Health Affairs

On November 8, 2011, the Centers for Medicare & Medicaid Services (CMS) solicited the public for feedback on Medicare’s controversial coverage with evidence development (CED) policy. Although CMS did not finalize the CED policy until 2006, the agency first applied the CED concept in 1995 through a national coverage determination (NCD) on lung volume reduction [...]

Editor’s Note: Below, William Sage analyzes Friday’s federal appellate court decision regarding the Affordable Care Act. See Timothy Jost’s earlier post for more on this decision. On August 12, a divided three-judge panel of the US Court of Appeals for the Eleventh Circuit ruled in State of Florida v. Sibelius that the individual mandate contained [...]

Timothy Jost’s series of posts on proposed new federal rules for state health insurance exchanges leads July’s list of most-read Health Affairs Blog posts. Jon Kingsdale’s article on Massachusetts’ efforts to control health care costs is also featured on the list, as are Jeff Goldsmith’s discussion of the effect of health reform on employer-based health [...]

Section 1001 of the Affordable Care Act establishes women’s preventive health benefits as a new mandatory coverage class for all insurance products sold in the individual and group markets, self insured employer-sponsored health plans, and benchmark plans enrolling newly eligible Medicaid beneficiaries.  In implementing the Act in accordance with the tight deadlines established under the [...]

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: The authors of the post below, Dan Mendelson and Tanisha Carino, also wrote an earlier post on the initial decision of the Centers for Medicare and Medicaid Services to undertake a national coverage review of the cancer drug Provenge. In one of its most anticipated national coverage decisions (NCD), issued on March 30, [...]

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 [...]

If you’re looking for a transformation in health care, look first to America’s cities, towns and communities. That’s where it happens, among local men and women who deliver and receive care, and the employers and consumers who pay for it. That’s why the Robert Wood Johnson Foundation (RWJF) and the U.S. Department of Health and [...]

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 [...]

The world faces a public health crisis: growing numbers of bacteria are becoming resistant to available antibiotics, and there are few new antibiotics in the drug development pipeline. Writing in the September issue of Health Affairs, Aaron Kesselheim and Kevin Outterson propose an innovative approach to this dilemma. Their  proposal is designed to both increase [...]

According to the American College of Gastroenterology, colorectal cancer is currently the third leading cause of cancer-related deaths in the United States. The colonoscopy is considered the “gold standard” for colon cancer detection. However, a new Health Affairs Web First study by researchers from RTI International demonstrates that for screening programs with limited budgets, using fecal [...]

Just over 1 in 4 dollars spent by the Medicare program last year was spent on someone who was in their last year of their life.  This is nothing new–the basic proportion has not changed since it was first noted in the 1970s.  Other nations that spend much less on health care nevertheless spend a similar [...]

It is clear to all informed persons that the nation needs better evidence of what works in health care, and this has propelled comparative effectiveness research (CER) policy developments of late.  However, for a number of—mainly political—reasons, recent Federal legislation separates the process of evidence generation and evidence synthesis from policy processes, e.g. Medicare coverage [...]

Misconceptions and a lack of knowledge have caused many Americans with health insurance to be at odds with policy makers when it comes to embracing the tenets of evidence-based health care. These conclusions, documented by focus groups, interviews, and an online survey, are contained in a Web first article published yesterday in Health Affairs. Kristin Carman of the [...]

A few weeks ago I toured a hospital that had recently adopted computerized physician order entry (CPOE). We visited a patient room on the Med-Surge floor, where a nurse explained what happens in an emergency. Before they adopted CPOE, nurses would run 300 feet down the hall to find the patient’s paper record during a [...]

Editor’s Note: Most health policy analysts believe that better evidence about quality and value, obtained through comparative effectiveness research (CER), can drive better clinical decision making and could potentially slow the rate of growth in health care spending.  But the success of any national CER initiatives will depend on how evidence is developed, whether it [...]

Editor’s Note: In terms of “bending the cost curve,” health-care providers in La Crosse, WI., have clearly demonstrated the ability to deliver high-qualty care for comparatively low costs. La Crosse was one of ten communities featured at a July 21 conference in Washington, D.C. titled “How Do They Do That?  Low-Cost, High-Quality Health Care in [...]

There is widespread agreement that greater investment in information technology (IT) is critical to reforming U.S. health care. The use of such technologies as electronic health record systems, personal health records, e-prescribing, and computerized physician order entry holds the potential for vastly improving care at a reasonable cost. The recently enacted economic stimulus legislation included [...]

With the U.S. tab for health care approaching one dollar out of every five, a key question on the health reform agenda is how to achieve value in health care. Jeanne Lambrew, the new deputy director of the White House Office on Health Reform, spoke this morning to nearly 800 health policy wonks at the [...]

Dr. John E. Wennberg of Dartmouth has earned the prestigious 2008 Gustav O. Lienhard award from the Institute of Medicine for landmark research that has stretched over four decades. By recognizing Wennberg, the IOM paid tribute this week to Wennberg’s leading role in reshaping the U.S. health care system to focus on objective evidence and [...]