Health Affairs

Editor’s note. In addition to Norman Kahn and John Rother (photos and bios above), this post is coauthored by Timothy Lynch, JD, Director of Foundation Programs for the ABIM Foundation; David Hoyt, MD, Executive Director of the American College of Surgeons; and Steven Weinberger, MD, Executive Vice President and Chief Executive Officer of the American... Read the rest of this entry »

Now that the Obama Administration has suspended implementation of the CLASS Act, what long-term care financing system should take its place? That is the question that Gloria Eldridge and Joanne Lynn address in the most-read Health Affairs Blog post for November. The November most-read list also features posts about reducing health care spending. For example,... Read the rest of this entry »

In a recent Health Affairs article, researchers from RAND and Harvard highlighted the difficulties associated with implementing bundled payment, based on an evaluation of the PROMETHEUS Payment program, an initiative of the Health Care Incentives Improvement Institute (HCI3). They identified challenges to implementation on the part of both payers and providers, including defining the bundles;... Read the rest of this entry »

Editor’s note: Below, we offer “Defensive Medicine,” the first health policy poetry to appear on Health Affairs Blog. The author is Adam Possner, a general internist and an assistant professor at The George Washington University School of Medicine and Health Sciences, whose poetry has been featured in the Journal of the American Medical Association and... Read the rest of this entry »

The Medicare Payment Advisory Commission (MedPAC) is the closest thing Congress has to adult supervision on important health policy questions. The Commission commands bipartisan respect both for its record of sound policy advice and for its leadership. With its October recommendations, MedPac attempted to solve the sustainable growth rate (SGR) physician payment formula budget crisis... Read the rest of this entry »

As Congress faces mounting pressure to rein in Medicare spending, two sides seem to be squaring off. The don’t-touch-a-thing-other-than-squeezing-provider-fees position seems to appeal to mainly Democrats, while eat-your-spinach reforms, including more cost sharing and higher premiums, seem to appeal mainly to Republicans. Neither position is very appealing to voters, however, nor should they be. Is... Read the rest of this entry »

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, Peter Carmel, the president of the American Medical Association, defends the role of the... Read the rest of this entry »

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... Read the rest of this entry »

“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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »

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... Read the rest of this entry »