Health Affairs

On Tuesday, June 5, Health Affairs will hold a briefing to discuss its June 2012 issue, “Focus On The Care Span For The Elderly And Disabled.” The volume explores a wide range of topics — from avoidable hospital admissions and readmissions, to coordination of care for dual eligibles, to reforming Medicare payment for skilled nursing... Read the rest of this entry »

On May 16, 2012, the Department of Health and Human Services moved three steps closer to the implementation of the Affordable Care Act’s health insurance exchanges, which will happen on January 1, 2014.  First, HHS announced the award of 5 new level 1 exchange establishment grants (Illinois, Nevada, Oregon, South Dakota, and Tennessee) and one... Read the rest of this entry »

Background:  The Centers for Medicare and Medicaid Services’ designation of 32 accountable care organizations (ACOs) across the U.S. to enroll Medicare fee-for-service patients beginning in 2012 makes ACOs an important feature of the national healthcare landscape–at least for publicly insured patients.However in 2007, Blue Shield of California, along with provider and employer partner organizations, began... Read the rest of this entry »

In a recent Health Affairs paper, we documented that the United States has a significant survival advantage over much of Europe when it comes to cancer: 1.8 years for those diagnosed during our study window.  Furthermore, we showed over a 17-year period that this gap had widened, not narrowed, and that this widening was more... Read the rest of this entry »

Knee osteoarthritis is a common ailment—and treatment is expensive: in 2008 total knee replacement inpatient costs in the United States exceeded $9 billion—the highest among the ten procedures for which demand is growing the fastest. A new study, released today as a Web First by Health Affairs, compares operating times, hospital lengths-of-stay, discharge dispositions, and... Read the rest of this entry »

In this post, we put forth a social compact intended to define the reciprocal obligations of health care professionals, patients and society that are necessary to achieve truly patient-centered, team-based care.  The compact and recommendations were developed from a working group formed at the March 2010 invitational conference co-sponsored by the American Board of Internal... Read the rest of this entry »

If, as suggested in the April Health Affairs article by Andrew Ryan and coauthors, the Premier/Medicare Hospital Quality Incentive Demonstration (HQID) program failed to achieve its goals, we can only hope that all subsequent demonstration projects fail so successfully. The fact is HQID showed that the combination of rewarding performance improvement and providing transparency of... Read the rest of this entry »

Whether Medicare Advantage plans should be paid more than traditional Medicare has long been an issue of debate. In the Patient Protection and Affordable Care Act of 2010, Congress voted to narrow the difference in payments between the two programs from 2012-2017, with some offsets based on quality bonuses for plans with higher quality scores.... Read the rest of this entry »

Editor’s note: You can hear Amy Berman discuss her April Health Affairs Narrative Matters essay at the recent release event for the April issue. You can also join Amy tomorrow (May 1) at noon for live online chat hosted by the Washington Post, which will also be publishing an abridged version of her essay. In... Read the rest of this entry »

Editor’s note: In the April issue of Health Affairs, Jean Mitchell reported that “self-referring” urologists, who billed Medicare for both prostate biopsies and the associated surgical pathology services, charged Medicare for more specimens per prostate biopsy than non-self-referring urologists sent to independent pathology providers. Additionally, the regression-adjusted cancer detection rate was higher for men treated... Read the rest of this entry »

Editor’s note: In the April issue of Health Affairs, Jean Mitchell reported that “self-referring” urologists, who billed Medicare for both prostate biopsies and the associated surgical pathology services, charged Medicare for more specimens per prostate biopsy than non-self-referring urologists sent to independent pathology providers. Additionally, the regression-adjusted cancer detection rate was higher for men treated by... Read the rest of this entry »

You are increasingly being held accountable for the outcomes of the health care you deliver. Pay for performance; shared savings in ACOs; public report cards…the list of strategies to monitor and measure the effects of your efforts is lengthening. Many of you seem dismayed by the increased weight accorded to the patient experience of care... Read the rest of this entry »

There are nearly nine million people in the United States who receive both Medicare and Medicaid benefits. Recent cost estimates show that this group, known as dual eligibles, accounts for a disproportionate share of spending in both programs. Although the Medicare and Medicaid programs were never intended to work together, a provision of the Affordable... Read the rest of this entry »

While Representative Paul Ryan’s (R-WI) most recent Medicare premium support proposal will be hotly debated during this charged political season, the more durable issue is what it means for the real debate on Medicare that looms after the election.  Regardless of who wins this November, the country is faced with a massive deficit, driven in... Read the rest of this entry »

At his blog Wright on Health, Brad Wright presents a “Masterful” edition of the Health Wonk Review. Celebrating the triumph of fellow University of Georgia grad Bubba Watson, Brad ties each health policy blog post to a hole on the famed course at Augusta. David Lansky’s Health Affairs Blog post on how to do —... Read the rest of this entry »

Editor’s note: For more on the first round of Medicare Shared Savings Program participants and payment and delivery system reform, see Douglas Hastings’s post. On Tuesday April 10, CMS announced 27 ACOs had begun operating under the Medicare Shared Savings Program (MSSP), joining the 32 Pioneer ACOs announced in December and the 6 physician group... Read the rest of this entry »

Editor’s note: For more on the first round of Medicare Shared Savings Program participants and payment and delivery system reform, see Steven Lieberman’s post. Back in 1996, the Federal Trade Commission and Department of Justice, in providing antitrust guidance for multi-provider networks, considered financial integration and clinical integration as separate pathways for such networks to... Read the rest of this entry »

Several papers in the March issue of Health Affairs expose some of the challenges with reporting information about health care quality to the public, including the shortcomings of hospital reporting, the importance of framing quality information in ways consumers can understand and apply to real-world decisions, and the need for more consumer-relevant measures.  Each paper... 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 was the theme, enunciated by Health Affairs Editor-in-Chief Susan Dentzer, of an event that Health Affairs cosponsored last year with the ABIM Foundation and the California HealthCare Foundation. The event... Read the rest of this entry »

On Day Three of arguments about the constitutionality of the Affordable Care Act, the Supreme Court turned its attention to the question of severability. Should the Court find that the ACA’s minimum coverage requirement is indeed a proper exercise of Congress’s right to regulate interstate commerce, today’s arguments were all for naught. However, if the... Read the rest of this entry »