In my first post, I described the major features and basic approach of HR 3962, as well as the provisions of the bill that would go into effect more or less immediately.  This post will look more closely at some of the bill’s basic insurance reform elements.  In a final post, I will discuss the [...]

HR 3962, the Affordable Health Care for Americans Act, hit the House floor with a thud Thursday morning at 1990 pages, almost double the size of the bill we last saw before the Energy and Commerce hearings at the end of July.  The bill incorporates, of course, amendments from the House jurisdictional committees, but also [...]

Editor’s note: Health Affairs Founding Editor John Iglehart recently interviewed American Hospital Association CEO Rich Umbdenstock. The wide-ranging conversation, transcribed below, touched on the ongoing health reform debate, the evolving role of hospitals in community health, the effect of the economy on hospital finances, the evolution of integrated medicine, patient safety, workforce concerns, and other [...]

Preventing and more effectively managing chronic illness are critical national health priorities. Patients with chronic disease currently account for three-quarters of overall health spending. Multiple morbidities are common: More than half of Medicare beneficiaries are treated for five or more chronic conditions yearly. Nine chronic ailments account for nearly 60% of the recent rise in [...]

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 [...]

Editor’s Note: The post below argues that accountable care organizations (ACOs) represent a critical step away from volume-driven health care payment and toward better health and better care at lower cost. In addition to Aaron McKethan and Mark McClellan of the Engelberg Center for Health Reform at the Brookings Institution (pictures and bios above), the post is coauthored [...]

Editor’s Note: In the post below, Jeff Goldsmith argues that the concept of accountable care organizations (ACOs) is “not ready for prime time.” In a response, Aaron McKethan, Mark McClellan, Elliott Fisher, and Jonathan Skinner state that ACOs represent a critical step away from volume-based health care payment and toward better health and better care at lower cost.
Everyone [...]

The “public plan” is today’s ultimate Rorschach test; different observers may see very different perspectives.  Particularly when the advocates leave loose ends, their opponents weave those untied threads as they will.  Nobody’s on firm ground so no concrete debate is possible.  Lots of smoke, hardly any light. 
It seems that there are some simpler clarifying questions [...]

As President Barack Obama and his allies press their case for health care reform, the president exhorts that his vision will slow the growth of medical expenditures, expand coverage to millions, and improve the quality of care.  In the trenches, where millions of medical interventions occur daily, physicians and hospital managers who do the heavy lifting describe a [...]

Editor’s Note: In the post below, Uwe Reinhardt proposes to move from the present, price-discriminatory system of private-sector pricing of health services toward an all-payer system that could serve as a transition to an eventual system based on bundled payments per episode of illness for acute care, or capitation for chronic care.
In a response to Reinhardt’s [...]

Editor’s Note: The Centers for Medicare and Medicaid Services has been deprived of needed resources and authority by Congresses and Presidents of both parties, former CMS acting director Kerry Weems said in a recent Health Affairs interview with the journal’s founding editor, John Iglehart. To follow up on this interview, the Health Affairs Blog convened [...]

Editor’s Note: The Centers for Medicare and Medicaid Services has been deprived of needed resources and authority by Congresses and Presidents of both parties, former CMS acting director Kerry Weems said in a recent Health Affairs interview with the journal’s founding editor, John Iglehart. To follow up on this interview, the Health Affairs Blog convened [...]

Editor’s Note: In a recent Health Affairs essay titled “What ‘Patient-Centered’ Should Mean: Confessions Of An Extremist,” Don Berwick surveyed the debate in the health policy community over how the principle of “patient-centeredness” should be defined and implemented. He argued for “a radical transfer of power and a bolder meaning of ‘patient-centered care,’ whether in [...]

Editor’s Note: Dr. Patchin wrote the blog post below in her official capacity as Chair of the Board of Trustees of the American Medical Association.
Health Affairs recently published an interview with Kerry Weems, former acting administrator of the Centers for Medicare and Medicaid Services. In the interview, inaccurate statements were made about the role of the [...]

Editor’s Note: Below is the transcript of a Health Affairs Blog Roundtable on Atul Gawande’s New Yorker article on McAllen, Texas, and variations in health care costs. The roundtable used the article as a jumping-off point for a wide-ranging discussion on the policy implications of cost variations, delivery system reform, and other topics. Participants included Robert [...]

Federal support for graduate medical education (GME) training positions has been capped for more than a decade and it is no secret that the country’s teaching hospitals are restive. They want “more cap.” A number of bills have been introduced in the House and Senate proposing an increase in the Medicare funded GME cap by [...]

Last week’s New Yorker article by Atul Gawande highlighted the phenomenally high variations in cost of medical care and services between regions in the United States, specifically focusing on McAllen, Texas. Gawande’s spotlight on McAllen was based on many studies of our health care system. For Gawande’s readers, we would like to point you to [...]

The recent confusion surrounding the health care industry’s statement about reducing the growth in health care costs by 1.5 percentage points annually — it is a goal, the industry clarified, not a year-by-year target — underscores the need to put mechanisms in place to ensure that the industry’s spending growth target is met. Nonetheless, I [...]

Health Affairs and the Robert Wood Johnson Foundation (RWJF) are pleased to announce a new series of Health Policy Briefs aimed at providing clear, accessible overviews of timely and important health policy topics. The first brief explores the current debate over cutting payments to “Medicare Advantage” plans – the privately run health plans that now [...]

Health reform tops the most-read list for April on the Health Affairs Blog. A series of posts on health IT looked at building the new technology into the delivery system, effect on patient-physician relationships, and more. Additional commenting is always welcome.

No Direction Home: A Primary Care Physician Questions The Medical Home Model by Caroline Poplin
Health [...]