April 2017 - Health Affairs - The Network of Care

The MacArthur Amendment Language, Race In The Federal Exchange, And Risk Adjustment Coefficients

For a number of days negotiations have apparently been underway with respect to an amendment to the Republican American Health Care Act (AHCA) that has been proposed by Congressman Tom MacArthur (R.N.J.) A summary of this amendment became available on...

Published Tue, Apr 25 2017 7:47 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage

Health Policy’s Gordian Knot: Rethinking Cost Control

Medical spending has resumed its long-term rise. After several years of deceptive stability in the last, deep recession’s wake, health spending rose by 3.7 percentage points more than general inflation in 2014 , then by 5.8 percentage points more in 2015...

Published Wed, Apr 26 2017 7:28 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Health IT, Payment Policy, Insurance and Coverage, Costs and Spending, Drugs and Medical Technology, Research and Development, intellectual property, value-based payment, patents

The Future Of Investment In PEPFAR: Understanding PEPFAR’s Multiple Economic, Health, And Diplomatic Impacts

There is much concern about the future of the President’s Emergency Plan for AIDS Relief, or PEPFAR, under the new administration. Since the creation of PEPFAR in 2003, the US has been the global leader in responding to the urgent need for the treatment...

Published Mon, Apr 17 2017 7:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Maternal Health, HIV/AIDS, PEPFAR, Global Health Policy, health diplomacy

How Minnesota Is Stepping Up To Preserve Its Individual Market

Last December I wrote about the steps Minnesota was taking to save its individual insurance market. The state’s commissioner of commerce negotiated enrollment caps with five insurers in response to the decision of Blue Cross Blue Shield (BCBS) to leave...

Published Tue, Apr 18 2017 6:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Insurance and Coverage, Costs and Spending, Minnesota, 1332 waivers, Health Insurance Pemium Relief bill, Council of Health Plans, MinnesotaCare, Premium Security Plan, Health Care Access Fund, Mark Dayton

Evidence on Payment Reform: Where Are The Gaps?

The US health care system is transforming how it pays for and delivers care. New payment models and benefit designs aim to promote and sustain improvements in health and care delivery, specifically focusing on better outcomes and lower costs. Supporting...

Published Tue, Apr 25 2017 7:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Payment Policy, Insurance and Coverage, Costs and Spending, Accountable Care Organizations, Alternative Payment Models, Center for Medicare and Medicaid Innovation, health Care Payment Learning and Action Network, Laura and John Arnold Foundation

The Payment Reform Landscape: For Employers, Keep Pushing Ahead

With all the tumult in Washington, D.C. surrounding health care reform, it is hard to know which reforms will be prioritized at the federal level and whether provider payment reform will still be a central focus. But in some corners of the health care...

Published Fri, Apr 21 2017 10:45 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Quality, Payment Policy, Insurance and Coverage, Costs and Spending, Payment Reform, Behavioral Health, employer-sponsored health coverage, maternity care

Discrimination Against Patients With Substance Use Disorders Remains Prevalent And Harmful: The Case For 42 CFR Part 2

The authors of a recent Health Affairs Blog post argue that 42 CFR Part 2 , the law designed to protect confidentiality of patients with substance use disorders, is outdated and unnecessary. We could not disagree more. 42 CFR Part 2 provides bedrock protections...

Published Thu, Apr 13 2017 7:05 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Quality, Population Health, Featured, HIPAA, opioid epidemic, substance use treatment, patient privacy, patient discrimination, 24 CFR Part 2

Treasury Inspector General Assesses ACA-Related Tax Issues

On April 7 and April 10, the Treasury Inspector General for Tax Administration (TIGTA) released two reports on Affordable Care Act programs. Individual Tax Returns The April 7 report contains interim results on tax filings for the 2016 filing season through...

Published Tue, Apr 11 2017 2:28 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, ACA premium tax credits, employer mandate, individual mandate

A Good Deal For Eliminating Hepatitis C: Saving Money And Lives

The conundrum of hepatitis C is well known. The virus kills more than 20,000 Americans each year, more, according to Centers for Disease Control and Prevention , than the other 60 infectious causes of death combined. A cure is in hand, but is out of reach...

Published Mon, Apr 24 2017 8:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Costs and Spending, Medicaid and CHIP, hepatitis C, Drugs and Medical Innovation

GOP Removes AHCA Exemption Of Congress From State Coverage Limitations; Plaintiffs Seek End To Contraceptive Coverage Case Delay

On April 26, 2017, the House Rules Committee posted yet another proposed amendment to the American Health Care Act. This amendment would remove the provision in the MacArthur amendment , released on April 25, which would have exempted coverage for members...

Published Thu, Apr 27 2017 1:22 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage

Looking Ahead To 2018: Will A Shorter Open Enrollment Period Reduce Adverse Selection In Exchange Plans?

On April 13, 2017 the Centers for Medicare and Medicaid Services (CMS) released the final rule designed to “improve the risk pool and promote stability in the individual insurance market” for 2018. The rule finalizes the provision from the proposed rule...

Published Fri, Apr 14 2017 8:22 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, Marketplace Open Enrollment Notice, open enrollment, open enrollment period

Medicaid Responds To The Opioid Epidemic: Regulating Prescribing And Finding Ways To Expand Treatment Access

Medicaid programs are at the center of the opioid epidemic. Nearly 12 percent of adults covered by Medicaid have a substance use disorder, including opioid use disorder. Available data suggest that Medicaid beneficiaries are prescribed painkillers at...

Published Tue, Apr 11 2017 7:55 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Costs and Spending, Medicaid and CHIP, Section 1115 Waivers, prescription drug abuse, opioid epidemic, prescription drug monitoring programs, preferred drug lists, prior authorization requirements

Value Frameworks For Rare Diseases: Should They Be Different?

The US health care system is increasingly focusing on value as a basis for reimbursement of pharmacotherapies and devices, and as a result the use of “value frameworks” for measuring and comparing treatment value has grown in recent years. However, the...

Published Wed, Apr 12 2017 7:12 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Quality, Costs and Spending, Precision Medicine, Drugs and Medical Innovation, Orphan Drug Act, treatment value, rare disease treatment, value frameworks

ACA Round-Up: New Unified Rate Review Instructions, Redesigned QHP Website, And More

On April 6, 2017, Congress headed home for its spring recess having not achieved the Republican leadership’s goal of repealing, replacing, or repairing the Affordable Care Act. But even as these efforts go on, so does the life of the ACA. On April 7,...

Published Mon, Apr 10 2017 8:25 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, CMS, CMS Innovation Center

Overcoming Challenges Of Outcomes-Based Contracting For Pharmaceuticals: Early Lessons From The Genentech–Priority Health Pilot

In recent decades, treatment advances have helped people with cancer live longer and better lives. Scientific investments have led to breakthroughs not previously imaginable, such as the development of immunotherapies and precision medicines. However...

Published Mon, Apr 03 2017 9:37 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Payment Policy, Costs and Spending, Drugs and Medical Technology, Outcomes-based agreements

April 2017 - Health Affairs

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