The Senate Health Care Bill

Yesterday, Senate Republican leaders released their version of health-care legislation. The bill is best understood as a GOP amendment to the Affordable Care Act. In 2009, if the Republicans had attempted to modify rather than defeat the ACA, this is the kind of amendment they might have offered.

June 23, 2017

The Payment Reform Landscape: Is The Debate Over Retrospective Versus Prospective Bundled Payments A Distraction?

Setting a prospective target budget, instituting reasonable downside financial risk, and tying final payment amounts to performance on a set of outcome measures all provide powerful incentives to manage patients well while adhering to a budget.

June 23, 2017

Unpacking The Senate’s Take On ACA Repeal And Replace

On June 22, 2017, Senate Majority Leader Mitch McConnell (R-KY) released the Senate GOP’s version of Affordable Care Act repeal, the Better Care Reconciliation Act of 2017. The Senate bill is in many respects quite different from the House’s American Health Care Act.

June 22, 2017

Building Sustainable Partnerships To Improve Access To Breast Cancer Treatment For Uninsured Women

The nonprofit Breast Treatment Task Force, a partnership-based payment and delivery system model, facilitates screenings, diagnostic follow-ups, and treatments for a variety of people in New York City who lack insurance coverage. Donations from health care providers, foundations, and others are...

June 20, 2017

At Drug Hearing, Senators Discuss Meanings Of Price And Value—And Debate Health Reform

On Tuesday, June 13, the Senate HELP Committee held the first of three planned hearings on high drug prices. One of the most important points to come out of the hearing was that there is bipartisan concern about high drug prices, even if there is as yet little agreement on what to do about them.

June 20, 2017

Making Practice Guidelines And ‘Choosing Wisely’ More Effective

I believe one way to “preserve” Medicare is to stop paying for unnecessary care: Instead, we should Choose Wisely.

June 20, 2017

Sandoz v. Amgen: What The Court Settled, What It Didn’t, And What Might Come Next

On June 12, the Supreme Court ruled that biosimilar companies will generally be able to launch their product as soon as the data exclusivity on the innovative product expires. In simple terms, this translates to cheaper medicines sooner. On a second issue, the outcome was more complex.

June 19, 2017

Savings Reported By CMS Do Not Measure True ACO Savings

The bottom line is that we should not pay attention to any analysis that uses the benchmarks as the basis for assessing the effects of accountable care organizations on Medicare spending.

June 19, 2017

Medicare’s Programs Should Compete

Fielding three Medicare programs might make sense if they were designed to compete against one another.

June 15, 2017

The American Health Care Act Could Chip Away At The Medicare Savings Programs

Eleven million Americans are enrolled in both Medicare and Medicaid. Of these dually eligible beneficiaries, roughly 80 percent qualify for help paying for their Medicare coverage through the Medicare Savings Programs.

June 15, 2017