Health Affairs

The Affordable Care Act’s state health insurance exchanges for small businesses present a host of opportunities for states now creating them, but they also present design and regulatory challenges that could make or break the success of the program, according to a cluster of articles in the February issue of Health Affairs, released yesterday. The [...]

November 9, 2011. Time fell back three days ago, leaving me one less hour of daylight to enjoy on a gorgeous Indian summer Wednesday. I’m the attending physician on a busy family medicine inpatient service, and it’s been a long week of patient care and meetings. I rush out of the hospital somewhere near 5 pm, [...]

Last Thursday’s Republican Presidential Debate in Florida included a lively, but not always accurate, exchange on health reform in Massachusetts.  In particular, Senator Santorum reported that one in four Massachusetts residents were going without needed care because of high costs; he also implied that the share of residents choosing to pay the fine for failing [...]

Video of the release event for the January issue of Health Affairs, “Confronting The Growing Diabetes Crisis,” is now available on the Health Affairs Web site.

WHAT:      More than 1,000 health care leaders, entrepreneurs, innovators, government officials and others will join the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), Health Affairs, the West Wireless Health Institute and keynote speaker Dr. Atul Gawande, at the Care Innovations Summit. WHO:       Marilyn Tavenner, Acting Administrator, [...]

At a recent symposium concerning both saving money and improving patient care, Health Affairs Editor-in Chief Susan Dentzer stated, “It is well established now that one can in fact improve the quality of health care and reduce the costs at the same time.”  This is exactly the principle behind the growing movement toward patient-centered care.  [...]

Diabetes now affects nearly twenty-six million Americans, and over the next decade, an estimated forty million more US adults could develop the condition. Another 100 million more could suffer from an insidious prediabetic condition, one that often leads to the full-blown disease.  Growing scientific evidence suggests that lifestyle interventions, such as weight loss and fitness [...]

Editor’s note: See additional posts discussing Pioneer accountable care organizations by Debra Ness and William Kramer and Douglas Hastings. The December 19 announcement by the Centers for Medicare and Medicaid Services (CMS) of 32 Medicare Pioneer ACOs underscores the transition of “shared savings” and “accountable care” from policy concepts to implementation. Perhaps more than any [...]

If we’re truly serious about reining in health care costs and improving patient outcomes at the same time, then improving medication adherence is absolutely key. And if we’re serious about improving medication adherence, then the time to strike is now. That’s because there are major opportunities in health reform and major trends in the health [...]

As health care costs increase around the world, many countries are beginning to rely on disease registries, which can produce substantial savings. An international study of thirteen registries in five countries (Australia, Denmark, Sweden, the United Kingdom, and the United States) finds that registries enable health care professionals to engage in continuous learning as well [...]

In a recent Health Affairs article, researchers from RAND and Harvard highlighted the difficulties associated with implementing bundled payment, based on an evaluation of the PROMETHEUS Payment program, an initiative of the Health Care Incentives Improvement Institute (HCI3). They identified challenges to implementation on the part of both payers and providers, including defining the bundles; [...]

The McKinsey Global Institute reported in 2007 and 2008 that the United States spends twice as much for health care as for food. According to Census and Department of Agriculture data that pattern continues. Yet millions remain outside the protection of health insurance and many nominally within its bounds are seriously underinsured. Millions of individuals [...]

Editor’s note: See additional posts on the Medicare Shared Savings Program Final Rule  and related delivery system and payment reform initiatives by Debra Ness and William Kramer, Lawrence Casalino and Stephen Shortell,  Douglas Hastings, and Don Berwick and Richard Gilfillan. The release yesterday of the regulation to launch the Medicare Shared Savings Program (MSSP) marks [...]

Significant steps are being taken to implement the Affordable Care Act (ACA) even as the challenges to its constitutionality make their way through the federal courts.  For example, the Institute of Medicine recently released its much-anticipated report to the Secretary of Health and Human Services on the principles and methods that should guide the design [...]

Tomorrow, October 19, Health Affairs, along with co-sponsors the ABIM Foundation, the California HealthCare Foundation and the Foundation for Informed Medical Decision Making, will present ideas endorsed by leading physicians for Saving Money and Improving Patient Care in Medicare.  A list of speakers and other information is available in this earlier post.  WHEN:                  Wednesday, October [...]

The much anticipated Institute of Medicine Report on essential health benefits (EHB) was released last week with a series of recommendations that answered some questions and raised many more. The report offers a very important opportunity for researchers, policymakers, providers and patients to fill in some of the white space between the recommendations. Background on EHB [...]

With apologies to my more creative predecessors as Health Wonk Review hosts, there’s no theme today. (After all, how could one top Alistair Cookie?) I will get right to the great posts in this week’s edition. Costs And Premiums. At Managed Care Matters, Joe Paduda explores an apparent disconnect: flat medical costs coupled with rising [...]

This Friday, Oct. 14, 2011, a working meeting of innovators, policy and health IT experts, health care providers, patient organizations, technology companies, and government agencies will convene in Washington to assess progress in improving transitions in care and prioritize how the increasing availability of health IT can address some of the most intractable challenges related [...]

The nation’s 178 “worst” hospitals—the lowest-quality, highest-cost institutions—care for more than twice the proportion of elderly minority and poor patients as the  nation’s 122 “best” hospitals, where costs are lowest and quality highest. What’s more, the patients at the worst institutions are more likely than patients elsewhere to die of certain conditions, such as heart [...]

When making health care choices, is there a relationship between what health care consumers pay and the quality of services they receive? While this has been long debated, a soon-to-be published survey commissioned this year by the California HealthCare Foundation (CHCF) found uncertainty about the relationship between the cost and quality of care. The survey [...]