Editor’s Note: In the post below, John Wennberg and Shannon Brownlee discuss the controversy over a proposed study of regional variations in Medicare spending. Wennberg and Brownlee rebut claims that spending and utilization variations among academic medical centers are due to differences in patient income, race, and health status. In another post coming next week, [...]

Editor’s Note: In addition to John Wennberg and Shannon Brownlee (photos and bios above), authors of this post include James Weinstein, MS, DO, and Elliott Fisher, MD, MPH. Weinstein is chair of the Department of Orthopaedic Surgery at the Dartmouth-Hitchcock Medical Center. Fisher is Director of the Center for Population Health at The Dartmouth Institute for Health Policy and [...]

According to the first national study of hospital board chairs linked to quality performance, just half the boards rated quality of care as one of their two top priorities and only a minority reported receiving training in quality.  The study was published today on the Health Affairs Web site.
“Most boards have primarily focused on financial issues, mistakenly [...]

Posts on public opinion about health reform and how to achieve high-quality, low-cost health care topped the Health Affairs Blog most-read list for October. Additional comment on these and all posts is always welcome.

Can Slumping Support For Health Care Reform Be Turned Around?
by S. Ward Casscells, Hiliary Critchley, Thomas Amoroso, James Tyll, and John Zogby
Are [...]

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 [...]

As Congress prepares for an historic floor debate over health care reform, those of us who have worked in the trenches to measure and improve the quality of care are watching with a mix of anticipation and concern. Reform has the potential to significantly improve the transparency and, ultimately, the quality of our system of [...]

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 [...]

Editor’s Note: In addition to Arnold Milstein and Pranav Kothari (pictures and bios above), coauthors of this post include Rushika Fernandopulle MD, MPP, of Harvard Medical School and Renaissance Health in Boston, and Theresa Helle of the Boeing Company in Seattle. For more on health care delivery system innovations and reforms, see the Sept-Oct 2009 issue of Health Affairs, [...]

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 [...]

Early in President Barack Obama’s speech to Congress about health care reform, he mentioned health care costs as one of the causes of the problem of lack of insurance coverage. But most of the speech focused on what to do about health insurance costs, not health care costs. Changing the rules about how insurance companies operate [...]

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 [...]

Reforming the way health care is paid for and delivered in the United States is serious business. It deserves an equally serious discussion
rising above partisanship and hot air. 
Join Health Affairs, the nation’s leading health policy journal,
for a special conference on Key Issues in Health Reform: Fact vs. Fiction.
WHEN: Thursday August 20, 2009 – 8:30 am [...]

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 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 [...]

It is often observed wryly that Americans have more interest in the well-being of their automobiles and pets than their own health. The challenges of activating patients to manage diet, lifestyle, and chronic conditions are well documented, and the accompanying costs of chronic illness are even more thoroughly characterized. The threats these pose to health [...]

While the most visible national health reform fight at the moment focuses on a public plan option for people covered through health insurance exchanges (or gateways), a quieter debate is brewing over whether coverage for low-income people should be achieved through Medicaid expansions or subsidies to purchase insurance through an exchange. For example, the Senate [...]

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 [...]

Editor’s Note: Health Affairs has recently published two studies looking at the association between hospital costs and quality. The first, by Ashish Jha and coauthors, appeared in our May-June issue, and the second by Laura Yasaitis, Amitabh Chandra, and coauthors, was published online.
Variations in spending and intensity of care, and the effects of these variations [...]

Editor’s Note: Health Affairs has recently published two studies looking at the association between hospital costs and quality. The first, by Ashish Jha and coauthors, appeared in our May-June issue, and the second by Laura Yasaitis, Amitabh Chandra, and coauthors, was published online.
Variations in spending and intensity of care, and the effects of these variations [...]