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Changes Needed To Fulfill The Potential Of Medicare’s ACO Program

The Medicare Shared Savings Program (MSSP), Medicare’s main program for accountable care organizations (ACOs), has grown rapidly since it began in 2012. It added 89 new provider organizations earlier this year, bringing the total to over 400 Medicare...

Published Wed, Apr 04 2015 10:23 AM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Insurance, Payment, Health Care Costs, Spending, Medicare, Quality, Health Care Delivery

The Medicare Shared Savings Program: CMS Turns To Stakeholders On Incentivizing ACO Risk

On December 1, 2014, the Centers for Medicare & Medicaid Services ("CMS") released its long awaited Proposed Rule to update regulation and operation of the Medicare Shared Savings Program (“MSSP”). In response to concerns raised by participating...

Published Fri, Dec 12 2014 8:45 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Insurance, Payment, Health Care Costs, Spending, Medicare, Quality

The Cost Of A Cure: Medicare’s Role In Treating Hepatitis C

Editor's note: In addition to Tricia Neuman, Jack Hoadley and Juliette Cubanski also coauthored this post. For a patient with hepatitis C, a potentially deadly disease, the prospect of finding a cure with minimal side effects is a really big deal...

Published Thu, Jun 06 2014 8:23 AM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Payment, Health Care Costs, Spending, Medicare, Pharma, Cost

A Lifetime Value-Based Proposal For Medicare Payment Reform

urrent Medicare reform policy proposals mainly focus on lowering annual cost or cost increase per capita, but they fail to recognize Medicare as a lifetime plan that covers each beneficiary from age 65 to death. I propose a Lifetime Value-Based Payment...

Published Fri, Mar 03 2014 9:53 AM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Insurance, Payment, Chronic Care, Health Care Costs, Spending, Medicare, Innovation

Paying For A Permanent, Or Semi-Permanent, Medicare Physician Payment Fix

Editor's note: In addition to Mark McClellan (photo and linked bio above), this post is authored by Keith Fontenot, Alice Rivlin, and Erica Socker. Fontenot is a visiting scholar at the Engelberg Center for Health Care Reform at the Brookings Institution;...

Published Fri, Feb 02 2014 11:18 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Payment, Physicians, Spending, Medicare, Medicaid

Why Are Cancer Drugs Commonly The Target Of Schemes To Extend Patent Exclusivity?

The makers of branded pharmaceuticals have devised numerous ways to extend patent exclusivity for lucrative products in the United States. In June, the Supreme Court gave the Federal Trade Commission (FTC) clear authority to investigate and prosecute...

Published Wed, Dec 12 2013 12:47 PM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Insurance, Payment, Health Care Costs, Spending, Medicare, Competition, Pharma, Business of Health Care

The BPC Health Care Reform Plan: A Response To Coulam, Feldman, and Dowd

We commend Robert Coulam, Roger Feldman, and Bryan Dowd for bringing attention to competitive bidding in Medicare, a meaningful strategy to constrain health care costs through reducing inefficiencies in the health care system. The authors have made valuable...

Published Tue, Jul 07 2013 12:06 PM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Politics, Payment, Health Care Costs, Uncategorized, Spending, Medicare, Competition, Quality

Hospital Charges And The Need For A Maximum Price Obligation Rule For Emergency Department & Out-Of-Network Care

The release of average charges for common procedures in more than 3,000 U. S. hospitals last week by the Centers for Medicare and Medicaid Services (CMS) elicited divergent reactions – not surprisingly. On one hand, it was front-page news for most of...

Published Thu, May 05 2013 12:12 PM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Insurance, Payment, Health Care Costs, States, Spending, Medicare, Competition, Hospitals

A Framework For Accountable Care Measures

The Affordable Care Act included provisions to accelerate the transition to value-based payment, including Accountable Care Organizations (ACOs). Many private sector insurers, providers and employers also are moving in this direction. However, many of...

Published Thu, May 05 2013 11:17 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Payment, Health Care Costs, Spending, Medicare, Quality

The Affordable Care Act At Three: Paying For Quality Saves Health Care Dollars

For decades before the passage of the Affordable Care Act, health care costs outstripped inflation, without corresponding improvements in health care quality. Our system didn’t incentivize quality or efficiency. We paid providers for the quantity of care...

Published Wed, Mar 03 2013 6:17 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Prevention, Policy, Payment, Health Care Costs, Spending, Medicare, Quality, Hospitals, Medicaid

Will The Readmission Rate Penalties Drive Hospital Behavior Changes?

Since the development of the metric in 1984 by Anderson and Steinberg , inpatient hospital readmission rates have been used as a marker for hospital quality. A good deal of attention is now being paid to the new readmission rate penalties in the Affordable...

Published Thu, Feb 02 2013 9:41 AM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Payment, Health Care Costs, Spending, Medicare, Quality, Hospitals, Disparities

The Current Medicare Debate Will Not Solve The Program’s Problems

The mistake policymakers have long made in debating Medicare (and Medicaid, though that’s a topic for another day) is that they talk about Medicare the same way they talk about Social Security. It’s understandable at some level, since these two programs...

Published Tue, Feb 02 2013 11:03 AM by Health Affairs Blog

Filed under: All Categories, Consumers, Policy, Payment, Chronic Care, Health Care Costs, Spending, Medicare, Quality, Innovation

P4P Concerns, Medicare Vs. Private Insurance Lead HA Blog’s 2012 Most-Read List

Will pay for performance in health care backfire? That was the question addressed through the lens of behavioral economics by Steffie Woolhandler, Dan Ariely, and David Himmelstein in the most-read Health Affairs Blog post for 2012 . Next on the most...

Published Thu, Jan 01 2013 11:13 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Blog, Consumers, Policy, Politics, Insurance, Payment, Primary Care, Health Care Costs, Spending, Medicare, Hospitals, Health Law, Comparative Effectiveness

Bring Medicare Into The Twenty-First Century

Twentieth Century Medicare. Medicare, the federal medical and hospital insurance program for seniors and disabled, reflects the popular understanding of medical care 50 years ago: primarily treatment by doctors of acute episodes such as pneumonia. Medicare...

Published Thu, Aug 08 2012 11:40 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Payment, Spending, Medicare, Competition, Quality

Pioneer ACOs: The Right Direction, But What’s The Goal?

Editor’s Note: The post below discusses the recent announcement regarding accountable care organizations by the Center For Medicare and Medicaid Innovation. This is also the topic of another post, by Douglas Hastings, published today on Health Affairs...

Published Wed, May 05 2011 8:31 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Payment, Spending, Medicare, Quality, Health Law

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