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Breaking Down The MACRA Proposed Rule

The mother ship has landed. On Wednesday, April 27, the Centers for Medicare and Medicaid Services (CMS) released the highly anticipated proposed rule that would establish key parameters for the new Quality Payment Program, a framework that includes the...

Published Fri, Apr 29 2016 7:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Medicare, Quality, Featured, Payment Policy, Organization and Delivery, Costs and Spending, Medicaid and CHIP, Health Professionals, CMS, EHRs, MACRA, payment models, mips, APMS
Medicaid Managed Care Final Rule: Examining The Alignment With Qualified Health Plan Requirements

Editor’s note: This post focuses on provisions in the Medicaid and CHIP managed care final rule regarding alignment, and sometimes lack of alignment, between Medicaid managed care requirements and those governing other insurance coverage programs, specifically...

Published Fri, Apr 29 2016 5:35 AM by Health Affairs BlogHealth Affairs Blog

Filed under: States, Medicare, Quality, Following the ACA, Insurance and Coverage, Medicaid and CHIP, medical loss ratios, network adequacy, Summary of Benefits And Coverage, external review, provider directories, internal review
State Options To Control Health Care Costs And Improve Quality

The recent debate on health care reform has occurred mostly at the national level. The Affordable Care Act, or ACA, was a momentous change for the American health care system. So far, 20 million people have gained health insurance coverage due to the...

Published Thu, Apr 28 2016 10:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: States, Medicare, Quality, Featured, Payment Policy, Organization and Delivery, Costs and Spending, Medicaid and CHIP, Payment Reform, ACA, CMMI, Long-term Services and Supports, Telehealth, APCDs, state policy, Gobeille vs. Liberty Mutual Insurance Company
On Zika Preparedness And Response, The US Gets A Failing Grade

There are worrying signs that the United States is unprepared to contain a likely Zika virus outbreak this summer. The critical problems are: insufficient resources for mosquito control, surveillance, and health care; highly variable capabilities and...

Published Thu, Apr 28 2016 7:45 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Prevention, Featured, Costs and Spending, Equity and Disparities, WHO, Congress, CDC, Zika virus, Zika, outbreaks, PAHO
Health Affairs Web First: For Medical Procedure Costs Vary Greatly By Locale

There are many reasons for geographic differences in health expenditures, including utilization, the cost of doing business, and providers’ and insurers’ ability to negotiate prices. A new study , released as a Web First by Health Affairs , examined the...

Published Wed, Apr 27 2016 1:43 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Elsewhere@ Health Affairs, Costs and Spending, Web First, Ohio, Virginia, price variation
Increasing Access To Dental Care For Seniors To Improve Overall Health

Shirley, like other senior residents in downtown San Diego, faces stark choices in day-to-day life. With more than 40 percent of seniors in San Diego living below the self-sufficiency level , many, like Shirley, have to choose between paying rent and...

Published Tue, Apr 26 2016 2:06 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Consumers, Prevention, Coverage, Access, Medicaid, Aging, Health Philanthropy, GrantWatch, Health Care Delivery, Oral Health, Health Promotion and Disease PreventionGW, Insurance and Coverage, Organization and Delivery, Medicaid and CHIP, California, Medi-Cal, seniors, Denti-Cal, dental health
What Does A New Era Of Physician Accountability Mean For Patients?

With the implementation over the next several years of the Medicare Access and CHIP Reauthorization Act (MACRA) and the gradual build-out of Physician Compare, a website launched by the Affordable Care Act (ACA), we are entering a new era of physician...

Published Tue, Apr 26 2016 8:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Physicians, Medicare, Quality, Population Health, Featured, Payment Policy, Insurance and Coverage, Medicaid and CHIP, CMS, EHRs, MACRA, Merit-Based Incentive Payment System, physician perspective, mips
About That Cadillac Tax

In December 2015, Congress delayed implementation of the so-called Cadillac tax, a 40 percent excise tax on high-cost employer health benefit plans. Now scheduled to be implemented in 2020, the Cadillac tax would effectively cap the current tax exclusion...

Published Mon, Apr 25 2016 8:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Employer-Sponsored Insurance, Featured, Payment Policy, Insurance and Coverage, Costs and Spending, Cadillac tax, employer coverage, high deductible health plans, employer health benefits
New Health Policy Brief: Medicare’s New Physician Payment System

A new policy brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) provides a primer on the Medicare payment part of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. For more than two decades, Congress and the federal...

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

Filed under: Medicare, Elsewhere@ Health Affairs, Payment Policy, MACRA, Merit-Based Incentive Payment System
Accountable Care Organizations In 2016: Private And Public-Sector Growth And Dispersion

As of the end of January 2016, Leavitt Partners, in partnership with the Accountable Care Learning Collaborative, has identified 838 active Accountable Care Organizations (ACOs) (see Figure 1) across the country with service areas in all 50 states and...

Published Thu, Apr 21 2016 1:30 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Medicare, Population Health, Payment Policy, Insurance and Coverage, Organization and Delivery, Costs and Spending, ACOs, Medicare Shared Savings Program, MACRA, Bundled Payments, Accountable Care Learning Collaborative
Studies Reveal A Critical Need To Educate Texans On The Basics Of Health Insurance

As the United States celebrates the sixth anniversary of the Affordable Care Act (ACA), there’s no debate that more Texans now have health insurance than before the ACA went into effect. In fact, the uninsured rate has dropped by more than 20 percent...

Published Thu, Apr 21 2016 11:30 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Health Reform, Consumers, Coverage, Access, Health Law, Health Philanthropy, GrantWatch, Insurance and Coverage, Texas, ACA Marketplace, Affordable Care Act, health insurance, Hispanics, health literacy
Compromise Prospects Recede In Contraceptive Mandate High Court Litigation

While briefs filed on April 12 by the petitioners and the government in Zubik v. Burwell , the Supreme Court contraceptive mandate case, suggested that there might be room for the Court to impose a compromise , reply briefs filed on April 20, indicated...

Published Thu, Apr 21 2016 10:08 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Mental Health, Following the ACA, Substance Use Disorders, MHPAEA
Make The Clinician Burnout Epidemic A National Priority

The health care workforce burnout epidemic is a national crisis. The time to act like it is now. Despite the promise of delivery system reform, especially following passage of the Affordable Care Act (ACA), the risk of burnout among physicians (and other...

Published Thu, Apr 21 2016 7:27 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Physicians, Quality, Hospitals, Organization and Delivery, Health Professionals, triple aim, EHRs, physician perspective, doctor burnout
How Things Get Done In Washington: Insights From 23 Former CMS Leaders

If you like the series House of Cards , or perhaps you simply want a better understanding of how things get done in Washington D.C., you may want to check out a new resource from the National Academy of Social Insurance (NASI). Insights from the Top:...

Published Wed, Apr 20 2016 11:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Politics, Medicare, Featured, Organization and Delivery, Medicaid and CHIP, ACA, Health Professionals, CMS, Republicans, Democrats, HCFA, national academy of social insurance
Designing Successful Bundled Payment Initiatives

Bundled payment initiatives are a growing form of value-based payment. The use of bundled payments can align reimbursement with the health care triple aim of improving experience of care, improving population health, and reducing total costs of care....

Published Wed, Apr 20 2016 8:10 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Medicare, Quality, Population Health, Featured, Payment Policy, Insurance and Coverage, Costs and Spending, triple aim, chronic disease, Bundled Payments, High-Cost Patients

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Breaking Down The MACRA Proposed Rule

Medicaid Managed Care Final Rule: Examining The Alignment With Qualified Health Plan Requirements

State Options To Control Health Care Costs And Improve Quality

On Zika Preparedness And Response, The US Gets A Failing Grade

Health Affairs Web First: For Medical Procedure Costs Vary Greatly By Locale

Increasing Access To Dental Care For Seniors To Improve Overall Health

What Does A New Era Of Physician Accountability Mean For Patients?

About That Cadillac Tax

New Health Policy Brief: Medicare’s New Physician Payment System

Accountable Care Organizations In 2016: Private And Public-Sector Growth And Dispersion

Studies Reveal A Critical Need To Educate Texans On The Basics Of Health Insurance

Compromise Prospects Recede In Contraceptive Mandate High Court Litigation

Make The Clinician Burnout Epidemic A National Priority

How Things Get Done In Washington: Insights From 23 Former CMS Leaders

Designing Successful Bundled Payment Initiatives