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Section 1557 Of The ACA Should Not Allow Some Physicians To Discriminate

Section 1557 is the primary nondiscrimination provision of the Patient Protection and Affordable Care Act (ACA). It prohibits discrimination on the basis of race, color, national origin, sex, age, and disability by applying existing civil rights laws...

Published Wed, Jan 06 2016 11:00 AM by Health Affairs Blog

Filed under: Physicians, Quality, Payment Policy, Following the ACA, Insurance and Coverage, Costs and Spending, Equity and Disparities, Health Professionals, Medicare Advantage, Medicare Part B, Section 1557 waiver, nondiscrimination, civil rights
CMS’ Standardized Plan Option Could Reduce Discrimination

In their recently proposed rule , the Centers for Medicare and Medicaid Services (CMS) created a “ standardized option ” for plans at the bronze, silver, and gold metal levels. Insurers could elect—but are not required—to create a standardized...

Published Wed, Jan 06 2016 7:30 AM by Health Affairs Blog

Filed under: States, Quality, Featured, Payment Policy, Costs and Spending, Equity and Disparities, Drugs and Medical Technology, HIV/AIDS, CMS, Adverse Tiering, Massachusetts, New York, Essential Health Benefits
How Funders Can Support Emerging Accountable Care Organizations To Maximize Their Potential

Accountable care organizations (ACOs), once compared to mythical creatures , are now a widespread reality, with roughly 750 ACOs serving 23.5 million Medicare, Medicaid, and commercially insured patients across the United States. These models are designed...

Published Tue, Jan 05 2016 1:56 PM by Health Affairs Blog

Filed under: Health Reform, Nonmedical Determinants, Health Care Costs, Medicare, Quality, Medicaid, GrantWatch, Health Care Delivery, Population Health, Featured, Payment Policy, Organization and Delivery, Costs and Spending, Accountable Care Organizations, risk adjustment, Robert Wood Johnson Foundation, data
Health Affairs January Issue: High-Cost Populations, Medicaid Spending, And More

The January issue of Health Affairs explores the diverse needs of the small share of the population that accounts for the largest share of health spending in the United States. The issue also contains two studies examining how the Affordable Care Act...

Published Tue, Jan 05 2016 1:09 PM by Health Affairs Blog

Filed under: Global Health, Hospitals, Elsewhere@ Health Affairs, Medicaid and CHIP, ACA, Health Professionals, Medicaid expansion, Health Affairs journal, Substance Use Disorders
CBO Updates The Estimated Costs Of The Budget Reconciliation Act

Implementing Health Reform. On January 4, 2016, the Congressional Budget Office (CBO) released an updated estimate of the cost of the Budget Reconciliation Act as passed by the Senate. The CBO now estimates that the legislation would reduce federal outlays...

Published Tue, Jan 05 2016 10:13 AM by Health Affairs Blog

Filed under: Following the ACA, Costs and Spending, CBO, Budget Reconciliation Act
Medicaid Expansion In Michigan: The Second CMS Waiver

In the summer of 2013, when the State of Michigan Legislature debated whether or not to expand Medicaid, there was considerable discussion about a number of issues, including the role of the private sector and whether to include a “time limit” on Medicaid...

Published Tue, Jan 05 2016 7:00 AM by Health Affairs Blog

Filed under: Public Health, States, Quality, Following the ACA, Insurance and Coverage, Costs and Spending, Medicaid and CHIP, Equity and Disparities, Michigan, qualified health plans, Healthy Michigan Plan, Section 1115 Waivers
Hospice Payment Reforms Are A Modest Step Forward, But More Changes Are Needed

On August 6, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare hospice payment rates and wage index. This change was made in response to Section 3132(a) of the Affordable Care Act (ACA), which called...

Published Mon, Jan 04 2016 8:19 AM by Health Affairs Blog

Filed under: Medicare, End-of-Life Care, Aging, Palliative Care, Featured, Payment Policy, Insurance and Coverage, Costs and Spending, Long-term Services and Supports, Home Health, CMS, Social Work, Nursing, Medicare Advantage, hospice, MedPAC
Making Sense Of Price And Quantity Variations In U.S. Health Care

A recent study by Zack Cooper, Stuart Craig, Martin Gaynor, and John Van Reenen has documented the remarkable variations across regions and age groups, and within regions, in U.S. health care spending. Previously, the Dartmouth Atlas project studied variations...

Published Wed, Dec 30 2015 9:23 AM by Health Affairs Blog

Filed under: Medicare, Hospitals, Featured, Payment Policy, Insurance and Coverage, Organization and Delivery, Costs and Spending, Equity and Disparities, Health Professionals, ACOs, Dartmouth
Six Big Trends To Watch In Health Care For 2016

With the upcoming Presidential election, health care is once again keeping us up at night. How much of the current debate is hyperbolic rhetoric? What policy changes are realistic in an election year? What market trends in the private sector will drive...

Published Wed, Dec 30 2015 7:00 AM by Health Affairs Blog

Filed under: Physicians, Health IT, Medicare, Quality, Hospitals, Population Health, Featured, Payment Policy, Costs and Spending, Medicaid and CHIP, Drugs and Medical Technology, Health Professionals, generic drugs, Telemedicine, MACRA, Sovaldi, chronic illness, EMRs, trends
People Post: Staff And Board Changes In Health Philanthropy; Honors; Request For Proposals

Happy New Year to GrantWatch readers! Here is some light reading for the holiday weekend. Grantmakers In Health (GIH) has announced that six new members have been elected to its board. They are Ned Calonge, president and CEO of the Colorado Trust ; Nichole...

Published Tue, Dec 29 2015 3:54 PM by Health Affairs Blog

Filed under: Physicians, States, Global Health, Disparities, Health Philanthropy, GrantWatch, Environmental Health, Oral Health, Equity and Disparities, Health Professionals, California, Commonwealth Fund, Rhode Island, Colorado, Colorado Health Symposium, Kaiser Family Foundation, medical schools
The Price Of Inequality For Puerto Rico

Puerto Rico is in the midst of an economic and fiscal crisis and without congressional action the situation could become a humanitarian crisis. — Andrew Weiss, Treasury Testimony to the Senate … Committee on October 21, 2015 The effects of the Puerto...

Published Tue, Dec 29 2015 7:40 AM by Health Affairs Blog

Filed under: Public Health, Medicare, Global Health, Quality, Featured, Costs and Spending, Medicaid and CHIP, Equity and Disparities, Congress, Medicare Advantage, immigration, Puerto Rico, U.S. citizens
IRS Again Delays Minimum Essential Coverage Reporting Requirement, And Other ACA Developments

Implementing Health Reform. The Affordable Care Act imposes certain reporting requirements on large employers and providers of minimum essential coverage . Insurers, self-insured employers, and government programs must provide 1095-B statements to individuals...

Published Tue, Dec 29 2015 7:31 AM by Health Affairs Blog

Filed under: Following the ACA, Insurance and Coverage, IRS, employers, Affordable Care Act, minimum essential coverage, advance premium tax credits
Synchronizing Medicare Advantage And ACOs To Support The Secretary’s Quality And Value Payment Goals

In January 2015, Department of Health and Human Services Secretary Sylvia Burwell announced the Department will tie an increasing percentage of Medicare reimbursement to quality or value. While unanticipated, the announcement was not surprising, since...

Published Mon, Dec 28 2015 8:45 AM by Health Affairs Blog

Filed under: Medicare, Hospitals, Population Health, Featured, Payment Policy, Organization and Delivery, Costs and Spending, ACOs, value based care, fee-for-service, Medicare Advantage, Catalyst for Payment Reform, MACRA, Alternative Payment Models
CMS Releases Draft 2017 Letter To Issuers In The Federally Facilitated Marketplaces

Implementing Health Reform. On December 23, 2017, the Centers for Medicare and Medicaid Services (CMS) released its draft 2017 Letter to Issuers in the Federally Facilitated Marketplaces (FFMs). CMS also released a draft bulletin on the timing of rate...

Published Thu, Dec 24 2015 9:01 AM by Health Affairs Blog

Filed under: Medicare, Payment Policy, Following the ACA, Medicaid and CHIP, QHPs, Essential Health Benefits, Federally Facilitated Marketplace, essential community providers, SHOP exchanges, Provider Participation Rate, cost-sharing reductions
Four Readings On Health Philanthropy: A Holiday Potpourri

These items recently came across my desk, and I thought they were interesting enough to point out now, in case you missed them. Happy Holidays to all of our GrantWatch readers and thank you for your interest in health philanthropy. Health Care for the...

Published Wed, Dec 23 2015 5:33 PM by Health Affairs Blog

Filed under: Health IT, Access, Nurses, Health Philanthropy, GrantWatch, Health Care Delivery, Health Promotion and Disease PreventionGW, Organization and Delivery, Health Professionals, Patient Engagement, homelessness, Mark Zuckerberg, health care for the homeless

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Section 1557 Of The ACA Should Not Allow Some Physicians To Discriminate

CMS’ Standardized Plan Option Could Reduce Discrimination

How Funders Can Support Emerging Accountable Care Organizations To Maximize Their Potential

Health Affairs January Issue: High-Cost Populations, Medicaid Spending, And More

CBO Updates The Estimated Costs Of The Budget Reconciliation Act

Medicaid Expansion In Michigan: The Second CMS Waiver

Hospice Payment Reforms Are A Modest Step Forward, But More Changes Are Needed

Making Sense Of Price And Quantity Variations In U.S. Health Care

Six Big Trends To Watch In Health Care For 2016

People Post: Staff And Board Changes In Health Philanthropy; Honors; Request For Proposals

The Price Of Inequality For Puerto Rico

IRS Again Delays Minimum Essential Coverage Reporting Requirement, And Other ACA Developments

Synchronizing Medicare Advantage And ACOs To Support The Secretary’s Quality And Value Payment Goals

CMS Releases Draft 2017 Letter To Issuers In The Federally Facilitated Marketplaces

Four Readings On Health Philanthropy: A Holiday Potpourri