Health Affairs

In his post “Why don’t Republicans Have a Vision for Health Reform” (April 2, 2013) John Goodman offers interesting comments on my earlier post “Reflections on The Federal Budget Resolutions” (March 21, 2013). I thank him for the comments.

My post was focused strictly on the vision for U.S. health care that Democrats and Republicans on Capitol Hill now project through the Senate budget resolution and the House budget resolution. Goodman, on the other hand, builds from my post a bridge to the vision some Republicans – including Goodman himself – have in the past projected for U.S. health care.

I can understand why Goodman used the well-known technique of the bridge, because he believes that Republicans currently do not have vision for health care. On this point, however, I beg to differ. There actually is a current Republican vision. It has been expressed through the House budget resolution.

You are invited to join us on Wednesday, April 11, when Health Affairs will hold a briefing to discuss its April 2013 issue, “Triple Aim Goes Global.”

The April issue examines how all high-income countries are struggling to pursue better health, better care, and lower cost – and to bring all of these goals into alignment. The issue received funding support from The Commonwealth Fund, the Nuffield Trust, and Imperial College London.

The briefing will take place at the Barbara Jordan Conference Center at the Kaiser Family Foundation, 1330 G Street, NW, in Washington, DC, on Thursday, April 11, 2013, 8:00 a.m. – 12:30 p.m.

A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation discusses the Multi-State Plan Program created under the Affordable Care Act. Under the program, at least two health insurance plans choosing to participate will offer coverage through every state-run, federally facilitated, and partnership exchange created under the law. Insurance companies meeting the eligibility criteria have until March 29, 2013, to submit applications to participate in 2014.

The program was created to enhance competition among health plans within the new exchanges. It will be administered by the federal Office of Personnel Management, or OPM, which also administers the Federal Employees Health Benefits program offering coverage through a variety of health plans.

A Health Affairs Web First article released today describes the new rapid-cycle approach to program evaluation at the recently established Center for Medicare and Medicaid Innovation. The Affordable Care Act created the Innovation Center within the Centers for Medicare and Medicaid Services (CMS) to test payments and service delivery models, reduce costs in Medicare and Medicaid, and improve quality.

As the Innovation Center moves ahead with innovative payment and service delivery models, the Rapid Cycle Evaluation Group at the center delivers frequent feedback to providers while evaluating the outcomes of each model tested. When a model is considered for testing, staff from the Rapid Cycle Evaluation Group and CMS’ Office of the Actuary are immediately assigned to help create the model. The Office of the Actuary provides timely and impartial actuarial, economic, and statistical estimates–and monitors Innovation Center initiatives once testing has begun. This group’s rigorous and speedy assessment and evaluation is driven by performance metrics and robust new methodologies.

Researchers from the evaluation group have also been organized into “affinity groups” and use CMS data to answer critical policy questions that may shape future payment and service delivery models. The Innovation Center also plans to identify and promote population health metrics–measures of the functional status, healthy behavior, and health outcomes of a population–to promote disease prevention and achieve a more accountable, equitable, and coordinated health care system. All these efforts will contribute to the Innovation Center’s success in carrying out its mission of improving the quality of care combined with the slowing spending growth.

Editor’s Note: This is the latest in a series of posts by Timothy Jost on the implementation of the Affordable Care Act.  Earlier posts have analyzed some important guidances, as well as provisions governing state waiver requests, student health plans, premium review, medical loss ratios, insurance exchanges, coverage for pre-existing conditions, appeals of coverage denials, coverage for... Read the rest of this entry »

In the December issue, Health Affairs published a series of papers on the effects of self-referral by physicians for imaging services. Princeton economist Uwe Reinhardt spotlighted the set of papers in a Christmas Eve blog post in the New York Times’ Economix blog: A fascinating narrative on how private health insurers and Medicare have both... Read the rest of this entry »

Editor’s Note: This is the latest in a series of posts by Timothy Jost on the implementation of the Affordable Care Act.  Earlier posts analyze provisions governing the medical loss ratio, insurance exchanges, coverage for pre-existing conditions, appeals of coverage denials, coverage for preventive services, a patient bill of rights, grandfathered plans, tax-exempt hospitals, the small employer tax credit, the... Read the rest of this entry »

The busy daytime schedules of office-based primary care doctors, coupled with limited access to primary care services, have led a large number of Americans to seek care in hospital emergency departments, even when the problem may not be an emergency.  According to a new study in the September issue of Health Affairs, more than a quarter... Read the rest of this entry »

As Americans start to understand the concrete benefits contained in the Patient Protection and Affordable Care Act (PPACA), public attitudes about the new law will become more favorable. That at least is what the Obama administration is counting on. The administration has worked to quickly begin some of those benefits – such as a ban... Read the rest of this entry »

The Senate Finance Committee is scheduled to vote today on the nomination of Sherry Glied to be the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services. The President nominated Glied, a professor and chair of the department of Health Policy and Management at Columbia University’s Mailman School of Public... Read the rest of this entry »

Reducing Medicare Part D drug prices requires careful tools, not simply the power to negotiate

Here in DC we’re bracing for the storm of the century — snow storm, that is.  What better time to catch up on some health policy reading? We list here the top 10 most-read posts from January on Health Affairs Blog. Topics cover health reform, health care costs, the mammography guidelines controversy, and more. And... Read the rest of this entry »

We offer readers the annual “top 10″ list of most-read posts from Health Affairs Blog. Health reform topped the list in 2009. If you missed any of these posts, here’s your chance to catch up on your reading. Propaganda And Prejudice Distort The Health Reform Debate by Merton Bernstein Nurse Shortage Eases Under Recession by... Read the rest of this entry »

The January 2010 edition of Health Affairs focuses on long-term services and supports and the challenges of ensuring affordable, high-quality care to people with disabilities, including many of the nation’s aged. The journal has invited key lawmakers and leading experts in aging and health policy to discuss the policies and new approaches needed to address... Read the rest of this entry »

A new policy brief from Health Affairs and the Robert Wood Johnson Foundation explores a key aspect of landmark health reform legislation passed by the House of Representatives: the proposal for a government-run public health insurance plan. The brief lays out details of the plan, including who could enroll, who could receive subsidies to buy... Read the rest of this entry »

Both the new House health reform bill and the Senate Finance Committee bill, despite their best efforts, have to impose some taxes on some taxpayers; they cannot get all of a trillion dollars of subsidies for insurance out of Medicare.  But they differ on what and whom to tax: the House proposes to tax well-off... Read the rest of this entry »

Narrative Matters recently brought together 80 writers, journalists, and academics to celebrate the Tenth Anniversary of Narrative Matters.  There was much to celebrate: over 150 Narratives published in Health Affairs that covered a spectrum of human stories set in the increasingly institutionalized health care system.  We came to celebrate the power of stories and storytelling in the... Read the rest of this entry »

There has been much debate about whether the various health reform bills being debated in Congress contain enough measures to reform the health care delivery system and slow the rate of growth in health care spending. Speaking at the Sept. 9 briefing held to release Health Affairs’ Sept-Oct issue, a thematic volume titled “Bending The... Read the rest of this entry »

Early in President Barack Obama’s speech to Congress about health care reform, he mentioned health care costs as one of the causes of the problem of lack of insurance coverage. But most of the speech focused on what to do about health insurance costs, not health care costs. Changing the rules about how insurance companies operate... Read the rest of this entry »

Health reform proposals and an examination of what’s working to control health care costs dominated the most-read posts on Health Affairs Blog in August. Additional commenting is always welcome. A Modest Proposal On Payment Reform by Uwe Reinhardt Low-Cost Health Quality Care In America by John Iglehart Obesity Spending Estimated at 147 Billion Annually by Chris... Read the rest of this entry »