Health Affairs

Raising The Age Of Purchase For Tobacco Products: Lessons Learned from Tobacco21

In 2015 the Greater Kansas City Chamber of Commerce—in partnership with Blue Cross and Blue Shield of Kansas City, the Health Care Foundation of Greater Kansas City , and many other business, health, nonprofit, and government leaders—launched Healthy...

Published Thu, Mar 31 2016 1:59 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Prevention, Politics, Children, Health Philanthropy, GrantWatch, Health Promotion and Disease PreventionGW, Smoking Prevention, tobacco, e-cigarettes

Tamiflu For All? Evidence Of Morbidity In CDC’s Antiviral Guidelines

The Centers for Disease Control and Prevention (CDC) has boiled down its public health campaign against influenza to a single slogan: “Take 3.” Vaccines, everyday preventive actions like handwashing, and influenza antivirals. Last year, because of a mismatch...

Published Thu, Mar 31 2016 11:22 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Public Health, Prevention, Physicians, Global Health, Quality, Research, Drugs and Medical Technology, vaccines, Health Professionals, FDA, drug safety, CDC, clinical trials, influenza

The Payment Reform Landscape: Where We Started On Transparency Tools And Where We Need To Go

Today we live in the age of information. Modern technology is abundant, providing many with access to a wealth of knowledge and resources. With so much information at our fingertips, we can easily learn more about many of the choices we face in daily...

Published Thu, Mar 31 2016 9:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Consumers, Quality, Featured, Payment Policy, Costs and Spending, Catalyst for Payment Reform, high deductible health plans, tiered networks

First Medical Loss Ratio Audits Suggest Need For Clearer Standards

Implementing Health Reform. On March 29, 2016, the Centers for Medicare and Medicaid Services (CMS) posted the results of the first audits it has conducted of insurers under the Affordable Care Act’s (ACA) medical loss ratio (MLR) program. The MLR provisions...

Published Wed, Mar 30 2016 9:48 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, CMS, medical loss ratio, COBRA

The Challenges Of Rewarding Value Over Volume Without Penalizing Safety-Net Hospitals

Public and private insurers are increasingly paying health care providers based on the quality of care they provide rather than volume. This shift has generated some concerns about how performance on quality is measured and how rewards or penalties should...

Published Wed, Mar 30 2016 8:00 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Medicare, Quality, Hospitals, Narrative Matters, Elsewhere@ Health Affairs, Social Determinants of Health, Population Health, Featured, Organization and Delivery, Health Professionals, safety-net providers, value-based payment, safety-net organizations, Improving Medicare Post-Acute Care Transformation Act, Hospital Readmission Reductions Program

Time to Fashion A Quilt From The Patchwork Of Advance Care Planning

Thank you for David Tuller’s outstanding synthesis of the issues and opportunities surrounding end-of-life discussions in the United States, presented in the March 2016 Health Affairs Entry Point, “Medicare Coverage For Advance Care Planning: Just The...

Published Tue, Mar 29 2016 2:13 PM by Health Affairs Blog

Filed under: Consumers, Physicians, Medicare, Coverage, End-of-Life Care, Aging, Health Philanthropy, Palliative Care, Featured, Health Professionals, Aging and Health, advance care planning

CMS White Paper Examines The ACA Risk Adjustment Methodology

On March 31, 2016, the Centers for Medicare and Medicaid Services (CMS) will hold a day-long public meeting in Baltimore to discuss potential changes to its Affordable Care Act (ACA) risk-adjustment program . On March 24, CMS published a White Paper describing...

Published Tue, Mar 29 2016 11:00 AM by Health Affairs Blog

Filed under: Medicare, Following the ACA, Insurance and Coverage, Costs and Spending, Drugs and Medical Technology, Prescription Drugs, risk adjustment program, special enrollment periods, hierarchical condition categories

What Risk Adjustment Does — The Perspective Of A Health Insurance Actuary Who Relies On It

For decades before the Affordable Care Act (ACA), American health insurers were very good at avoiding enrolling people who were likely to be high-cost in the individual (or “non-group”) health insurance market. When individuals applied for coverage, they...

Published Tue, Mar 29 2016 10:30 AM by Health Affairs Blog

Filed under: Medicare, Featured, Following the ACA, Insurance and Coverage, Costs and Spending, Medicare Advantage, Covered California, risk corridors, safety net and value, guaranteed-issue requirement

An Innovative Patient-Centered Total Joint Replacement Program

Total joint replacement surgery is among the most commonly performed inpatient procedures in the United States. More than 1,000,000 hip and knee replacements are performed each year, and, with the aging of our population, that number is expected to grow...

Published Mon, Mar 28 2016 10:00 AM by Health Affairs Blog

Filed under: Physicians, Quality, Innovations in Care Delivery, Insurance and Coverage, Organization and Delivery, Costs and Spending, Health Professionals, patient-centered care, safety net and value, surgery, hip and knee replacements, surgeons

Value Pricing For Drugs: Whose Value, What Price?

It is hard to read a newspaper these days without coming across a story about the high and ever increasing cost of drugs. The Wall Street Journal named drug prices the top health story of 2015. Stories about drug prices fall into two general categories...

Published Mon, Mar 28 2016 8:15 AM by Health Affairs Blog

Filed under: Medicare, Featured, Costs and Spending, Drugs and Medical Technology, ACOs, Big Pharma, QUALY, value-based payment, PCSK9 inhibitors, high-cost drugs, cost effectiveness analysis

How Solid Is The Primary Care Foundation Of The Medical Home?

The patient-centered medical home (PCMH) has received attention as an improved care delivery model for primary care physicians — and possibly also for specialists who serve as principle physicians for patients with particular chronic conditions...

Published Fri, Mar 25 2016 9:00 AM by Health Affairs Blog

Filed under: Physicians, Primary Care, Quality, Hospitals, Population Health, Health Professionals, ACOs, Patient-Centered Medical Home, MACRA, Alternative Payment Models, physicians perspective

In Annual Baseline Budget Projections, CBO Decreases Marketplace Enrollment Estimates

On March 24, 2016, the Congressional Budget Office and Joint Committee on Taxation (collectively referred to here as the CBO) released their annual baseline budget projections regarding Federal Subsidies for Health Insurance Coverage for People Under...

Published Fri, Mar 25 2016 5:45 AM by Health Affairs Blog

Filed under: Health IT, Medicare, Following the ACA, Insurance and Coverage, Costs and Spending, Medicaid and CHIP, healthcare.gov, Congressional Budget Office, CBO, GAO, data services hub, Government Accountability Office, federal budget projections, data privacy and security

Health Affairs Briefing: Patients’ And Consumers’ Use Of Evidence

The health policy literature is filled with references to providers, but patients are all too often left out of the conversation regarding how to best meet their needs. Growing attention to patient-centered care – with the attendant need for a better...

Published Thu, Mar 24 2016 12:41 PM by Health Affairs Blog

Filed under: Elsewhere@ Health Affairs, patient uses of evidence, events

A New Arena For Reducing Antibiotic Misuse: Outpatient Care

Antibiotic resistance related to the misuse and overuse of antibiotics has emerged as a growing public health concern, with at least 2 million people infected with resistant bacteria each year . To date, most efforts to promote more judicious use of antibiotics...

Published Thu, Mar 24 2016 11:38 AM by Health Affairs Blog

Filed under: Public Health, Consumers, Quality, Hospitals, Health Philanthropy, GrantWatch, Health Care Delivery, Health Promotion and Disease PreventionGW, Drugs and Medical Technology, Health Professionals, Antibiotic Resistance

Funding Zika But Forgetting Tuberculosis

On February 8, the day before the White House sent its Fiscal Year (FY) 2017 budget request to Congress, President Obama requested $1.8 billion in emergency funding to respond to the Zika virus at home and abroad. The World Health Organization (WHO) has...

Published Thu, Mar 24 2016 6:51 AM by Health Affairs Blog

Filed under: Public Health, Global Health, Featured, Costs and Spending, infectious disease, WHO, USAID, TB, Obama, 2017 budget, tuberculosis

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