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Value Based Reimbursement: The Rock Thrown Into The Health Care Pond

Editor’s note: This post is part of a series based on the 5th Forum: Learning from each other – Scaling ideas up to the next level . The forum was held in Berlin, Germany on June 9 and 10, 2016 and organized by the Center for Healthcare Management . Value...

Published Fri, Jul 08 2016 7:30 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Medicare, Quality, Featured, Payment Policy, Insurance and Coverage, Organization and Delivery, Costs and Spending, Medicaid and CHIP, fee-for-service, value-based reimbursement, MACRA, value-based payment, Center for Healthcare Management 5th Forum, value-based insurance design
CMS Provides New Clarity For Family Planning Under Medicaid

Family planning services and supplies have been a part of the Medicaid program since it was first established half a century ago. And over the past several decades, Medicaid has become the dominant public funding source for family planning in the United...

Published Tue, Jul 12 2016 8:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, States, Quality, Featured, Costs and Spending, Medicaid and CHIP, Equity and Disparities, Women's Health, CMS, contraceptive coverage, family planning, long-acting reversible contraceptives
Health Expenditure Projections: When Does ‘New’ Become ‘Normal’?

The Centers for Medicare and Medicaid Services (CMS) has released its latest forecast of medical spending for the next decade. The headline number is that medical care as a share of gross domestic product (GDP) is expected to increase from its current...

Published Wed, Jul 13 2016 1:30 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Medicare, Featured, Payment Policy, Insurance and Coverage, Costs and Spending, Medicaid and CHIP, ACA, ACOs, spending projections, MACRA, Alternative Payment Models
How Policymakers Can Foster Organizational Innovation In Health Care

Editor’s note: This post is part of a series based on the 5th Forum: Learning from each other – Scaling ideas up to the next level . The forum was held in Berlin, Germany on June 9 and 10, 2016 and organized by the Center for Healthcare Management . For...

Published Fri, Jul 15 2016 8:30 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Featured, Organization and Delivery, Costs and Spending, risk adjustment program, Center for Healthcare Management 5th Forum, Medicare DRG program
CMS Releases 2017 Enrollment Manual For Individual And Small Business Marketplaces

On July 19, 2016, the Centers for Medicare and Medicaid Services released the Federally-facilitated Marketplace (FFM) and Federally-facilitated Small Business Health Options Program (FF-SHOP) Enrollment Manual for the fourth (2017) marketplace open enrollment...

Published Wed, Jul 20 2016 2:44 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, Federally Facilitated Marketplace, agents and brokers, Federally-facilitated Small Business Health Options Program
People Post: Staff And Board Changes At Foundations; Job Opening: Foundation President

In June, Becky Hayes Boober left the Maine Health Access Foundation , where she was a senior program officer. She is now vice president of community impact at the Maine Community Foundation (MaineCF) and is working out of its Ellsworth office. She told...

Published Fri, Jul 22 2016 10:30 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Hospitals, Aging, Long-Term Care, Health Philanthropy, GrantWatch, Mental Health, Health Promotion and Disease PreventionGW, Long-term Services and Supports, California, Behavioral Health, Climate Change, Robert Wood Johnson Foundation, culture of health, Opioid Addiction, New York State, adolescents, California Health Care Foundation, Centers for Disease Control and Prevention, impact investing
CMS Releases Draft QRS And QHP Enrollee Experience Call Letter

The Centers for Medicare and Medicaid Services (CMS) has released a draft 2016 call letter proposing refinements to the Quality Rating System (QRS) and Qualified Health Plan (QHP) Enrollee Experience Survey. The QRS and QHP Enrollee Experience Survey...

Published Tue, Jul 26 2016 1:00 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, CMS, qualified health plans, quality rating system, ERISA
Why ‘Government Patent Use’ To Lower Drug Costs Won’t Stifle Innovation

In a May article in Health Affairs , we proposed that the federal government consider using an existing law to negotiate or compel lower drug prices in the United States for certain important drugs with excessive prices. We’ve been gratified at the interest...

Published Thu, Jul 28 2016 8:30 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Quality, Featured, Costs and Spending, Drugs and Medical Technology, hepatitis C, Research and Development, drug innovation
Minimum Essential Coverage Reporting And ‘No Wrong Door’ Coordination

The Affordable Care Act requires individuals to have minimum essential coverage (MEC) or pay a tax, unless they qualify for an exemption from the requirement. MEC includes coverage through government programs (such as Medicare or Medicaid), employer coverage...

Published Mon, Aug 01 2016 9:44 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, minimum essential coverage, No Wrong Door
Gulf War Illness 25 Years After Desert Storm

In the 25 years since Desert Storm, about 250,000 of the almost 700,000 involved in the Gulf War 1 theater have suffered from some version of the complex of symptoms now called Gulf War Illness . This illness was discussed in a recent symposium co-hosted...

Published Thu, Aug 04 2016 9:30 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Quality, Research, Veterans, Organization and Delivery, Department of Defense, desert storm, Gulf War Illness, Veterans Administration
Texas Judge Refuses To Dismiss Health Insurance Provider Fees Case

On August 4, 2016, Judge Reed O’Connor of the Northern District of Texas, Wichita Falls Division, refused to dismiss an action brought by the states of Texas, Indiana, Kansas, Louisiana, Nebraska, and Wisconsin which claimed that the requirement that...

Published Mon, Aug 08 2016 10:05 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, Medicaid and CHIP, NFIB v. Sebelius, health insurance provider fee, managed care organizations, Actuarial Standards Board
Suicide Prevention: Access To Behavioral Health Services Lacking

Suicide is a leading cause of death in the United States. From 2000 to 2014 , it was the third most common cause of death among 10 to 24 year olds, the second most common cause of death among 25 to 34 year olds, and the tenth most common cause of death...

Published Wed, Aug 10 2016 8:30 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Health IT, Mental Health, Featured, Drugs and Medical Technology, Behavioral Health, SAMHSA, mobile health, suicide prevention
Judge Rules In ACA Premium Stabilization Program Case; New Hardship Exemption

On August 12, Judge Rebecca Ebinger of the United States District Court for the Southern District of Iowa entered the first decision in one of the growing number of cases challenging the administration of the premium stabilization programs, denying a...

Published Mon, Aug 15 2016 9:52 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, reinsurance, risk adjustment, advance premium tax credits, CO-OPs
Health Affairs Web First: New ACA Coverage Enrollees Increased Prescription Use And Lowered Spending

While there is evidence that the Affordable Care Act’s (ACA’s) coverage expansion provisions have increased the number of Americans covered by health insurance, less information exists about how new enrollees, particularly those with chronic health conditions...

Published Wed, Aug 17 2016 1:35 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Elsewhere@ Health Affairs, Insurance and Coverage, Costs and Spending, Medicaid and CHIP, Web First, chronic conditions, Health Affairs journal
CMS Releases Form For Insurers Submitting Contraceptive Claims

The final preventive services regulations issued by the Departments of Health and Human Services (HHS), Labor, and Treasury state that group health plans must provide their enrollees with the full range of FDA-approved contraceptive services without cost...

Published Tue, Aug 23 2016 11:11 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, contraceptive coverage, contraceptive mandate, Zubik v. Burwell

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Value Based Reimbursement: The Rock Thrown Into The Health Care Pond

CMS Provides New Clarity For Family Planning Under Medicaid

Health Expenditure Projections: When Does ‘New’ Become ‘Normal’?

How Policymakers Can Foster Organizational Innovation In Health Care

CMS Releases 2017 Enrollment Manual For Individual And Small Business Marketplaces

People Post: Staff And Board Changes At Foundations; Job Opening: Foundation President

CMS Releases Draft QRS And QHP Enrollee Experience Call Letter

Why ‘Government Patent Use’ To Lower Drug Costs Won’t Stifle Innovation

Minimum Essential Coverage Reporting And ‘No Wrong Door’ Coordination

Gulf War Illness 25 Years After Desert Storm

Texas Judge Refuses To Dismiss Health Insurance Provider Fees Case

Suicide Prevention: Access To Behavioral Health Services Lacking

Judge Rules In ACA Premium Stabilization Program Case; New Hardship Exemption

Health Affairs Web First: New ACA Coverage Enrollees Increased Prescription Use And Lowered Spending

CMS Releases Form For Insurers Submitting Contraceptive Claims