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 [...]

“It is well established now that one can in fact improve the quality of health care and reduce the costs at the same time.” That statement by Health Affairs Editor-in-Chief Susan Dentzer summarized the message of a recent event sponsored by the journal, the ABIM Foundation, and the California HealthCare Foundation. The briefing was intended [...]

Two studies, released last week as Health Affairs Web First articles, examine some of the ramifications of the Affordable Care Act. One, by John Sheils and Randall Haught, of the Lewin Group, estimates that if the individual mandate were eliminated, the Affordable Care Act would still cover some 23 million previously uninsured US residents, indicating [...]

Editor’s note: See additional posts on the Medicare Shared Savings Program Final Rule  and related delivery system and payment reform initiatives by Lawrence Casalino and Stephen Shortell,  Douglas Hastings, and Mark McClellan and Elliott Fisher, and Don Berwick and Richard Gilfillan. Last week, the Centers for Medicare and Medicaid Services (CMS) may have done what once [...]

Editor’s Note: There are ongoing legal and policy debates regarding the role of the Relative Value Scale Update Committee (RUC) in advising the Centers for Medicare and Medicaid Services on relative Medicare payment rates for different types of physician services. Below, Brian Klepper and David Kibbe argue for ending the RUC’s role in the Medicare [...]

Editor’s note: See additional posts on the Medicare Shared Savings Program Final Rule  and related delivery system and payment reform initiatives by Debra Ness and William Kramer, Douglas Hastings, Mark McClellan and Elliott Fisher, and Don Berwick and Richard Gilfillan. On October 20, the Centers for Medicare and Medicaid Services issued its final rules for [...]

Editor’s note: See additional posts on the Medicare Shared Savings Program Final Rule  and related delivery system and payment reform initiatives by Debra Ness and William Kramer, Lawrence Casalino and Stephen Shortell,  Mark McClellan and Elliott Fisher, and Don Berwick and Richard Gilfillan. To answer the question in my title, I think we are making progress, and [...]

Editor’s note: See additional posts on the Medicare Shared Savings Program Final Rule  and related delivery system and payment reform initiatives by Debra Ness and William Kramer, Lawrence Casalino and Stephen Shortell,  Douglas Hastings, and Don Berwick and Richard Gilfillan. The release yesterday of the regulation to launch the Medicare Shared Savings Program (MSSP) marks [...]

Significant steps are being taken to implement the Affordable Care Act (ACA) even as the challenges to its constitutionality make their way through the federal courts.  For example, the Institute of Medicine recently released its much-anticipated report to the Secretary of Health and Human Services on the principles and methods that should guide the design [...]

Tomorrow, October 19, Health Affairs, along with co-sponsors the ABIM Foundation, the California HealthCare Foundation and the Foundation for Informed Medical Decision Making, will present ideas endorsed by leading physicians for Saving Money and Improving Patient Care in Medicare.  A list of speakers and other information is available in this earlier post.  WHEN:                  Wednesday, October [...]

The congressional Joint Select Committee on Deficit Reduction has been charged with finding ways to decrease federal budget deficits by at least $1.2 trillion between fiscal 2012 and 2021. There is broad recognition among policy makers that savings in Medicare should be part of the solution.  Happily, there are measures that would not only save [...]

With apologies to my more creative predecessors as Health Wonk Review hosts, there’s no theme today. (After all, how could one top Alistair Cookie?) I will get right to the great posts in this week’s edition. Costs And Premiums. At Managed Care Matters, Joe Paduda explores an apparent disconnect: flat medical costs coupled with rising [...]

Relatively higher physician spending in the United States is driven by higher fees, rather than greater practice expenses or training costs, according to the Health Affairs journal study discussed in the most-read Health Affairs Blog post for September. The study also finds that the gap between physician reimbursement for primary care versus speciality care is larger in [...]

Having both medical and law degrees typecasts me.  New acquaintances ask if I have ever sued myself.  Within the health policy community, colleagues assume I study medical malpractice. So I have let it become a self-fulfilling prophecy.  I worked on medical malpractice in the Clinton White House, and devoted my first scholarly efforts to analyzing [...]

If the last few months have made anything clear, it’s that the fiscal climate has changed and there are no longer any sacred cows.  Medicare and other essential health programs are on the chopping block, despite their immense popularity and the fact that they stand between life and death for millions of the most vulnerable [...]

Since last March when we began tracking national health expenditures (NHE) on a monthly basis, we have been wondering when the health spending share of GDP would hit the 18 percent threshold. The recent downward revision of historical GDP estimates has provided the answer – it already happened — back in the summer of 2009, [...]

Not surprisingly, the Affordable Care Act figures prominently in the list of the ten most-read Health Affairs Blog posts for August. The list includes posts on efforts to implement the Act, as well as essays on the legal fight over its constitutionality. Heading up the list is a post announcing a summer edition of the [...]

In commemoration of the tenth anniversary of 9-11, Health Affairs has added a new recording to its free collection of Narrative Matters essay podcasts on iTunes U.  “Mosaics And Misery,” a poem written on September 14, 2011, was inspired by the New York Presbyterian Hospital emergency department staff members waiting for the arrival of the injured [...]

Research appearing in the newly released September issue of Health Affairs shows that physicians in the United States are paid more per service than doctors in other countries—in some cases double. There is also a far bigger gap between fees paid for primary care and fees paid for specialty care in the United States, compared [...]

With the Budget Control Act of 2011 now signed into law, health care lobbyists are preparing to fight any changes to federal programs that affect their constituents.  One particular concern for physicians is the scheduled 30 percent cut to Medicare reimbursement mandated by the Sustainable Growth Rate (SGR) formula. Any attempt to waive these cuts will need [...]