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 […]

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 […]

Editor’s Note: This is the last in a series of posts on health and health care disparities that Health Affairs Blog is publishing in conjunction with the new March/April issue of Health Affairs on Disparities: Expanding The Focus, published with support from the Robert Wood Johnson Foundation. Brian Smedley, Richard Epstein, Dora Hughes, and […]

For your Leap Day reading pleasure, we offer here the list of Top 10 most-read Health Affairs Blog Posts of 2007. Next up—Top 10 for January-February 2008. Additional commenting always welcome.

INSURANCE: A Closer Look At HSAs
by Uwe Reinhardt
REFORM: Musings On SiCKO, July 4th, and Visions of America
by Sarah Dine
HEALTH REFORM: Redefining Health Care
by Michael E. […]

Having reviewed the latest report on national health spending in 2006 (Health Affairs, Jan/Feb 2008) from the Centers for Medicare and Medicaid Services (CMS) and Paul Ginsburg’s commentary (“Don’t Break out the Champagne: Continued Slowing of Health Spending Growth Unlikely to Last”), I want to offer a dissenting view. Though I do not have the […]

As patient volumes in hospital emergency departments (EDs) are going up, waiting times to see an ED physician are getting longer, particularly for heart attack patients and those in need of the most immediate attention, according to a study by Harvard Medical School researchers at the Cambridge Health Alliance published today as a Health Affairs […]

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 […]

No–health systems today are still not prepared to handle the risk of a Katrina-level disaster, says one Gulf-area health care provider in an interview published today on Health Affairs’ Web site [2-week free access]. Other news stories today, the second anniversary of the Katrina hurricane, also highlight the long road ahead on the health care front. […]

At least 150 million people worldwide suffer financial catastrophe each year and 100 million are pushed under the poverty level simply because they need to pay for health services, according to new World Health Organization (WHO) research published July 16 in the July/August issue of Health Affairs. The researchers found that countries could reduce the extent of health-related […]

Editor’s Note: Why have so few provider groups undertaken the self-analysis that the Virginia Mason Medical Center (VMMC) entered into through its use of the famed Toyota Production System, even before Aetna and large employers began to push VMMC to cut costs? This is just one question posed by James C. Robinson, Berkeley economist and […]

How prepared are U.S. hospital emergency rooms to handle a public health emergency stemming from natural disaster or pandemic? According to witnesses and Members of Congress at a hearing of the House Oversight and Government Reform Committee last Friday—not very. Rep. Elijah Cummings (D-MD), who chaired the hearing, said in his opening statement:
“Last summer, Congress […]

This week’s Health Wonk Review is now up featuring highlights from the health policy blogosphere. Bob Laszewski of the Health Care Policy and Marketplace Review blog hosts a lively edition and shows how the same data (from Jerry Anderson’s new Health Affairs paper on hospital pricing trends for the uninsured) can be viewed very differently. Bob also […]

Uninsured patients are billed on average 2.5 times more than insured patients and 3 times more than Medicare patients for hospital care, according to a new study published in Health Affairs. Professor Gerard F. Anderson of the Johns Hopkins Bloomberg School of Public Health writes: “Fifty years ago the poor and uninsured were often charged […]

Old hands in Washington are getting a here-we-go-again feeling about health care these days. Candidates and polls are pushing reform toward the top of the nation’s agenda. Many states are on the march. Realism occasionally rears its head in the right places: Controlling cost growth seems to be recognized increasingly as a priority of the […]

It’s Health Wonk Review week! Oh, and the State of the Union was delivered, too. Even though the deadline for entries to this edition of the best of health policy blogging was 9 am the morning after, many bloggers were already debating the president’s foray into health reform.
The President’s plan. Robert Laszewski on the new Health […]

Elliott Fisher and colleagues in their provocative paper published online December 5 validated an approach to quantifying the clinical and economic performance of physician communities clustered statistically around hospitals. Fisher describes the so-called extended hospital medical staff as “hospital-associated multispecialty group practices” or “virtual organizations.” While some physician markets do indeed function as “communities,” with […]

Relations between hospitals and physicians are broken. Can they be improved by lodging accountability for cost and quality in delivery systems consisting of local hospitals and the physicians who work within and around them?
Extended hospital medical staff. The prospects for these still mostly virtual systems –- dubbed “extended hospital medical staffs” by Dartmouth professor of […]

On Wednesday, Dec. 6, Health Affairs hosted a conference call among the authors of the primary papers in its Dec. 5 Web Exclusive package on hospital-physician relations:
Chris Fleming (communications manager, Health Affairs): You all wrote very interesting papers for our package on hospital-physician relations, and I thought I would start things out by just asking, […]

While about one-quarter of physicians were using an electronic health record (EHR) as of 2005, fewer than one in ten physicians were using EHRs with functionalities such as electronic prescribing, researchers say in a Health Affairs article published yesterday [2-week free access] online and reported in today’s Washington Post.