Health Affairs

Editor’s Note: In the October issue of Health Affairs, Steven Pearson and Peter Bach proposed a new Medicare payment model incorporating comparative effectiveness research. Under the model, services offering greater health benefits than an existing alternative would receive cost-based reimbursement, but services offering benefits only comparable to an existing alternative would receive a “reference price” equal to... Read the rest of this entry »

Editor’s Note: In the October issue of Health Affairs, Steven Pearson and Peter Bach proposed a new Medicare payment model incorporating comparative effectiveness research. Under the model, services offering greater health benefits than an existing alternative would receive cost-based reimbursement, but services offering benefits only comparable to an existing alternative would receive a “reference price” equal to the reimbursement... Read the rest of this entry »

In late December, the Food and Drug Administration (FDA) revoked approval of the cancer drug Avastin for metastatic breast cancer. The decision set off a firestorm of reaction: the right condemned the denial of a potential life-saving drug for breast cancer patients, while the left cheered the withdrawal of an expensive drug that seemed to offer little... Read the rest of this entry »

Editor’s Note: In the post below, Caroline Poplin takes a skeptical look at Accountable Care Organizations (ACOs) and the trends they represent. For more on ACOs from various perspectives, readers can consult the January issue of Health Affairs, released on Thursday, January 6, titled “Accountable Care Organizations: Making Them Work.” Physicians have doubtless been issuing jeremiads since... Read the rest of this entry »

In his recent book, NIH Director Francis Collins refers to DNA and the new science of genomics as “the language of life.”  Thanks to the mapping of the human genome, says Collins, virtually all biomedical researchers agree “that their approach to understanding how life works has been profoundly and irreversibly affected….”  This profound new knowledge, of... Read the rest of this entry »

In the December issue, Health Affairs published a series of papers on the effects of self-referral by physicians for imaging services. Princeton economist Uwe Reinhardt spotlighted the set of papers in a Christmas Eve blog post in the New York Times’ Economix blog: A fascinating narrative on how private health insurers and Medicare have both... Read the rest of this entry »

When physicians who aren’t radiologists refer patients to imaging facilities they own or lease—known as self-referral—their patients don’t always benefit. In fact, these self-referrals lead to overuse of services, escalate spending, and rarely shorten the duration of illness, according to a series of studies in the December issue of Health Affairs. The findings challenge what... Read the rest of this entry »

Recent press reports on Medicare’s decision to evaluate coverage policy for the new cancer therapy Provenge were highly critical of the Centers for Medicare and Medicaid Services (CMS) and its role in examining the evidence behind FDA-approved products.  Let’s take a step back. In fact, this is exactly what CMS should be doing – carefully... Read the rest of this entry »

The federal government’s unsustainable long-run fiscal picture has been outlined in successive versions of the Congressional Budget Office’s Long-Term Budget Outlook.  The policy problem is that spending rises above any reasonable level of taxation for the indefinite future.  As it currently stands, committed federal expenditures are expected to grow from 20 percent of gross domestic... Read the rest of this entry »

Which groups of women, if any, should get regular mammograms to screen for breast cancer? This question has been the subject of passionate debate. For example, when the United States Preventive Services Task Force recommended that women without special risk factors begin regular mammograms at age 50, rather than 40, it unleashed an uproar that threatened... Read the rest of this entry »

The new health reform law charges the U.S. Department of Health and Human Services (HHS) with testing new payment and delivery models intended to improve health outcomes and restrain costs. But as the July issue of Health Affairs, published yesterday, points out, implementing all of these activities will require a combination of flexibility, leadership, coordination,... Read the rest of this entry »

Editor’s Note: Below, Amy Abernethy discusses the potential of a rapid learning system to improve the quality and efficiency of cancer care. Lynn Etheredge also addresses this subject in a another Health Affairs Blog post published today. With respect to rapid learning healthcare, it’s time to get serious about implementation.  National entities, such as the Institute of Medicine and the... Read the rest of this entry »

Editor’s Note: Below, Lynn Etheredge discusses the potential of a rapid learning system to improve the quality and efficiency of cancer care. Amy Abernethy also addresses this subject in another Health Affairs Blog post published today. Cancer is among the most complicated group of diseases to research and treat. The progress in the federal government’s... Read the rest of this entry »

A roundtable on the Centers for Medicare and Medicaid Services and health reform — featuring Bob Berenson, Tom Scully, Gail Wilensky, and Bruce Vladeck — was the most-read Health Affairs Blog post for April. Also on the list were posts on Don Berwick, President Obama’s nominee to head CMS, as well as pieces on self-directed care, health... Read the rest of this entry »

Editor’s Note: In October 2009, Health Affairs published two papers on factors driving imaging utilization. One paper, by Jacqueline Baras and Laurence Baker, analyzes the relationship between MRI supply and care for fee-for-service Medicare patients with low back pain. It finds that increases in MRI supply are related to higher use of both low back MRI and... Read the rest of this entry »

Although President Obama has only just signed national health reform into law, the “first wave” of health care reform started a year earlier when substantial federal investments in health information technology (IT) were approved as part of the economic stimulus package. The newly released April issue of Health Affairs looks at what’s happened since passage of... Read the rest of this entry »

A few weeks ago I toured a hospital that had recently adopted computerized physician order entry (CPOE). We visited a patient room on the Med-Surge floor, where a nurse explained what happens in an emergency. Before they adopted CPOE, nurses would run 300 feet down the hall to find the patient’s paper record during a... Read the rest of this entry »

Editor’s Note: Most health policy analysts believe that better evidence about quality and value, obtained through comparative effectiveness research (CER), can drive better clinical decision making and could potentially slow the rate of growth in health care spending.  But the success of any national CER initiatives will depend on how evidence is developed, whether it... Read the rest of this entry »

Editor’s Note: In addition to Peter Pronovost (photo and biography above), authors of this post include Julius Pham, Assistant Professor, Emergency Medicine, Johns Hopkins University School of Medicine; Sara Singer, Assistant Professor, Harvard School of Public Health,  Department of Health Policy and Management, Massachusetts General Hospital; Jerod Loeb, Executive Vice President for Research, The Joint... Read the rest of this entry »

Editor’s Note: In the post below, Healthwise CEO Don Kemper discusses empowering patients through information therapy. Kemper will participate in a panel on this topic at the 2010 National Health Policy Conference, which will take place February 8 and 9 in Washington DC. The conference, cosponsored by AcademyHealth and Health Affairs, will include discussion of hot topics... Read the rest of this entry »