Health Affairs

How Should The Trump Administration Handle Medicare’s New Bundled Payment Programs?

Secretary of Health and Human Services (HHS) Dr. Tom Price and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma face significant decisions across a range of programs in the first half of 2017. Decisions regarding how the new...

Published Mon, Apr 10 2017 8:07 AM by Health Affairs BlogHealth Affairs Blog

Filed under: Medicare, Quality, Featured, Costs and Spending, oncology care model, tom price, CMS Innovation Center, bundled payment, Bundled Payments for Care Improvement Initiative, Episode Payment Model, Seema Varma, Comprehensive Care for Joint Care Model

Pharmacy Benefit Management Of Opioid Prescribing: The Role Of Employers And Insurers

In the last two decades, prescribing rates for opioids have increased nearly three-fold, from 76 million prescriptions in 1991 to approximately 207 million prescriptions in 2013 . This remarkable volume of opioid prescribing is unique to the United States...

Published Wed, Sep 20 2017 9:05 PM by Health Affairs BlogHealth Affairs Blog

Filed under: Payment Policy, Insurance and Coverage, Organization and Delivery, Costs and Spending, opiods, PBMs

Implementing Health Reform: First-Year Results From Reinsurance And Risk Adjustment Programs

On June 30, 2015, right on schedule, the Centers for Medicare and Medicaid (CMS) announced the results of the first year (2014) of the operation of the reinsurance and risk adjustment programs. The reinsurance and risk adjustment programs are two of the...

Published Wed, Jul 01 2015 7:24 AM by Health Affairs Blog

Filed under: Payment Policy, Following the ACA, Insurance and Coverage, Costs and Spending, CMS, insurers, reinsurance, health insurance, risk adjustment, premium stabilization programs

Health Spending Post Heads HA Blog February Most-Read List

How much health spending is sustainable? Charles Roehrig’s post addressing this question heads the list of most-read Health Affairs Blog posts for February. Next on the list is a post contrasting Medicare and commercial insurance by Diane Archer...

Published Wed, Mar 07 2012 10:22 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Blog, Consumers, Insurance, Physicians, Health IT, States, Spending, Medicare

The Ryan Plan And The Medicare Debate: The Crucial Questions

While Representative Paul Ryan’s (R-WI) most recent Medicare premium support proposal will be hotly debated during this charged political season, the more durable issue is what it means for the real debate on Medicare that looms after the election. Regardless...

Published Wed, Apr 18 2012 11:25 AM by Health Affairs Blog

Filed under: Policy, Politics, Health Care Costs, Spending, Medicare, Competition, Quality

Patient Advocates: Flies In The Ointment Of Evidence-Based Care

The women recounted how their lives had been saved as they pleaded for the Food and Drug Administration not to withdraw approval for Avastin as a treatment for advanced *** cancer. They did so even without evidence that it provides benefit and with evidence...

Published Mon, Jul 18 2011 11:07 AM by Health Affairs Blog

Filed under: All Categories, Public Health, Consumers, Public Opinion, Health Care Costs, Spending, Access, Pharma, Personal Experience, Effectiveness

A December Health Reform Implementation Update: A Health Affairs Conversation With Gail Wilensky And Tim Jost

What should we make of the latest enrollment numbers in the health insurance exchanges created under the Affordable Care Act? What sort of problems should we expect when coverage begins through the exchanges in January? Should we be worried that some...

Published Mon, Dec 16 2013 11:34 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Politics, Insurance, Physicians, Hospitals, Medicaid, Podcast

Health Beyond Health Care: RWJF Commission Issues New Report

Much of the political debate over health reform has focused on the important questions of affordable health insurance coverage and access to medical care. However, medical care is far from the most important factor influencing health, a fact that is at...

Published Wed, Jan 15 2014 1:40 PM by Health Affairs Blog

Filed under: All Categories, Nonmedical Determinants, Public Health, Prevention, Policy, Disparities, Children, Health Philanthropy

Why I Oppose Payment Reform

I recently gave the keynote address at the New York State Health Foundation Conference “Payment Reform: Expanding the Playing Field.” This blog post is adapted from those remarks (you can watch the half-hour speech beginning around the eight-minute mark...

Published Fri, Dec 12 2014 6:00 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Payment, Physicians, Health Care Costs, Spending, Quality, Hospitals, Innovation, Health Care Delivery, Once In A Weil

What To Watch For During This Year’s Open Enrollment Period: Lessons From The Health Reform Monitoring Survey

The Obama Administration recently lowered its expectations on the number of individuals that are likely to enroll in health insurance plans through the Marketplace by the end of 2015—suggesting that it might be more difficult than expected to find and...

Published Wed, Dec 10 2014 12:07 PM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Insurance, Health Care Costs, Coverage, Access, Health Law

New Health Affairs Issue Focuses On Emergency Medicine

The December issue of Health Affairs , released today, examines the state of emergency care in the United States. As Founding Editor John Iglehart describes in the issue: “Emergency departments seem like orphans in the US health care system, with few...

Published Tue, Dec 03 2013 1:21 PM by Health Affairs Blog

Filed under: All Categories, Health Care Costs, Hospitals, Medicaid, Children, Aging, Mental Health, Substance Abuse

Implementing Health Reform: The Role Of Agents And Brokers In The Exchanges

The torrent of Affordable Care Act guidance that marked the end of April has continued into May, as the Centers for Medicare and Medicaid Services (CMS) released on May 1, 2013, a Health Insurance Marketplace Guidance on the role of agents, brokers, and...

Published Thu, May 02 2013 6:37 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Policy, Insurance, States, Employer-Sponsored Insurance, Competition

Embedding Civil Legal Aid Services In Care for High-Utilizing Patients Using Medical-Legal Partnership

Mr. Jackson (not his real name) is a 42-year old man who was hospitalized three times in a seven-month period at Lancaster General Hospital in Pennsylvania. These hospitalizations were due to complications from chronic obstructive pulmonary disease, morbid...

Published Wed, Apr 22 2015 6:00 AM by Health Affairs Blog

Filed under: Health Law, Innovations in Care Delivery, Featured, civil legal aid, super-utilizers

If The ACA Were Repealed, Just What Would Replace It?

For five years Republicans have been clamoring for repeal of the Affordable Care Act. With Republicans gaining control of both houses of Congress in 2014, it is now conceivable that they could actually get repeal legislation---or repeal and replace legislation...

Published Tue, Apr 14 2015 12:55 PM by Health Affairs Blog

Filed under: Politics, States, Medicare, Featured, Following the ACA, Insurance and Coverage, Organization and Delivery, Costs and Spending, Medicaid and CHIP, public opinon

The Patient Is In: Listening To Low-Income Californians

The dramatic expansions in health insurance coverage included in the Patient Protection and Affordable Care Act (ACA) will give millions of low-income Americans greater choice in where and how they receive their health care. Until now, most of the discussion...

Published Mon, Feb 11 2013 10:21 AM by Health Affairs Blog

Filed under: All Categories, Health Reform, Consumers, Physicians, Primary Care, States, Competition, Disparities

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