To Get Dems On Board With ACA Replacement, Republicans Should Take Medicare Off The Table

With two relatively straightforward acknowledgements, Republicans could create a pathway for bipartisan reconsideration of health care coverage in America.

January 10, 2017

Oregon’s High-Risk, High-Reward Gamble On Medicaid Expansion

Health policy in Oregon is like football in the SEC: not only a contact sport but also a source of intense civic pride. The state's Medicaid expansion was similarly turbulent.

January 10, 2017

Germany’s Model For Drug Price Regulation Could Work In The US

If the U.S. cares to examine national models for reducing drug prices, Germany's AMNOG should top the list.

December 29, 2016

The Demise of the Part B Demo: Doom For Value-Based Payment?

Despite widespread, bipartisan agreement that we should be paying for value, even with respect to drugs, the uproar over Part B shows there remains strong resistance to specific policies that attempt to move towards that goal.

December 27, 2016

Taking Stock Of Health Reform: Where We’ve Been, Where We’re Going

What are the ACA’s successes and failures? How might the new administration and Congress proceed with repealing and replacing it? What provisions might be adopted to replace the ACA and how might these provisions improve on, or undermine, the law's accomplishments?

December 6, 2016

Rewarding Provider Performance: Ten Years In

Ten years ago, the Institute of Medicine released a report reflecting the work of an IOM subcommittee that Robert Reischauer and I co-chaired. Ten years later, the country is further along this path, but we are still relatively early in the process.

December 6, 2016

President-Elect Trump Selects Price For HHS And Verma For CMS

As has been widely reported, President-elect Donald Trump has put forward the names of Tom Price for Secretary of Health and Human Services and Seema Verma for Administrator of the Centers for Medicare and Medicaid Services.

December 1, 2016

Calculating Medicare Advantage/Fee-For-Service Price Differences Is Harder Than It Looks

The fundamental problem is that payments to hospitals from fee-for-service have Indirect Medical Education included in them, but payments from Medicare Advantage plans do not.

November 28, 2016

Foundation Reactions To The 2016 Presidential Election: Round-Up

Following the US presidential election on November 8, what are foundation staffers saying? Colleagues from one national funder, for example, said they hope that the election results "will not alter the nation's commitment to improving insurance coverage and health care."

November 22, 2016

Divorcing Reimbursement From Real-World Prices: Medicare Still Uses 2003 AWPs For Some Drugs

About two-to-three dozen durable medical equipment infusion drugs were exempted from the switch to average sales price. The consequences have been well documented in several OIG reports. This post examines these issues and suggests a path forward for policymakers.

November 21, 2016