nation’s unsustainable entitlement spending programs, the effects of the Patient Protection and Affordable Care Act (PPACA) seem to have gone largely unnoticed. This oversight is hard to explain. In recent decades, real Medicare spending has been growing at a [...]

With the federal government poised to propose rules governing accountable care organizations, a broad array of public and private health care stakeholders has laid out a consensus on how to use ACOs and patient-centered medical homes to move toward the “triple aim” of better health, better care, and lower costs. The report, Better to Best: [...]

The challenge of reining in the rising costs of the Medicare Program is particularly thorny because it confronts a recalcitrant societal tension between the necessity for cost control and the value of open-ended technology use for life extension in the later years. That tension is becoming more deeply entrenched because a growing number of older [...]

Over the next decade I believe we are going to see a major transformation of American medicine. It won’t be the kind of transformation that is normally discussed at health care conferences and at inside-the-Beltway briefings. Nor will it be the kind of change anticipated by the people who gave us the Affordable Care Act [...]

All eyes are focused on the many state challenges to health reform.  Florida’s recent federal court decision held the entire health reform law unconstitutional, based on the unconstitutionality of the mandate requiring all U.S. citizens to maintain a minimum level of health insurance coverage beginning in 2014, or pay a penalty.  Virginia’s earlier decision severed [...]

The story was tragic. A Tuberculosis patient from India who died because the system which was expected to provide for his treatment failed to deliver… and then the dessert arrived.  The setting? The official dinner of the First Global Symposium on Health Systems Research organized at the Montreux Casino. A photo of the dying TB [...]

Income fluctuations among people who will become eligible for subsidized health insurance under the Affordable Care Act could disrupt coverage for as many as 28 million adults within the first twelve months, as their eligibility shifts between Medicaid and the new state health insurance exchanges, according to a new study published in the February 2011 [...]

In late December, the Food and Drug Administration (FDA) revoked approval of the cancer drug Avastin for metastatic breast cancer. The decision set off a firestorm of reaction: the right condemned the denial of a potential life-saving drug for breast cancer patients, while the left cheered the withdrawal of an expensive drug that seemed to offer little [...]

We may never know the motivations behind the horrific acts in Tucson and whether they could have been prevented. Mental illness, however, has been tentatively identified as a “suspect” in the shootings.   If we are to learn anything from this tragedy, we must look at mental health as a public health issue and give it [...]

When physicians who aren’t radiologists refer patients to imaging facilities they own or lease—known as self-referral—their patients don’t always benefit. In fact, these self-referrals lead to overuse of services, escalate spending, and rarely shorten the duration of illness, according to a series of studies in the December issue of Health Affairs. The findings challenge what [...]

As the United States begins implementing health reform, how does the U.S. experience compare with that of other high-income countries? To answer that question, The Commonwealth Fund conducted its thirteenth annual health policy survey, this year focusing on access, cost, and care experiences. The survey findings were published today in a Health Affairs Web First [...]