MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'health care costs'. Sat, 03 Sep 2011 01:59:09 +0100 http://www.medworm.com/index.php?rid=5181736&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F09%2F01%2Fberwick-to-keynote-health-affairs-briefing%2F Don Berwick, the Administrator of the Centers for Medicare and Medicaid Services, will keynote Health Affairs’ September 8 briefing on controlling health care costs. At the briefing, Health Affairs will release its September 2011 issue, “The New Urgency To Lower Costs.” Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181736 Thu, 01 Sep 2011 14:09:50 +0100 5181736 http://www.medworm.com/index.php?rid=5181737&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F31%2Fthe-challenges-of-payment-reform-and-administrative-simplification%2F As both a Canadian and an analyst who focuses on US healthcare, I have an abiding curiosity in comparisons between the US and Canadian systems, so it was with great interest that I read the recent Health Affairs article by Dante Morra and coauthors entitled “US Physician Practices Versus Canadians: Spending Nearly Four Times As Much Money [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181737 Wed, 31 Aug 2011 16:57:12 +0100 5181737 http://www.medworm.com/index.php?rid=5158921&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F24%2Fmedicares-looming-risk-transfer%2F Editor’s Note: Below, Jaan Sidorov analyzes the risk-shifting inherent in proposals for Medicare reform. Today, Health Affairs Blog is also publishing the first installment of a two-part post by Troyen Brennan and Thomas Lee, which addresses risk-shifting in the health care system as well. Suppose, despite my good health and lifelong habit of avoiding doctors, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158921 Wed, 24 Aug 2011 15:53:07 +0100 5158921 http://www.medworm.com/index.php?rid=5158922&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F24%2Frisk-shifting-in-health-care-and-its-implications-part-one%2F Editor’s Note: Below, in the first installment of a two-part Health Affairs Blog post, Troyen Brennan and Thomas Lee discuss the shifting of risk they see taking place in the health care system, from insurers and employers to provider and patients. In part two tomorrow, Brennan and Lee will discuss the implications of this shift [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5158922 Wed, 24 Aug 2011 15:50:18 +0100 5158922 http://www.medworm.com/index.php?rid=5158999&cid=t_99592_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fare-patients-considering-the-idea-of-medical-tourism-to-receive-health-care%2F2011.08.24 I must confess that I have a weakness for medical tourism. Patients have always been ready to go on a pilgrimage to find the world’s leading expert (we call it ‘key opinon leader’ now) hoping to find a cure. As long as traditional leaders in the field of Medicine have been the Germans, the French and the English -with some occasional Austrian and Spanish name in the mix- traffic of wealthy patients across Europe is nothing new. Since we entered the antibiotics era, these leaders started to be located mainly in the United States, the cradle of modern, technology-driven Medicine. Thus hi-tech centers got ready to welcome foreign patients, building strong International Customer Support departments. A random example -by no means the only one- would be the Mayo Clinic. On their website y... Better Health blogs http://www.medworm.com/rss/comments.php?id=5158999 Wed, 24 Aug 2011 14:00:07 +0100 5158999 http://www.medworm.com/index.php?rid=5139672&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F18%2Fimplementing-health-reform-informing-consumers%2F One of the most important innovations of the Affordable Care Act (ACA) is that it dramatically increases and improves the information that consumers have available about health insurance and health care.  HHS has already implemented provisions of the ACA requiring insurers to disclose information regarding their medical loss ratios and to publicly justify unreasonable rate [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139672 Thu, 18 Aug 2011 14:49:06 +0100 5139672 http://www.medworm.com/index.php?rid=5118590&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F11%2Fhealth-spending-projection-spin-cycle-rinse-and-repeat-or-reset%2F One of the annual rituals of Washington’s health policy calendar involves the release of projections for the next ten years of national health spending by actuaries at the Centers for Medicare and Medicaid Services (CMS). It then is followed immediately by desperate efforts by various interest groups and advocacy “analysts” to spin the new numbers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118590 Thu, 11 Aug 2011 16:41:21 +0100 5118590 http://www.medworm.com/index.php?rid=5118591&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F10%2Fhealth-affairs-briefing-confronting-costs%2F On September 8, Health Affairs will release its September 2011 issue, “Confronting Costs.” The issue explores the third element of the famed Three-Part Aim for health care: namely, the objective of lowering costs. Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears the burden of health costs; the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118591 Wed, 10 Aug 2011 15:36:17 +0100 5118591 http://www.medworm.com/index.php?rid=5107477&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F09%2Fjulys-most-read-ha-blog-posts%2F Timothy Jost’s series of posts on proposed new federal rules for state health insurance exchanges leads July’s list of most-read Health Affairs Blog posts. Jon Kingsdale’s article on Massachusetts’ efforts to control health care costs is also featured on the list, as are Jeff Goldsmith’s discussion of the effect of health reform on employer-based health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5107477 Tue, 09 Aug 2011 13:44:43 +0100 5107477 http://www.medworm.com/index.php?rid=5077641&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F29%2Fa-call-for-physicians-to-contribute-to-solutions-not-costs%2F  It’s time for America’s physicians, particularly its highly paid procedural specialists, to make a choice.  Are we primarily businessmen with a keen eye on the financial bottom line, or are we above all professionals, well versed in the healing arts and dedicated to our patients’ care, regardless of their circumstances?  America’s medical system is breaking [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5077641 Fri, 29 Jul 2011 14:11:18 +0100 5077641 http://www.medworm.com/index.php?rid=5077642&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F28%2Fu-s-health-spending-projected-to-grow-5-8-percent-annually%2F All health care spending in the United States is projected to grow at an annual average rate of 5.8 percent for the period 2010 through 2020, 1.1 percentage points faster than expected growth in Gross Domestic Product (GDP). By 2020, health care spending is projected to be 19.8 percent of GDP, nearly one-fifth of economic [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5077642 Thu, 28 Jul 2011 13:48:45 +0100 5077642 http://www.medworm.com/index.php?rid=5069421&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F27%2Fthe-beacon-communities-at-one-year-the-mississippi-delta-experience%2F The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the fifth in a series of Health Affairs Blog posts in which leaders of several Beacon communities discuss their [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5069421 Wed, 27 Jul 2011 18:59:24 +0100 5069421 http://www.medworm.com/index.php?rid=5050506&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F18%2Fpatient-advocates-flies-in-the-ointment-of-evidence-based-care%2F 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 breast cancer. They did so even without evidence that it provides benefit and with evidence that it confers risks. Their efforts were ultimately not successful: the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5050506 Mon, 18 Jul 2011 18:07:44 +0100 5050506 http://www.medworm.com/index.php?rid=5028116&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F14%2Flow-income-patients-in-california-experiences-and-expectations%2F Editor’s Note: Another Health Affairs Blog post published today also discusses the California health care system and how the Affordable Care Act will affect the way the state meets the needs of low-income patients. Many low-income patients have had little or no choice about where they obtain health care. But this will change when the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028116 Thu, 14 Jul 2011 18:24:00 +0100 5028116 http://www.medworm.com/index.php?rid=5008114&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F06%2Fhypercostitis-political-theater-in-massachusetts%2F The Play’s the Thing. America boasts the highest health care costs on God’s green earth, and Massachusetts spends more per capita than any other state. Some might say we have a problem. On June 30th, Massachusetts completed four days of hearings on run-away medical costs — what drives them and how to rein them in. [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008114 Wed, 06 Jul 2011 16:35:34 +0100 5008114 http://www.medworm.com/index.php?rid=5008115&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F05%2Fjosts-look-at-court-fight-over-reform-tops-ha-blogs-june-most-read-list%2F Tim Jost’s analysis of crucial appellate arguments over the constitutionality of the Affordable Care Act leads June’s list of most-read Health Affairs Blog posts. Jost examines the arguments before the federal Eleventh Circuit Court of Appeals in a challenge to the legislation brought by more than half the states and the National Federation of Independent [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008115 Tue, 05 Jul 2011 16:31:47 +0100 5008115 http://www.medworm.com/index.php?rid=4984408&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F30%2Fin-first-appellate-case-a-significant-victory-for-the-affordable-care-act%2F On June 29, 2011, the Sixth Circuit federal court of appeals held that Congress has the power under the Constitution to adopt the minimum coverage requirement of the Affordable Care Act. The decision in Thomas More Law Center v. Obama is very significant for several reasons.  First, it is the first ruling by a federal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4984408 Thu, 30 Jun 2011 11:22:04 +0100 4984408 http://www.medworm.com/index.php?rid=4968442&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F24%2Festablishing-sensible-cost-sharing-for-medicare-cancer-patients%2F A new study by Avalere Health, presented at the recent meeting of the American Society of Clinical Oncology, analyzed the pharmacy claims of 10,508 commercially-insured and Medicare patients who required oral therapy for cancer. The purpose of the study was to assess the effects of cost-sharing on the abandonment of these medications. The analysis showed [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4968442 Fri, 24 Jun 2011 15:19:10 +0100 4968442 http://www.medworm.com/index.php?rid=4960013&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F22%2Fa-physician-fallow-program-to-improve-quality-safety-and-costs%2F In a recent New York Times op-ed, Rita Redberg MD, a cardiologist and Chief Editor of Archives of Internal Medicine, described the American health system’s penchant for delivering high volumes of “procedures and devices [to] patients who get no benefit and incur risks from them.” The culprit, of course, is fee-for-service reimbursement, used by Medicare, Medicaid and commercial [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4960013 Wed, 22 Jun 2011 19:12:02 +0100 4960013 http://www.medworm.com/index.php?rid=4952777&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F17%2Fthe-mixed-demerits-of-bending-the-cost-curve%2F Political scientists emphasize the importance of “framing” in policy debates.  The health care cost control debate in the United States has been reframed by the promotion of a metaphor, “bending the curve.”  This metaphor has merits but they are decidedly mixed. The sudden popularity of the idea of “bending the cost curve” is significant because [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4952777 Fri, 17 Jun 2011 13:41:22 +0100 4952777 http://www.medworm.com/index.php?rid=4921370&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F09%2Fanalyzing-a-crucial-battle-in-the-legal-war-over-health-reform%2F For a lawyer, the argument of Florida v. the Department of Health and Human Services before a three judge panel of the Eleventh Circuit Federal Court of Appeals on Wednesday, June 8, was a beauty to behold.  (For a non-lawyer it was probably tedious, repetitive, and much too long).  Three active and very well-prepared judges [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4921370 Thu, 09 Jun 2011 13:44:03 +0100 4921370 http://www.medworm.com/index.php?rid=4893371&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F02%2Fcreating-value-based-incentives-for-primary-care%2F In a remarkable recent interview, Donald Berwick MD, Administrator of the Centers for Medicare and Medicaid Services (CMS), eloquently described his vision of value-based health care. Paying for value is an incentive…The underlying idea of improvement is that American health care, historically built in fragments, often cannot achieve for patients what it really wants to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4893371 Thu, 02 Jun 2011 17:25:08 +0100 4893371 http://www.medworm.com/index.php?rid=4872049&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F26%2Fhealth-wonk-review-memorial-day-edition%2F If you’re traveling over the long weekend, you’ll want to take along some reading material. While some might reach for a good novel by John Grisham or Dan Brown, the health policy blogs in this edition of the Health Wonk Review tackle equally compelling mysteries. Was the Medicare Trustees report really that gloomy? If Workers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4872049 Thu, 26 May 2011 13:29:21 +0100 4872049 http://www.medworm.com/index.php?rid=4862491&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F24%2Fprotecting-children-from-environmental-chemical-exposures-an-economic-priority%2F In the May Health Affairs issue, Sarah Vogel and Judy Roberts map out the disastrous history of the 1976 Toxic Substances Control Act (TSCA), the major legislation that regulates chemicals.  TSCA makes it difficult for the Environmental Protection Agency (EPA) to restrict use of any of the 62,000 chemicals already in commerce.  It does not [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862491 Tue, 24 May 2011 13:03:06 +0100 4862491 http://www.medworm.com/index.php?rid=4862492&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F23%2Fjust-another-hospital-weekend-or-life-and-death%2F Suppose you need to drive from Boston to San Francisco, about 3200 miles, over the next 7 days.  At an average speed limit of 55 mph you could accomplish this by driving about 10 hours a day, including stops for rest and food breaks; a grueling but not impossible journey. Now suppose that gas stations [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862492 Mon, 23 May 2011 19:25:39 +0100 4862492 http://www.medworm.com/index.php?rid=4841411&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F19%2Fha-studies-focus-on-reducing-costs-reaching-the-underserved%2F The Affordable Care Act of 2010 is expected to extend health coverage to some thirty-two million previously uninsured Americans.  Two of the many challenges faced by both the private sector and the government are getting a handle on rapidly rising medical costs and providing care to the many new enrollees with chronic illnesses who are [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4841411 Thu, 19 May 2011 19:36:27 +0100 4841411 http://www.medworm.com/index.php?rid=4841412&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F19%2Fthe-beacon-communities-at-one-year-the-colorado-experience%2F Editor’s Note: The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the second in a series of Health Affairs Blog posts in which leaders of several Beacon communities [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4841412 Thu, 19 May 2011 18:56:51 +0100 4841412 http://www.medworm.com/index.php?rid=4828841&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F16%2Fthe-beacon-communities-at-one-year-the-central-indiana-experience%2F Editor’s note: The federal government’s Beacon Program provides funding to 17 communities that have already made inroads in the development of secure, private, and accurate systems of electronic health record (EHR) adoption and health information exchange. This is the first in a series of Health Affairs Blog posts in which leaders of several Beacon communities [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4828841 Mon, 16 May 2011 16:14:39 +0100 4828841 http://www.medworm.com/index.php?rid=4820800&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F12%2Fwhat-health-reform-means-for-medicare%2F While President Barack Obama and congressional leaders continue to tussle over what to do about the nation’s unsustainable entitlement spending programs, the effects of the Patient Protection and Affordable Care Act (PPACA) seem to have gone largely unnoticed. This oversight is hard to explain. In recent decades, real Medicare spending has been growing at a [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4820800 Thu, 12 May 2011 12:26:08 +0100 4820800 http://www.medworm.com/index.php?rid=4813229&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F11%2Fclinical-registries-the-opportunity-for-the-nation%2F In the early 1970s, the Cystic Fibrosis Foundation began tracking the health of patients with cystic fibrosis.  What began as a modest data collection effort is today a comprehensive clinical registry of 26,000 patients.  Caregivers and researchers use the registry to identify new trends in outcomes; recognize the most effective treatments; and design clinical trials [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4813229 Wed, 11 May 2011 16:22:36 +0100 4813229 http://www.medworm.com/index.php?rid=4794833&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F06%2Fnew-answers-on-macular-degeneration-important-questions-for-comparative-effectiveness-research%2F On April 28th, the New England Journal of Medicine published the results of a study that compared two drugs head-to-head for the treatment of age-related macular degeneration (AMD), the leading cause of legal blindness in the United States.  The two drugs, Ranibizumab (Lucentis) and Bevacizumab (Avastin), are very similar molecules and are both meant to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4794833 Fri, 06 May 2011 15:45:32 +0100 4794833 http://www.medworm.com/index.php?rid=4789633&cid=t_99592_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Frn2r9MWhDMo%2F Conceived as part of health care reform, accountable care organizations may become the next big thing in lowering cost. The basic premise involves a network of doctors and hospitals that share responsibility for providing care to patients. Each ACO would receive financial incentives to provide quality care to Medicare beneficiaries while holding down costs. And since the intiative is scheduled to launch in January 2012, there is a scramble under way among physician practices and hospitals to form ACOs. The Obama administration, meanwhile, recently proposed guidelines on how ACOs will work (look here). But what are the implications for the pharmaceutical industry? We spoke with Ian Spatz, a senior advisor to Manatt Health Solutions, founder of Rock Creek Policy Group and a former vp for pub... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4789633 Thu, 05 May 2011 20:50:41 +0100 4789633 http://www.medworm.com/index.php?rid=4753649&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F26%2Fwhere%25e2%2580%2599s-the-patient-in-the-patient-centered-medical-home%2F The patient-centered medical home (PCMH) has grabbed the limelight as a new model of health care that offers an alternative to fragmented, impersonal and wasteful care that has become the norm throughout much of the U.S.  The PCMH model promises each patient a primary care provider leading an interdisciplinary care team, with the intent of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4753649 Tue, 26 Apr 2011 17:58:32 +0100 4753649 http://www.medworm.com/index.php?rid=4734026&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F21%2Fwill-price-competition-lead-to-quality-competition%2F Editor’s Note: In addition to John Goodman (photo and bio above), this post was coauthored by Gerald Musgrave and Devon Herrick. In our third-party-payer health insurance system the price for care is typically set by entities external to the doctor-patient relationship.  As a result, providers rarely compete for patients based on money prices. Potentially they [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4734026 Thu, 21 Apr 2011 13:13:12 +0100 4734026 http://www.medworm.com/index.php?rid=4723782&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F18%2Fcomparative-effectiveness-research-how-can-it-change-practice%2F The Patient Protection and Affordable Care Act (ACA)  is designed to increase the number of U. S. citizens with access to health insurance.  Along with augmented access to health insurance and hopefully health care for millions of the currently uninsured, as well as some degree of overall health care cost containment,  the ultimate success of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4723782 Mon, 18 Apr 2011 13:59:19 +0100 4723782 http://www.medworm.com/index.php?rid=4714710&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F14%2Fthe-proposed-accountable-care-organization-antitrust-guidance-a-first-look%2F Editor’s note: This post, by Joe Miller, is part of a series of Health Affairs Blog posts examining the proposed rules and guidelines implementing the Medicare Shared Savings Program, issued March 31 by the Centers for Medicare and Medicaid Services and other agencies.  You can read other posts in the series by Mark McClellan and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4714710 Thu, 14 Apr 2011 19:11:59 +0100 4714710 http://www.medworm.com/index.php?rid=4610785&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F18%2Fpallone-cites-michael-oggs-narrative-matters-essay-in-class-act-hearing%2F Michael Ogg’s Narrative Matters essay in the January issue of Health Affairs “powerfully illustrates the realities of the current long-term care environment,” Rep. Frank Pallone (D-NJ) said yesterday at a House Energy and Commerce Health Subcommittee hearing.  Pallone, the panel’s senior Democrat, entered the essay into the hearing record. Ogg suffers from primary progressive multiple [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4610785 Fri, 18 Mar 2011 15:39:56 +0100 4610785 http://www.medworm.com/index.php?rid=4592345&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F15%2Fwhat-employers-don%25e2%2580%2599t-spend-for-health-will-cost-them%2F Recently it was reported that the federal government has issued more than a thousand waivers concerning various provisions of the Affordable Care Act. Some of the earliest and most high-profile waiver requests involved the McDonald’s restaurant chain, whose capped benefit “mini-med” plans, — provided by McDonald’s to 30,000 hourly employees, about 8 percent of all [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4592345 Tue, 15 Mar 2011 17:04:05 +0100 4592345 http://www.medworm.com/index.php?rid=4642758&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Fletstalkhealthcare.org%2Fblog%2Fblog-post-title-lorem-ipsum-dolor-sit-amet%2F Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut eu turpis odio, non vehicula nisl. Vivamus justo urna, dictum vitae dapibus sit amet, ullamcorper eu dui. Sed quam est, imperdiet vel faucibus non, hendrerit ac tellus. Praesent eu ligula nibh, vitae pharetra lacus. (Source: HPHC) HPHC blogs http://www.medworm.com/rss/comments.php?id=4642758 Thu, 10 Mar 2011 02:48:14 +0100 4642758 http://www.medworm.com/index.php?rid=4566355&cid=t_99592_167_f&fid=38271&url=http%3A%2F%2Frebeccascritchfield.wordpress.com%2F2011%2F03%2F09%2Fneed-a-nutritionist-see-a-registered-dietitian%2F Who hoo! It’s a blog carnival for registered dietitians, celebrating #RDday (for those twitter-ers). Be sure to check back at this post for links to other blogs by my RD colleagues participating. I can’t wait to get into my piece, but I just can’t help myself to use this opportunity to explain what and RD is and why we are essential to the health and wellness of the people and a healthy economy. What is an RD? When you’re sick and you need to see a doctor, your doctor has a credential – the “MD” – which stands for medical doctor. The nurse takes your weight and blood pressure – and that person has a credential too – the “RN” – which stands for registered nurse. Then there’s the RD – which stands for r... Balanced Health and Nutrition Rebecca Scritchfield's Blog blogs http://www.medworm.com/rss/comments.php?id=4566355 Wed, 09 Mar 2011 14:24:11 +0100 4566355 http://www.medworm.com/index.php?rid=4549728&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F04%2Fthe-real-issue-controlling-all-health-care-costs%2F The current cry to reduce Federal deficits and debt growth by reducing Medicare and Medicaid entitlements is totally missing the key issue: the need to moderate all health care inflation. This should be the time for a national debate on how to best tackle the underlying cost problem, for the sake of our future, the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4549728 Fri, 04 Mar 2011 17:16:19 +0100 4549728 http://www.medworm.com/index.php?rid=4522081&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F25%2Fhouse-family-planning-cuts-bad-medicine-and-bad-economics%2F Last week, on February 19, under the pretext of cutting the federal deficit, the United States House of Representatives voted to eliminate funding and end reimbursement to health care providers supplying crucial sexual and reproductive health care to millions of women and men across the country.   The provisions are part of the House-passed Continuing [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4522081 Fri, 25 Feb 2011 14:01:03 +0100 4522081 http://www.medworm.com/index.php?rid=4489622&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F17%2Fdefining-essential-benefits-congress-once-and-future-role%2F A non-governmental advisory body has begun to define one of the most important elements of last year’s health reform law. A committee of the Institute of Medicine will develop recommendations to the Department of Health and Human Services on how to define an “essential health benefit.” The ultimate resolution of this question, which may not [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4489622 Thu, 17 Feb 2011 18:38:46 +0100 4489622 http://www.medworm.com/index.php?rid=4489623&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F16%2Feradicating-polio-will-we-succeed-this-time%2F Editor’s Note: The Bill and Melinda Gates Foundation and other global health leaders recently launched a new effort to eradicate polio. Below, Scott Barrett comments on the potential rewards and the risks of this new initiative, and in another post Judith Kaufmann offers her thoughts on the new initiative as well. The global effort to eradicate polio [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4489623 Wed, 16 Feb 2011 20:42:19 +0100 4489623 http://www.medworm.com/index.php?rid=4489624&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F16%2Feradicating-polio-challenges-and-questions%2F Editor’s Note: The Bill and Melinda Gates Foundation and other global health leaders recently launched a new effort to eradicate polio. Below, Judith Kaufmann comments on the potential rewards and the risks of this new initiative, and in another post Scott Barrett offers his thoughts on the new initiative as well. On January 31, Bill Gates introduced [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4489624 Wed, 16 Feb 2011 20:37:38 +0100 4489624 http://www.medworm.com/index.php?rid=4477683&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F14%2Fsebelius-tells-story-of-ha-narrative-matters-author%2F In a speech last week at the Kaiser Family Foundation, Health and Human Services Secretary Kathleen Sebelius said that the Administration was looking at ways to buttress the financing of a new long-term care insurance program included in the Affordable Care Act. This comes in response to concerns raised by President Obama’s National Commission on [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4477683 Mon, 14 Feb 2011 17:29:55 +0100 4477683 http://www.medworm.com/index.php?rid=4459931&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F10%2Fthe-individual-mandate-neither-essential-nor-enough%2F All eyes are focused on the many state challenges to health reform.  Florida’s recent federal court decision held the entire health reform law unconstitutional, based on the unconstitutionality of the mandate requiring all U.S. citizens to maintain a minimum level of health insurance coverage beginning in 2014, or pay a penalty.  Virginia’s earlier decision severed [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4459931 Thu, 10 Feb 2011 19:48:36 +0100 4459931 http://www.medworm.com/index.php?rid=4419097&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F31%2Ftop-10-health-affairs-articles-in-2010%2F We are pleased to announce the “most-read” Health Affairs journal articles published in 2010. The number 1 article published in 2010 with more than 44,000 pageviews was ”What Changes In Survival Rates Tell Us About US Health Care,” by Peter A. Muennig and Sherry A. Glied from the November 2010 issue of Health Affairs. The most-viewed [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4419097 Mon, 31 Jan 2011 22:12:36 +0100 4419097 http://www.medworm.com/index.php?rid=4405747&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F26%2Fhealth-care-and-the-state-of-the-union%2F Below, Kavita Patel, former director of policy for the White House Office of Public Engagement and Intergovernmental Affairs, discusses President Obama’s State of the Union address and House Budget Committee chairman Paul Ryan’s (R-WI) Republican response. See other posts on this topic by Len Nichols and Joseph Antos.  The Constitution mandates that the President “from time to time [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4405747 Wed, 26 Jan 2011 21:05:12 +0100 4405747 http://www.medworm.com/index.php?rid=4322486&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F07%2Fnew-health-affairs-the-next-phase-for-acos%2F The Affordable Care Act created new “accountable care organizations” (ACOs) in Medicare, and an accompanying “shared savings” program, to improve the quality of care for Medicare beneficiaries and reduce unnecessary costs. Now, health systems across the country are building on the model by drawing up ACO-like contracts with private payers.  The January issue of Health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4322486 Fri, 07 Jan 2011 16:15:30 +0100 4322486 http://www.medworm.com/index.php?rid=4313986&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F3Z8bfN325lM%2F By Michael F. CannonSomething smells fishy here. Today, the federal agency that runs Medicare and Medicaid released its estimates of national health expenditures in 2009.  Interestingly, the U.S. Centers for Medicare & Medicaid Services re-categorized about 6 percent of national health expenditures — well over $100 billion — from “government” to “private,” at the very moment that the government share of NHE appeared set to hit 50 percent. Last year, CMS projected that government health spending would “account for more than half of all U.S. health care spending by 2012.”  But it looks like we were set to reach (have reached?) that milestone much sooner.  See the below table, which I made using CMS’s estimates from 2008 and Exhibit 5 (p. 1... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4313986 Thu, 06 Jan 2011 00:05:30 +0100 4313986 http://www.medworm.com/index.php?rid=4298611&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F29%2Fhealth-policy-brief-preventive-services-without-cost-sharing%2F A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation describes the ways the Affordable Care Act mandates coverage for the complete cost of 45 preventive services, both for those with new private insurance plans and Medicare patients. Preventive services include a wide range of clinical activities to avoid, detect, and slow the progression of disease. [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4298611 Wed, 29 Dec 2010 18:56:33 +0100 4298611 http://www.medworm.com/index.php?rid=4294827&cid=t_99592_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2F-uEjqrPKAcM%2F This study shows once again how physical fitness is directly related to mental fitness. At all age, exercising the body benefits the brain. Interestingly, aerobic training is usually related to better cognitive performance. This new study shows that resistance training can be added to our list of exercise to do. Related posts: Physical exercise: why aerobic exercise enhances neurogenesis and neuroplasticity Walking increases brain volume and reduces risks of decline (Source: SharpBrains) SharpBrains blogs http://www.medworm.com/rss/comments.php?id=4294827 Tue, 28 Dec 2010 16:13:34 +0100 4294827 http://www.medworm.com/index.php?rid=4642759&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Fletstalkhealthcare.org%2Fblog%2Fopening-the-black-box-part-2%2F In my last blog, I explained how insurance premiums are calculated for employers having less than 51 employees and for individuals and how state regulations affect those rates. In this blog post I will provide examples that drive a: Premium decrease of 37% Premium increase of 16% Premium increase of 52% …even when the medical cost trend is increasing at 10% in all three examples. To keep the math simple, each example is based on an employer with two employees, but the same concepts are applicable to employers that have up to 50 employee lives.I also assume the customer will keep their benefits exactly the same. For a quick review from the last post, the premium is determined by two components: the Base Rate – or the average rate for all small employers and individuals covered by ... HPHC blogs http://www.medworm.com/rss/comments.php?id=4642759 Wed, 22 Dec 2010 23:39:25 +0100 4642759 http://www.medworm.com/index.php?rid=4265607&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F12%2Fcost-awareness-anecdote-between-the-cracks-contest-finalist.html By KELLY CHERAMY Between the cracks is a frightening place to be. During the course of trying to improve our family’s financial stability, my husband and I were blind-sided by one hidden detail: We’d face $10,000 in costs to continue... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4265607 Sat, 18 Dec 2010 00:00:00 +0100 4265607 http://www.medworm.com/index.php?rid=4249014&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F10%2Fhealth-affairs-conference-innovations-in-health-care-delivery-2%2F Health Affairs, the nation’s leading journal on health policy, is convening a day-long conference on “Innovations Across the Nation in Health Care Delivery.” The free conference is scheduled for Thursday, December 16, from 8:30 a.m. to 4:00 p.m., at the Ronald Reagan Center for International Trade, 1300 Pennsylvania Avenue, NW, in Washington, D.C. Richard Gilfillan, the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4249014 Fri, 10 Dec 2010 19:36:57 +0100 4249014 http://www.medworm.com/index.php?rid=4249003&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F12%2Fcost-awareness-anecdote-978-american-dollars-contest-finalist-.html By JESSA HARTFORD The following story is from Jessa Hartford, a social worker and substitute teacher from Sacramento, CA On 4/29/10 I received a Mirena IUD. I thought about this a lot; I read forums and articles on the device... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4249003 Fri, 10 Dec 2010 00:00:00 +0100 4249003 http://www.medworm.com/index.php?rid=4245276&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F09%2Fregional-quality-initiatives-expanding-the-partnership%2F If you’re looking for a transformation in health care, look first to America’s cities, towns and communities. That’s where it happens, among local men and women who deliver and receive care, and the employers and consumers who pay for it. That’s why the Robert Wood Johnson Foundation (RWJF) and the U.S. Department of Health and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4245276 Thu, 09 Dec 2010 15:58:37 +0100 4245276 http://www.medworm.com/index.php?rid=4251101&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F12%2Fcost-awareness-anecdote-978-american-dollars-contest-finalist-.html By JESSA HARTFORD On 4/29/10 I received a Mirena IUD. I thought about this a lot; I read forums and articles on the device and its side-effects. I decided that because I already have a beautiful son who is 2... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4251101 Thu, 09 Dec 2010 00:00:00 +0100 4251101 http://www.medworm.com/index.php?rid=4245259&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F12%2Fbending-the-curve-beginning-with-birth.html By AMY M. ROMANO As I prepare for next week’s webinar on payment reform to align incentives with quality, I have been thinking a lot about how we pay for maternity care in this country, and the opportunities to rein... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4245259 Thu, 09 Dec 2010 00:00:00 +0100 4245259 http://www.medworm.com/index.php?rid=4241697&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F08%2Fstudies-puncture-arguments-about-benefits-of-imaging-self-referral%2F When physicians who aren’t radiologists refer patients to imaging facilities they own or lease—known as self-referral—their patients don’t always benefit. In fact, these self-referrals lead to overuse of services, escalate spending, and rarely shorten the duration of illness, according to a series of studies in the December issue of Health Affairs. The findings challenge what [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4241697 Wed, 08 Dec 2010 16:24:00 +0100 4241697 http://www.medworm.com/index.php?rid=4233131&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F12%2Fthe-problem-with-free-market-healthcare.html By JOE FLOWER The right payment structure keeps patients healthy while saving money. We want healthcare to be abundant, effective, easy, and cheap; for too many of us too much of the time it is scarce, ineffective, and maddeningly difficult.... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4233131 Mon, 06 Dec 2010 00:00:00 +0100 4233131 http://www.medworm.com/index.php?rid=4233130&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F12%2Famerican-healthcare-x-.html By RONALD PIES, MD “A decent provision for the poor is the true test of civilization.” ~Samuel Johnson “Joe” has been on the streets now for two months. He’s 35, unmarried, and diagnosed with chronic schizophrenia since age 19. His... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4233130 Mon, 06 Dec 2010 00:00:00 +0100 4233130 http://www.medworm.com/index.php?rid=4207271&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F11%2Fbond-markets-and-health-care-financing.html By ROBERT LASZEWSKI When will the Congress and the White House finally make the hard decisions in order come to grips with the federal deficit problem? When will we finally deal with real health care reform and get the entitlements,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4207271 Sun, 28 Nov 2010 00:00:00 +0100 4207271 http://www.medworm.com/index.php?rid=4200548&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F24%2Fthoughtful-purchasing-at-cms%2F Recent press reports on Medicare’s decision to evaluate coverage policy for the new cancer therapy Provenge were highly critical of the Centers for Medicare and Medicaid Services (CMS) and its role in examining the evidence behind FDA-approved products.  Let’s take a step back. In fact, this is exactly what CMS should be doing – carefully [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4200548 Wed, 24 Nov 2010 14:21:49 +0100 4200548 http://www.medworm.com/index.php?rid=4642760&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Fletstalkhealthcare.org%2Fblog%2Fopening-the-black-box-part-1%2F How can it be that health insurers indicate that total medical cost is rising 8 – 10% but a small employer may see premium increases as high as 20% – 30%, or more? Increasingly, we read or hear about small employers that were shocked after receiving very large health insurance premium increases. There is no question that we collectively need to find better strategies to reduce cost of care, but it’s also important to understand how insurance premiums are calculated. So the purpose of this blog is to open up the so-called “black box” for calculating insurance premiums. To begin, I will only focus with the part of the insurance market that can see some of the biggest swings – namely the “merged market,” which includes small employers (50 or fewer employees) and individual... HPHC blogs http://www.medworm.com/rss/comments.php?id=4642760 Mon, 22 Nov 2010 17:44:06 +0100 4642760 http://www.medworm.com/index.php?rid=4183272&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F19%2Fimplementing-health-reform-emerging-guidance-on-insurance-exchanges%2F Editor’s Note: This is the latest in a series of posts by Timothy Jost on the implementation of the Affordable Care Act.  Earlier posts by Jost provide analyses of regulations implementing provisions of the Act governing coverage for pre-existing conditions, appeals of coverage denials, coverage for preventive services, a patient bill of rights, grandfathered plans, tax exempt hospitals, the small employer tax [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4183272 Fri, 19 Nov 2010 17:29:55 +0100 4183272 http://www.medworm.com/index.php?rid=4179295&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F18%2Fconsumers-and-insurance-experiences-in-eleven-countries%2F As the United States begins implementing health reform, how does the U.S. experience compare with that of other high-income countries? To answer that question, The Commonwealth Fund conducted its thirteenth annual health policy survey, this year focusing on access, cost, and care experiences. The survey findings were published today in a Health Affairs Web First [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4179295 Thu, 18 Nov 2010 15:51:36 +0100 4179295 http://www.medworm.com/index.php?rid=4179296&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F18%2Fthe-fiscal-commission-co-chairs%25e2%2580%2599-health-proposals-the-good-the-bad-and-the-ugly%2F The federal government’s unsustainable long-run fiscal picture has been outlined in successive versions of the Congressional Budget Office’s Long-Term Budget Outlook.  The policy problem is that spending rises above any reasonable level of taxation for the indefinite future.  As it currently stands, committed federal expenditures are expected to grow from 20 percent of gross domestic [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4179296 Thu, 18 Nov 2010 13:33:36 +0100 4179296 http://www.medworm.com/index.php?rid=4159195&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F12%2Fhow-do-you-solve-a-problem-like-health-reform-has-singapore-got-it-right%2F Editor’s Note: This week, senior health policy experts and emerging health care leaders from around the world have gathered in Salzburg, Austria, where the Salzburg Global Seminar, in association with the Nuffield Trust, has convened a health care series titled, “Reforming Health Care: Maintaining Social Solidarity and Quality in the Face of Economic, Health and Social Challenges.” Health Affairs Deputy [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4159195 Fri, 12 Nov 2010 12:02:01 +0100 4159195 http://www.medworm.com/index.php?rid=4151696&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F11%2Fthe-6-an-hour-health-minimum-wage.html By JOHN GOODMAN The stunning election results will put even more pressure on Congress to deal with the economy and jobs when it reconvenes in mid-November. But as it turns out, one way to boost the economy is to reconsider... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4151696 Mon, 08 Nov 2010 00:00:00 +0100 4151696 http://www.medworm.com/index.php?rid=4118856&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F28%2Freminder-health-affairs-briefing-on-value-based-insurance-design%2F On November 2, 2010, Health Affairs will welcome policy experts at a briefing to discuss key topics in value-based insurance design. VBID is the primary focus of the journal’s November issue, published with the support of the California HealthCare Foundation. Areas to be discussed will include: the evidence supporting the impact of value-based insurance design; the effectiveness of value-based insurance design in getting [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4118856 Thu, 28 Oct 2010 16:28:24 +0100 4118856 http://www.medworm.com/index.php?rid=4118857&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F27%2Finterstate-insurance-sales-questioning-the-race-to-the-bottom%2F The House Republican “Pledge to America” calls for opening up the health insurance marketplace by allowing people to purchase insurance across state lines. Families USA director Ron Pollack objects that this would cause a “race to the bottom,” with consumers buying insurance in states with the fewest consumer protections (read: regulations) and, therefore, the lowest [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4118857 Wed, 27 Oct 2010 22:10:48 +0100 4118857 http://www.medworm.com/index.php?rid=4118858&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F27%2Fthe-politics-of-health-reform-will-it-get-better-for-democrats%2F In next week’s elections, voters will punish Democrats for passing health reform legislation that focused on expanding coverage rather than controlling costs, Republican pollster Whit Ayres said at a Health Affairs media breakfast this morning. Democratic pollsters Stan Greenberg and Celinda Lake argued that the issue of health reform would play better for Democrats in [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4118858 Wed, 27 Oct 2010 18:53:41 +0100 4118858 http://www.medworm.com/index.php?rid=4105641&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F25%2Fhealth-care-prices-ignored-once-again%2F The United States spends far more on health care than other industrialized countries, yet Americans visit the doctor less and spend fewer days in the hospital than our counterparts abroad. Why do we get less for more? Because we pay far higher prices, four Health Affairs authors declared in a seminal 2003 article, “It’s The [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4105641 Mon, 25 Oct 2010 21:05:46 +0100 4105641 http://www.medworm.com/index.php?rid=4105624&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F10%2Fdear-mr-smith.html By DAVID DRANOVE John Smith of Chicago (not his real name) asked the following question in a recent letter to a local newspaper: “Over the last several years my annual deductible has increased from $500 to $2000…With higher rates, I... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4105624 Sun, 24 Oct 2010 23:00:00 +0100 4105624 http://www.medworm.com/index.php?rid=4086243&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F20%2Fhealth-affairs-briefing-value-based-insurance-design%2F The November issue of Health Affairs,with the support of the California HealthCare Foundation, focuses on the growing interest in and adoption of value-based insurance design.  Value-based insurance design is based on the simple concept that incentives matter – and if insurance coverage is an obvious set of incentives for both provider and patient, it should be [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4086243 Wed, 20 Oct 2010 15:52:28 +0100 4086243 http://www.medworm.com/index.php?rid=4082031&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F10%2Fpbm-industry-reforms-can-reduce-wasteful-health-care-spending-protect-patient-choice-of-pharmacy.html By CSS American businessman Victor Kiam best described the small business owners’ mindset by declaring, “An entrepreneur assumes the risk and is dedicated and committed to the success of whatever he or she undertakes.” However, external forces can occasionally constrain... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4082031 Mon, 18 Oct 2010 23:00:00 +0100 4082031 http://www.medworm.com/index.php?rid=4082029&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F10%2Fmedicare-costs-rise-health-outcomes-suffer-when-seniors-are-over-medicated.html By NAOMI FREUNDLICH The problem of elderly people taking too many medications is not new, but continues to pose a serious risk to health as well as contribute significantly to rising Medicare costs. The fact is that nearly 20% of... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4082029 Mon, 18 Oct 2010 23:00:00 +0100 4082029 http://www.medworm.com/index.php?rid=4074011&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F14%2Fplugging-into-the-future-of-health-care%2F Lonny Reisman, Aetna’s chief medical officer, was a participant in an August 5  National Press Club briefing on steps the private sector can take to promote meaningful use of health IT. The briefing was cosponsored by Health Affairs and the Health Industry Forum at Brandeis University. The post below highlights some aspects of Reisman’s presentation and supplements his discussion. Too often, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4074011 Thu, 14 Oct 2010 18:37:14 +0100 4074011 http://www.medworm.com/index.php?rid=4060546&cid=t_99592_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F10%2Ffirst-bend-in-the-health-care-cost-curve.html By PAUL LEVY Recent trends in radiology imaging portend a dramatic and rapid reduction in this segment of a hospital's business plan. Even before capitated (or global) payments have come into full play, there has been a large reduction in... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4060546 Mon, 11 Oct 2010 23:00:00 +0100 4060546 http://www.medworm.com/index.php?rid=4055703&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FjyWDFq34l5Q%2F By Michael F. Cannon“The Affordable Care Act offers new benefits like preventive care with no out-of-pocket cost and tools to help fight unreasonable premium increases that will save money for consumers.” — Jessica Santillo, a spokeswoman at the Department of Health and Human Services The Cognitive Dissonance of ObamaCare Supporters is a post from Cato @ Liberty - Cato Institute Blog (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4055703 Mon, 11 Oct 2010 13:31:07 +0100 4055703 http://www.medworm.com/index.php?rid=4022885&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F01%2Fbending-the-cost-curve%2F In the national debate leading up to the passage of the Patient Protection and Affordable Care Act (PPACA), President Obama said on several occasions that he would veto any bill that did not lower the growth rate of health care spending. So now that the Act is law, you would expect to find a lot [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4022885 Fri, 01 Oct 2010 05:22:56 +0100 4022885 http://www.medworm.com/index.php?rid=4003231&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F27%2Fgilfillan-to-head-cms-innovation-center%2F Richard Gilfillan, MD, will be the new Acting Director of the new Center for Medicare and Medicaid Innovation (“CMI,” or “Innovation Center”) at the Centers for Medicare and Medicaid Services (CMS), CMS Administrator Don Berwick announced today. Gilfillan currently directs CMS’ performance-based payment policy staff. The Affordable Care Act gives the Innovation Center the crucial mission of testing “innovative payment [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4003231 Mon, 27 Sep 2010 16:36:27 +0100 4003231 http://www.medworm.com/index.php?rid=3998941&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F24%2Fout-of-pocket-theory-for-health-spending-cutbacks-is-clueless%2F The predictable lead sentence in a recent New York Times story proclaimed not only the obvious — that the economic crisis in the U.S. reduced use of routine medical care – but observed that such cutbacks are much deeper here than in countries with universal health care systems. And the supposed culprit was the usual [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3998941 Fri, 24 Sep 2010 13:44:44 +0100 3998941 http://www.medworm.com/index.php?rid=3987026&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F20%2Fhealth-affairs-briefing-comparative-effectiveness-research%2F A major new national initiative in comparative effectiveness research is under way, thanks to the Affordable Care Act and 2009 stimulus legislation. The research is aimed at giving patients, health care providers and those paying the bill for health care far better information than ever on which to base health care decisions, as well as [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3987026 Mon, 20 Sep 2010 19:13:55 +0100 3987026 http://www.medworm.com/index.php?rid=3972893&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fwww.ihi.org%2Fihi%2Ffiles%2FWIHI%2FWIHI_20091202_Patient_Flow.mp3 Editor’s Note. This post is authored by Eugene Litvak PhD, Arnold Milstein MD, MPH and Mark Smith MD, MBA. Photos and bios for Milstein and Smith are above. Litvak is President and CEO of the Institute for Healthcare Optimization and also an Adjunct Professor in Operations Management in the Department of Health Policy and Management [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3972893 Wed, 15 Sep 2010 13:45:36 +0100 3972893 http://www.medworm.com/index.php?rid=3946416&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F08%2Fnew-health-affairs-acute-but-nonemergency-patients-going-to-ers%2F The busy daytime schedules of office-based primary care doctors, coupled with limited access to primary care services, have led a large number of Americans to seek care in hospital emergency departments, even when the problem may not be an emergency.  According to a new study in the September issue of Health Affairs, more than a quarter [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3946416 Wed, 08 Sep 2010 16:07:20 +0100 3946416 http://www.medworm.com/index.php?rid=3933077&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F30wBufdzMh0%2F By Michael F. CannonAs I blogged earlier, yesterday the Kaiser Family Foundation and the Health Research & Educational Trust released their survey of employer-sponsored health benefits in 2010. For most of this survey’s history, it included a very useful graph of the average growth rate of employer-sponsored insurance premiums.  Here’s the graph from their 2007 survey: (The grey and light-green lines represent year-to-year growth in overall inflation and wages, respectively.) Unfortunately, 2007 was the last year that KFF/HRET included that graph in their annual survey.  Had they included that graph this year, it would have shown an even more heartening moderation of premium growth: A lot of things can drive premium growth.  I discussed a couple of them in my last post... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3933077 Fri, 03 Sep 2010 19:20:13 +0100 3933077 http://www.medworm.com/index.php?rid=3929197&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F02%2Ffirms-shifting-burden-to-workers-for-family-coverage%2F Workers on average are paying nearly $4,000 this year toward the cost of family health coverage — an increase of 14 percent, or $482, above what they paid last year, according to the benchmark 2010 Employer Health Benefits Survey released today by the Kaiser Family Foundation and the Health Research & Educational Trust (HRET). Selected [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3929197 Fri, 03 Sep 2010 03:34:03 +0100 3929197 http://www.medworm.com/index.php?rid=3920803&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F08%2F31%2Fhealth-affairs-briefing-medical-liability-and-er-use%2F The September 2010 issue of Health Affairs is devoted to two issues that arguably were insufficiently addressed by the Affordable Care Act:  medical liability and patient safety; and the growing nonemergency use of the nation’s hospital emergency rooms. The issue contains new estimates of how much medical liability costs the health care system overall; of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3920803 Tue, 31 Aug 2010 16:27:26 +0100 3920803 http://www.medworm.com/index.php?rid=3865252&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FzEpq-o68-0w%2F By Michael F. CannonRep. Paul Ryan (R-WI) ably defends his “Roadmap for America’s Future” in today’s Washington Post.  He doesn’t mention Paul Krugman’s attacks thereon, nor should he.  (To read why, consult The Atlantic’s Megan McArdle and Ted Gayer of the Tax Policy Center.) I haven’t officially weighed in on the health-care aspects of the Roadmap, but hope to do so in the near future.  For the moment, I’ll use Ryan’s oped to stress a distinction that is crucial to thinking clearly about health care costs. Ryan writes of the dangers of an un-reformed Medicare program (emphasis added): Under an ever-expansive, all-consuming central government, costs will be contained with Washington’s heavy hand imposing price controls, ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3865252 Fri, 13 Aug 2010 15:10:18 +0100 3865252 http://www.medworm.com/index.php?rid=3802349&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F29%2Fviable-and-reliable-alternatives-to-colonoscopies%2F According to the American College of Gastroenterology, colorectal cancer is currently the third leading cause of cancer-related deaths in the United States. The colonoscopy is considered the “gold standard” for colon cancer detection. However, a new Health Affairs Web First study by researchers from RTI International demonstrates that for screening programs with limited budgets, using fecal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3802349 Thu, 29 Jul 2010 12:57:09 +0100 3802349 http://www.medworm.com/index.php?rid=3798522&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F28%2Fend-of-life-savings-the-fools-gold-of-reform%2F Just over 1 in 4 dollars spent by the Medicare program last year was spent on someone who was in their last year of their life.  This is nothing new–the basic proportion has not changed since it was first noted in the 1970s.  Other nations that spend much less on health care nevertheless spend a similar [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3798522 Wed, 28 Jul 2010 20:12:46 +0100 3798522 http://www.medworm.com/index.php?rid=3757828&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F15%2Fimplementing-health-reform-preventive-services%2F Editor’s Note: Earlier posts by Timothy Jost provide analyses of regulations implementing provisions of the new health reform legislation governing a patient bill of rights, grandfathered plans, tax exempt hospitals, the small employer tax credit, the Web portal, reinsurance for early retirees, and young adult coverage.  On July 14, 2010, the Departments of Treasury, Labor, and Health and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3757828 Thu, 15 Jul 2010 15:48:36 +0100 3757828 http://www.medworm.com/index.php?rid=3740564&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F09%2Fwill-more-insurers-control-health-care-costs-better%2F A common theme among health reformers has been that the small-group and individual markets for health insurance are too concentrated and thus inadequately competitive. The proposed remedy is to have more independent insurers compete within local markets.  Reformers left of center on the ideological spectrum – President Obama prominent among them – advanced this thesis [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3740564 Fri, 09 Jul 2010 17:38:26 +0100 3740564 http://www.medworm.com/index.php?rid=3690803&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F23%2Fimplementing-health-reform-a-patient-bill-of-rights%2F Editor’s Note: Earlier posts by Timothy Jost provide analyses of regulations implementing provisions of the new health reform legislation governing grandfathered plans, tax exempt hospitals, the small employer tax credit, the Web portal, reinsurance for early retirees, and young adult coverage.  On June 22, the Departments of Health and Human Services, Labor, and Treasury released interim final regulations implementing five of the insurance enrollee protections of the Patient Protection and Affordable Care Act: the prohibition against preexisting condition exclusions, the prohibition against lifetime health insurance coverage limits, the restriction of annual coverage limits, the limitation on rescissions, and the provisions guaranteeing direct access to certain types of providers a... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3690803 Wed, 23 Jun 2010 17:09:23 +0100 3690803 http://www.medworm.com/index.php?rid=3648454&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F09%2Fan-accountable-care-organization-reading-list%2F Having been blessed by the new health reform legislation, accountable care organizations (ACOs) are a hot topic in the health policy world, as evidenced by the just-concluded and well-attended National Accountable Health Care Organization Summit (cosponsored by Health Affairs) in Washington, D.C. Health Affairs has published much of the research and thinking related to ACOs. For example, in the May 2010 issue of the journal, Mark McClellan, Aaron McKethan, Julie Lewis, Joachim Roski, and Elliott Fisher lay out “A National Strategy To Put Accountable Care Into Practice.” The authors address the question of what exactly qualifies as an ACO and provide an update on implementation of ACOs in the context of other reforms, as well as mapping the way forward. In “Unchecked Provider Clout ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3648454 Wed, 09 Jun 2010 21:04:17 +0100 3648454 http://www.medworm.com/index.php?rid=3519416&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F04%2F30%2Fhow-to-simplify-medical-billing-and-reduce-costs%2F As every American knows, the process of billing third-party entities for health care services is complex and time-consuming, for the patient as well as for the provider.  According to the authors of an article published yesterday in Health Affairs, physicians use nearly 12 percent of their net revenue to cover the costs of these administrative charges. To improve this situation, Bonnie Blanchfield of Massachusetts General Hospital and her colleagues have created a hypothetical model, consisting of a single, transparent set of payment rules for multiple payers, a single claim form, and standard rules of submission. They estimate that the changes could result in $7 billion of annual savings for physician and clinical services billings, and four hours per physician and five hours per practi... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3519416 Fri, 30 Apr 2010 13:16:50 +0100 3519416 http://www.medworm.com/index.php?rid=3475780&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F04%2F15%2Fimaging-technology-adoption-the-impact-of-self-referral%2F Conclusion      Both articles, while informative, fail to address what I believe is the most significant driver of increased use of MRI for nonspecific low back pain and of hospitals’ adoption of the 64-slice CT scanner: self-referral. If Baras and Baker could identify self-referral physicians, I suspect their findings would show that the likelihood of undergoing an MRI is much higher for patients treated by referring physicians who stand to gain financially from each MRI scan performed.  Along the same line, if Lapado and colleagues had the data to capture competition from CT scans performed in nonhospital settings, I expect that this factor would be the driving force behind a hospital’s decision to acquire a 64-slice CT machine. Our efforts to bend the cost curve and rein in he... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3475780 Thu, 15 Apr 2010 19:22:10 +0100 3475780 http://www.medworm.com/index.php?rid=3453866&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F04%2F08%2Fmedicare-part-d-drug-pricing%2F Last month, Rep. Peter Welch (D-VT) introduced a bill (H.R. 4752) to overturn the 2003 ban on government-led price negotiations for Medicare Part D drug plans.  The bill has 67 co-sponsors so far.  While perhaps well intentioned, this bill will do little to reduce Part D drug prices. Giving the government the power to negotiate drug prices can work only if we have credible alternatives to the drug on the table.  Plans need: (1) generics or similar drugs in the therapeutic class; and (2) formulary flexibility to drive market share in exchange for price concessions. First, many complex specialty drugs are biological and don’t have generic equivalents.  Proposals debated in this Congress would establish a regulatory pathway for bio-similars, but the current language mandates a long excl... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3453866 Thu, 08 Apr 2010 18:55:04 +0100 3453866 http://www.medworm.com/index.php?rid=3424811&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F30%2Fmoving-toward-a-robust-comparative-effectiveness-research-enterprise%2F Editor’s Note: Most health policy analysts believe that better evidence about quality and value, obtained through comparative effectiveness research (CER), can drive better clinical decision making and could potentially slow the rate of growth in health care spending.  But the success of any national CER initiatives will depend on how evidence is developed, whether it is trusted, and how is used by patients, providers, and payers. Last fall,  the Health Industry Forum of Brandeis University hosted a roundtable in Washington DC, bringing together policymakers from HHS, AHRQ, NIH, and CMS with representatives from the Health Industry Forum’s Advisory Board to discuss how public and private investments in CER can be focused to achieve maximum value. Chaired by Professor Stuart Altman,... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3424811 Tue, 30 Mar 2010 18:48:26 +0100 3424811 http://www.medworm.com/index.php?rid=3370368&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F16%2Fa-consumers-advocacy-group-refutes-the-anti-health-reform-myths%2F At long last, health reform legislation appears headed for a series of final votes in the next few weeks. The ultimate outcome in treacherous political waters is uncertain. What should happen, from the perspective of a consumer advocacy organization, is abundantly clear: Congress should pass legislation this year to begin dramatically improving health care access, delivery, payment, and cost management in the United States. What drives our position is the widely recognized and urgent need of individual consumers and families, the economy, and public health for this reform. There is also one argument we find particularly compelling: virtually every major federal health care program that has been enacted over the last fifty years—from Medicare and Medicaid to COBRA, SCHIP, and the Medicare... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3370368 Tue, 16 Mar 2010 14:35:03 +0100 3370368 http://www.medworm.com/index.php?rid=3335288&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FeMoZExHNuB4%2F By Alan ReynoldsCongressman Paul Ryan (R-WI) takes the President to task for cooking the books on projected health care costs, most egregiously with the “doc fix” — namely, assuming Medicare slashes physician payments by 21.3% this year and subsequently lets them fall continuously in real terms. What nobody seems to have noticed is that the same phony “doc fix” taints the new “Health Spending Projections Through 2019” from Centers for Medicare and Medicaid Services (CMS). Drew Altman, president and CEO of the Kaiser Family Foundation, tries to downplay the CMS forecast “that the public sector will start paying more than half of the nation’s health care bill starting in 2012, and that government spending will grow faster than private spending from 2009 to 2019... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3335288 Thu, 04 Mar 2010 20:59:09 +0100 3335288 http://www.medworm.com/index.php?rid=3322332&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F02%2Fhealth-affairs-policy-briefs-examine-child-obesity%2F In conjunction with its March 2010 issue on child obesity, Health Affairs has prepared a series of policy briefs. The new Health Affairs volume demonstrates that policy leaders can and should take crucial steps to address the obesity epidemic,  and the briefs encapsulate policy recommendations from articles in the March issue. The briefs also contain links back to the full-length Health Affairs articles for additional information. The briefs, which are freely available to all, include: Overview: The State Of Childhood Obesity In America The Role Of Agriculture Policy In Reducing Childhood Obesity Food Marketing And Distribution’s Role In The Fight Against Childhood Obesity Speeding Up Progress In Fighting Obesity In Schools Lessons From States On Fighting Childhood Obesity ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3322332 Tue, 02 Mar 2010 16:43:14 +0100 3322332 http://www.medworm.com/index.php?rid=3322333&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F02%2Fchild-obesity-health-affairs-explores-strategies-for-combating-epidemic%2F How should America tackle an obesity crisis that is threatening the health and well-being of nearly one-third of its children? That is the subject of the March 2010 edition of Health Affairs, which both describes the root causes of this pathology and offers prescriptions for improving the health of America’s children. The March issue is funded by the Robert Wood Johnson Foundation. “Kids are becoming obese or overweight at the ripe old age of four, meaning that they are already predisposed to shorter, sicker lives from diabetes, heart problems, even certain types of cancer,” writes Health Affairs Editor-in-Chief Susan Dentzer. “What is this crisis if not some national form of child abuse?” A new study by Christina Bethell of the Oregon Health and Science Unive... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3322333 Tue, 02 Mar 2010 15:02:09 +0100 3322333 http://www.medworm.com/index.php?rid=3318368&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F01%2Flessons-from-the-health-care-summit%2F Many journalists have called and asked me what I have learned from watching the much heralded Health Care Summit at Blair House. Actually quite a bit, as the discourse there crystallized so clearly the ideological division that makes coherent and comprehensive health reform so difficult in this country, if not impossible. In thinking about this question, I make a distinction between the policy-making elite and the “American people” — the plebs — for whom, allegedly, the elite makes policy. My counter-question then is: Are either the elite or the plebs actually ready for health reform at this time? I think not. Let me focus on the policy-making elite first. The view from the left. In the ideal world envisaged by the policy-making elite left of center of the ideological spec... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3318368 Mon, 01 Mar 2010 15:54:25 +0100 3318368 http://www.medworm.com/index.php?rid=3318376&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FYB9U3Y7eSzg%2F By Michael F. CannonFrom my health care reform oped in today’s Daily Caller: President Obama wants to work with Republicans on health care reform. “I am going to be starting from scratch,” he says, “in the sense that I will be open to any ideas that help promote” controlling health care costs and making health insurance more widely available. As it happens, many of the worst ideas are in the legislation Obama supports. Republicans have embraced some of the best ideas, but also some of the worst. The best health care reform ideas ideas give consumers the money, let them choose a health plan regulated by a state of their choice, and reduce the federal government’s role in providing medical care to the needy.  The worst ideas?  Creating or expanding government health car... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3318376 Mon, 01 Mar 2010 14:44:40 +0100 3318376 http://www.medworm.com/index.php?rid=3294576&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FEC6-I7P_zjE%2F By Michael F. CannonHoping to revive his increasingly unpopular health care overhaul, President Obama has invited Republicans to a bipartisan summit this Thursday and plans to introduce a new reform blueprint in advance of the summit.  On Sunday, the White House announced that a key feature of that blueprint will be premium caps, a form of government price control that helped kill the Clinton health plan when even New Democrats rejected it. The New York Times reports on President Obama’s blueprint: The president’s bill would grant the federal health and human services secretary new authority to review, and to block, premium increases by private insurers, potentially superseding state insurance regulators. It bears repeating what Obama’s top economic advisor Larry Summers thi... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3294576 Mon, 22 Feb 2010 13:41:15 +0100 3294576 http://www.medworm.com/index.php?rid=3283514&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FxGrSu7A59YI%2F By Michael F. CannonKevin Williamson’s article “Priceless Is Worthless” from the December 21 issue of National Review sat on my nightstand for two months.  When I finally read it, I was glad I hadn’t pitched it.  It was like someone had taken Friedrich Hayek’s “The Use of Knowledge in Society” and made it accessible and entertaining: For the Soviets, there were no real prices, so there was no feedback loop between producers and consumers: If we’d had that model for soft drinks, we’d still be drinking New Coke, and the cola executives in Atlanta would be strutting around in their nifty military uniforms, with epaulets and braid, telling us to drink our New Coke and like it, because they had determined, RATIONALLY, that this is what we... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3283514 Thu, 18 Feb 2010 16:02:49 +0100 3283514 http://www.medworm.com/index.php?rid=3269676&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F02%2F12%2Fbuilding-a-path-to-integrated-care-payment-systems%2F With health reform currently in limbo, one of the few areas that command bipartisan support is reforming provider payments to promote integrated-care delivery models such as accountable care organizations, episode-based payments, and medical homes, Paul Ginsburg said as he introduced a February 8 panel on this subject at the National Health Policy Conference. As a result, even if Congress does not pass a comprehensive reform bill, payment reforms could still be enacted, for example as part of a Medicare bill blocking currently mandated physician payment cuts, said Ginsburg, the president and CEO of the Center for Studying Health System Change. The problem, Ginsburg said, is that “we’re not ready yet … development is needed, piloting is needed, a process to go from piloting to impleme... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3269676 Fri, 12 Feb 2010 17:19:02 +0100 3269676 http://www.medworm.com/index.php?rid=4642766&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Fletstalkhealthcare.org%2Fblog%2Fcost-containment-%25e2%2580%2593-can-pilots-studies-and-new-offices-work%2F As Congress and the President rethink their approach to health care reform, we have an opportunity to rethink our approach to health care cost containment. Both the House and Senate versions of health reform legislation rely heavily on Medicare payment reductions, pilot programs, studies, and new government offices to reduce future medical trends. Medicare payment reductions generally have the effect of raising commercial insurance costs, because many hospitals and physicians succeed in shifting their uncovered costs to private insurers, thereby undermining the value of the reduction. The open question is whether or not Medicare pilot programs, studies, and new offices are an effective way to control health care costs. It would seem to me, Dr. Gawande’s recent article on the value of pil... HPHC blogs http://www.medworm.com/rss/comments.php?id=4642766 Tue, 02 Feb 2010 21:16:38 +0100 4642766 http://www.medworm.com/index.php?rid=3189114&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F20%2Fan-inconvenient-truth-the-health-care-cost-curve-is-already-bent%2F No single government report more reliably generates editorials on the nation’s healthcare “crisis” than the annual CMS actuary’s report on US health spending. I’ve long suspected that a lot of these editorials, like obituaries, are written in advance, so that the editorialist can simply fill in the new numbers.  A two-decade long accumulation of these editorials has driven the political narrative that health costs are “out of control”.  This year, however, the editorial dogs failed to bark.   On January 5, the CMS actuary report on health spending for the year 2008 revealed a 4.4% increase in national health spending, the lowest rate of increase since end of the Eisenhower administration. Since we experienced nearly 1% population growth during 2008, per capita spending g... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3189114 Wed, 20 Jan 2010 14:00:51 +0100 3189114 http://www.medworm.com/index.php?rid=3175842&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F14%2Fwellness-programs-and-diabetes-costs%2F Two Web-First articles published today by Health Affairs analyze factors driving medical spending and the potential of certain strategies to curtail spending growth.  One study evaluates the evidence on workplace wellness programs and finds that the medical savings outweigh the costs for employers.  The second breaks new ground by developing a Cost of Diabetes Model and reporting that the national economic burden of that disease to have reached $218 billion. Workplace Wellness Programs Can Generate Savings By Katherine Baicker, David Cutler, and Zirui Song, all of Harvard With investment in disease prevention and wellness viewed as promising ways to achieve better heath and lower medical costs, workplace-based wellness programs are much touted in policy discussions.  The authors co... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3175842 Fri, 15 Jan 2010 04:21:53 +0100 3175842 http://www.medworm.com/index.php?rid=3171866&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F13%2Fabortion-coverage-and-health-reform-bringing-evidence-to-bear%2F Discussion:  As stated above, the median cost of first-trimester abortion care ($430) is almost twice the typical out-of-pocket health care expenses paid by young, uninsured individuals, and the median cost of second-trimester abortions ($1,260) is about four times typical out-of-pocket expenses. The cost of a first-trimester abortion represents 4 percent of income for uninsured females ages 25-34. Females and individuals who have difficulties obtaining needed health care have relatively higher out-of-pocket expenses and thus will be more affected by a lack of abortion coverage. This is particularly true for women who need second-trimester abortion because of health risks or fetal impairments or who are already paying a large portion of their income on health care. Furthermore, unins... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3171866 Wed, 13 Jan 2010 17:59:36 +0100 3171866 http://www.medworm.com/index.php?rid=3149017&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F07%2Fhealth-care-reform-state-winners-and-losers%2F Back in October, as health care financing options were being hotly debated and proposals changing on an almost daily basis, one of us noticed an editorial on health care reform in West Virginia’s Martinsburg Journal. We were struck by the extent of opposition to financing the reform package through a tax on high earners. West Virginia is not heavily populated with high earners—it is one of the three states with the smallest percentage of residents with incomes of $500,000 or more—and it therefore wouldn’t be greatly burdened by a tax on high earners. So it was somewhat surprising that a West Virginia newspaper would be so strongly opposed to this financing approach. This led us to think more generally about the redistributive implications of reform vis-à-vis the states. This is an... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3149017 Thu, 07 Jan 2010 15:49:37 +0100 3149017 http://www.medworm.com/index.php?rid=3915136&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2F_KGJ1zZN-T8%2F Now that Senator Reid has apparently found the path to 60 votes it is time to determine what the modifications were that produced agreement and take stock of what the impact might be if the bill were to become law. From the look of the finished product, most of the deals involved were unrelated to health reform, since the changes to the bill itself were marginal. The individual requirement to purchase has been tweaked, but still fails to ensure that individuals cannot delay buying coverage until they need it. A new Independent Payment Advisory Board will be created, but because its recommendations are not binding, its impact on meaningful cost containment is questionable. The most significant additions are new provisions directed at health insurers, including minimum medical expense ratio ... HPHC blogs http://www.medworm.com/rss/comments.php?id=3915136 Tue, 22 Dec 2009 17:47:19 +0100 3915136 http://www.medworm.com/index.php?rid=3111384&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F22%2Fwould-reform-bills-control-costs-a-response-to-atul-gawande%2F Atul Gawande, MD, is one of the best medical writers of our time. I subscribed to the New Yorker just so I could read him.  I reached eagerly for my Dec. 14, 2009 New Yorker when I heard he had an article there. I was deeply disappointed. What worries me is that his article will be used to support a political campaign to gloss over the failure of proposed legislation to significantly moderate health expenditure growth. Gawande acknowledges that the cost of health care “…will essentially devour all our future wage increases and economic growth.  The cost problem, people have come to realize, threatens not just our prosperity but our solvency.”  “So what does the reform package do about it? …Does it institute nationwide structural changes that curb costs and raise quality? I... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3111384 Tue, 22 Dec 2009 13:27:46 +0100 3111384 http://www.medworm.com/index.php?rid=3108334&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F21%2Fthe-revised-senate-health-reform-bill-cost-control-and-other-aspects%2F Editor’s Note: This is the second of two posts by Tim Jost analyzing the Senate health reform bill, as revised by the manager’s amendment offered on December 19. Jost’s first post focused on the health insurance reforms in the revised bill. One of the most common complaints about the health reform legislation pending in Congress is that the bills do nothing to control the growth in health care costs or improve the quality of health care.  Those who raise this complaint either have not read the bills or are very attached to a particular proposal that was somehow left out.  This is not to say that the legislation will actually control costs or improve quality; it is simply to say that many, if not most, of the credible ideas that health policy analysts or economists have ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3108334 Mon, 21 Dec 2009 05:14:56 +0100 3108334 http://www.medworm.com/index.php?rid=3106719&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F19%2Frevised-health-reform-bill-moves-forward-in-senate%2F The 384-page Senate Manager’s Amendment to the upper chamber’s health reform bill arrived on Saturday morning, December 19, apparently backed up by the 60 votes necessary to get the amended legislation out of the Senate.  Democratic senators braved a record blizzard to pass the defense spending bill, the last impediment to clearing the floor for the final hours of debate on the health reform bill, and the clock has been set for adoption Christmas Eve.  It is likely that the drama is not yet over, particularly as progressives continue to grumble about the bill, but Senator Reid’s Christmas wish now seems possible. Amendments to title I, the health insurance reform provisions of the bill, take up about a quarter of the Manager’s Amendment.  This post will discuss these provisions... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3106719 Sun, 20 Dec 2009 00:46:14 +0100 3106719 http://www.medworm.com/index.php?rid=3100781&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FbmiVeQhPtSY%2F By Alan ReynoldsDuring the runaway inflations of 1974 and 1979, Presidents Ford and Carter suggested that inflation was caused by the profligacy of American households. President Ford’s infamous “Whip Inflation Now” speech, for example, said, “Here is what we must do, what each and every one of you can do: To help increase food and lower prices, grow more and waste less; to help save scarce fuel in the energy crisis, drive less, heat less.” Much of the recent discussion of health care costs likewise treats this as a problem caused by a demonic private insurance industry, and therefore requiring such “reforms” as expanding Medicaid to the non-poor and Medicare to the non-old. The facts are quite different, as shown in “The Evolution of Medical Spending Risk” by Jonathan Gr... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3100781 Thu, 17 Dec 2009 17:52:23 +0100 3100781 http://www.medworm.com/index.php?rid=3096828&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FvG1MFG7RDvc%2F By Michael D. TannerPresident Obama gave what seems like his thousandth exclusive health care interview last night, this one to ABC News’s Charles Gibson.  In trying to sell his health care plan, the president warned that if Congress does not pass legislation controlling health care costs, the federal government “will go bankrupt.”  He also warned that unless health care is reformed, “your premiums will go up.”  The president is absolutely correct about that.  The only problem is that, according to the president’s own chief health care actuary, the bills that Congress is now considering do nothing to restrain either federal health care spending or total health care costs.  In fact, Rick Foster, chief actuary at the Center for Medicare and Medicaid Services (CMS) says that... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3096828 Thu, 17 Dec 2009 15:48:43 +0100 3096828 http://www.medworm.com/index.php?rid=3096819&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F16%2Fhealth-it-what-we-can-learn-from-toys-r-us%2F One of the more interesting recent health policy events took place at the Brookings Institution’s Engelberg Center for Health Care Reform. The December 2nd event did not focus on the reform bills in the House and Senate or the horse trading and sausage making that has gone into them.  The panels and discussion, titled “Using Data to Support Better Health Care: One Infrastructure with Many Uses,” chaired by Mark McClellan, focused explicitly on health information technology (IT).  Rather than another dreary recitation of how poorly the United States measures up to other developed countries or to systems such as Kaiser, Geisinger, or Mayo, the first round of panelists–L. Allen Dobson of Carolinas Care, Richard Platt of Harvard Medical School and Harvard Pilgrim, and Alan Garb... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3096819 Wed, 16 Dec 2009 18:29:05 +0100 3096819 http://www.medworm.com/index.php?rid=3092791&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FaUwKC5PL5Vw%2F An article in the Boston Globe on Thursday reported on last week’s Massachusetts Division of Insurance (DOI) public hearing at which health plans were asked to justify their business operations. The purpose of the DOI hearings is to try to determine why the cost of health insurance is so high for small businesses. At the direction of the Governor, DOI was asked to question insurers – insurers alone, not health care providers, for instance – about the causes of recent premium increases. The Globe’s coverage of the hearing perpetuates several myths that need dispelling. The perspective of the article is that health plans are responsible for small business health insurance costs that are disproportionately high. While this may have appeal politically and emotionally, it isn’t suppor... HPHC blogs http://www.medworm.com/rss/comments.php?id=3092791 Tue, 15 Dec 2009 22:24:26 +0100 3092791 http://www.medworm.com/index.php?rid=3067166&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FVxLY6Kzig3M%2F A little known provision of the Senate health reform bill would permit subscribers to keep their existing health insurance policies indefinitely, whether their policies comply with the new health reform rules or not. The intent of this grandfathering provision is to make good on the President’s promise that costs for existing policy holders must not increase as a result of reform. This seemingly simple and well intended provision is fraught with unintended consequences and is a good example of the inherent complexity involved in reforming the health insurance marketplace, especially when there isn’t enough money to do the job right.   The first thing to observe about this provision is that it will create an expensive and duplicative system that operates on two sets of rules – old an... HPHC blogs http://www.medworm.com/rss/comments.php?id=3067166 Tue, 08 Dec 2009 13:54:56 +0100 3067166 http://www.medworm.com/index.php?rid=3056601&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F03%2Fdo-cadillac-plans-equal-cadillac-benefits%2F Editor’s Note: For more on the controversy over taxing high-cost health plans, see a “Cadillacs Or Ambulances? The Senate Tax On ‘Excessive Benefits, a Health Affairs Blog post by Joseph White and Timothy Jost published today. The Senate Democratic health plan includes a provision, backed by the Obama administration, that would tax some “Cadillac” health plans to pay for health care reform.  One widely held assumption is that high-cost plans are expensive because they offer superior benefits. However, in a Health Affairs Web First article released today, Jon Gabel of the National Opinion Research Center (NORC) and coauthors report that other factors – regional differences in health care delivery cost and the industry sector offering the coverage – were... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3056601 Thu, 03 Dec 2009 20:57:29 +0100 3056601 http://www.medworm.com/index.php?rid=3056602&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F03%2Fcadillacs-or-ambulances-the-senate-tax-on-excessive-benefits%2F Editor’s Note: For more on the controversy over taxing high-cost health plans, see “Taxing Cadillac Health Plans May Produce Chevy Results,” a Health Affairs Web First article by Jon Gabel and coauthors published today. The Senate “Patient Protection and Affordable Care Act” draft legislation includes a steep excise tax on high-cost, so-called Cadillac insurance plans.  This provision is strongly supported by many economists and policy commentators, who believe that the tax could make the financing of U.S. health care more equitable and its provision more efficient.  Yet both propositions are highly questionable. Mistaking Cadillac Prices for Cadillac Plans The intent of the bill is to limit ability to pay for health insurance with pre-tax dollars.  The tax covers ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3056602 Thu, 03 Dec 2009 20:50:19 +0100 3056602 http://www.medworm.com/index.php?rid=3052113&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F02%2Forszag-on-health-reform-at-health-affairs-breakfast%2F At a Health Affairs reporters breakfast this morning, White House Office of Management and Budget Director Peter Orszag defended the ability of the health reform bill being debated in the Senate to “bend the cost curve” of health care costs. “The bill that is currently on the Senate floor contains more cost-containment and delivery system reforms, in its current form, than any bill that’s ever been considered on the Senate floor, period,” he said. Orszag said the Senate bill meets the four pillars of cost control laid out in a recent letter to President Obama by 23 noted economists: no increases in federal government deficits; an excise tax on high-cost health plans; a Medicare commission to ensure continuing flexibility and reform; and delivery system reforms such as inc... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3052113 Wed, 02 Dec 2009 18:28:32 +0100 3052113 http://www.medworm.com/index.php?rid=3044859&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FAGh_prKDR-Y%2F As the Senate begins debate on its health reform bill we should ask whether the bill is really about reform. I say this because it appears to be about covering the uninsured (a good thing) potentially at the expense of the currently insured and the federal budget (a bad thing) and about replacing the commercial health insurance marketplace with a government-run plan (also a bad thing). Consider a few ways the bill is not about reform: 1) Yesterday’s CBO report notwithstanding, the bill will raise health insurance costs. Beginning in 2010 a new premium tax on health plans; new taxes on pharmacy and equipment manufacturers; a mandate that dependents up to age 26 be covered by family plans; the elimination of annual benefit caps; and cuts in Medicare provider reimbursements will all increas... HPHC blogs http://www.medworm.com/rss/comments.php?id=3044859 Tue, 01 Dec 2009 15:33:37 +0100 3044859 http://www.medworm.com/index.php?rid=3026782&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2F-JqP6ESwCIw%2F As a non profit, mission driven health plan, we have given a lot of thought to the ethics of our role as a health insurer. The framework we use embraces two core values – fidelity to the needs of individual patients and responsible stewardship of the resources that members and their employers or public sponsors entrust to us. Fidelity is about individuals. Stewardship is about populations. We believe these two values are the pillars of an ethical health system. Fidelity is the commitment to seek benefit for the patient and avoid doing harm. It has been at the heart of medicine since the time of Hippocrates. As long as health care was a transaction between a single patient and a single physician paid for by the patient’s own funds (or by barter), there was no need for insurance. Steward... HPHC blogs http://www.medworm.com/rss/comments.php?id=3026782 Tue, 24 Nov 2009 19:06:29 +0100 3026782 http://www.medworm.com/index.php?rid=3012350&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F11%2F19%2Fthe-senate-health-reform-bill-a-first-look%2F As readers of Health Affairs are undoubtedly already aware, the Senate Democratic leadership has released HR 3590, the 2,074-page Patient Protection and Affordable Care Act.  The bill combines the Senate Health, Education, Labor, and Pensions (HELP) Committee bill marked up this summer and the Senate Finance Committee bill marked up earlier this fall.  On the whole, the combined bill resembles the Finance bill more closely than the HELP bill, but it does include important elements from the HELP bill, the most prominent of which is provision for the community health insurance (public) option.  As has been widely reported, the CBO has scored the gross cost of the coverage provisions of the Senate bill at $848 billion over 10 years, less than the cost of the House bill, and as reducing the... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3012350 Fri, 20 Nov 2009 00:12:37 +0100 3012350 http://www.medworm.com/index.php?rid=3008064&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F_bcLjY-XE4Q%2F The Obama administration and its allies in Congress want the federal government to expand its role in subsidizing health care. We are told that this expansion will restrain rising health care costs. But an OMB report yesterday that the government made $98 billion in improper payments last year — $55 billion of which came from Medicare and Medicaid — ought to raise suspicions about that claim. According to Reuters, OMB Director Peter Orszag told reporters that the embarrassing figures from Medicare and Medicaid demonstrate the need for health care reform. I would concur if “reform” meant reducing the government’s role in health care. However, he means the opposite, which raises the question of how giving more money to an already waste-prone and bureaucratic federal health ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3008064 Thu, 19 Nov 2009 15:56:49 +0100 3008064 http://www.medworm.com/index.php?rid=3003759&cid=t_99592_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Frrn6KHmheDw%2F The U.S. Preventive Services Task Force unleashed a tsunami this week with new breast cancer guidelines that are suspiciously timed to current efforts to rein in burgeoning healthcare costs. Indeed, the recommendations appear to be geared towards reducing overtreatment by eliminating what the Task Force considers unnecessary follow up screenings and tests. The recommendations even suggest the breast self-examination (BSE) should be discontinued. In essence, what the Task Force concluded was that while screening reduces deaths from breast cancer, it does not save enough lives to justify associated costs. To exacerbate the controversy, the American Cancer Society has publicly stated that it does not endorse Task Force recommendations and in a detailed analysis suggested that in the review of... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3003759 Wed, 18 Nov 2009 15:52:09 +0100 3003759 http://www.medworm.com/index.php?rid=2981195&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FgGCj41XCN30%2F The current House and Senate versions of federal health reform legislation have at least one thing in common: they will increase health insurance premiums. Consider this list of House and Senate proposals: o     $6.7 billion annual tax on health insurance premiums – Harvard Pilgrim has calculated the impact of this Senate proposal and concluded that it would result in an annual tax payment to the federal government of $34 million, roughly three times our current operating income. o     40% excise tax on “Cadillac” benefits – So-called excess benefits sold by health plans would be subject to federal taxation. In our New Hampshire market, for instance, we have calculated that this would affect many small companies with workforces averaging 45 years of age or older buying prod... HPHC blogs http://www.medworm.com/rss/comments.php?id=2981195 Tue, 10 Nov 2009 20:31:46 +0100 2981195 http://www.medworm.com/index.php?rid=2967273&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fp7YBAVv_WCo%2F If House Democrats hold a vote on their health-care overhaul this weekend, they might as well vote to abolish the Congressional Budget Office too. It would be no more audacious (and much more honest) than the way they have gamed the CBO’s rules to hide $1.5 trillion of the cost of their legislation — which has to be the biggest fiscal obfuscation in the history of American politics. Here’s how they did it. C/P Politico (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2967273 Fri, 06 Nov 2009 14:58:39 +0100 2967273 http://www.medworm.com/index.php?rid=2963064&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F11%2F05%2Fthe-most-read-blog-posts-for-october%2F Posts on public opinion about health reform and how to achieve high-quality, low-cost health care topped the Health Affairs Blog most-read list for October. Additional comment on these and all posts is always welcome. Can Slumping Support For Health Care Reform Be Turned Around? by S. Ward Casscells and Hiliary Critchley Are Higher-Value Care Models Replicable? by Arnold Milstein and Pranav P. Kothari High-Quality, Low-Cost Care: An Interview With Gundersen-Lutheran CEO Jeff Thompson by John Iglehart and Chris Fleming Creating the Virtual Integrated Delivery System by Ken Thorpe and Lydia Ogden Pros And Cons Of A Public Insurance Plan by Jane Hiebert-White A Tax That Targets Health Insurance Innovation by Alain C. Enthoven The Grandparents Corps: A New Primary Care Model by Arthur Garson ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2963064 Thu, 05 Nov 2009 16:08:58 +0100 2963064 http://www.medworm.com/index.php?rid=2958957&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2Fhuobv_Sg1h0%2F The major driver of commercial health care premium increases is not the use of health care services, which accounts for less than a third of annual premium increases, but unit costs. In other words, the price of health care is driving up commercial costs more quickly than overutilization of services. There are many reasons for this. Physicians and hospitals have begun consolidating into large health care systems with significant bargaining leverage. Many of these systems have brand strength that attracts consumers away from local, freestanding providers. Consumers value freedom of choice, have little tolerance for closed networks, are generally subsidized by employers and government, and are therefore relatively insulated from the cost of their health care decisions. Technology, like elect... HPHC blogs http://www.medworm.com/rss/comments.php?id=2958957 Tue, 03 Nov 2009 20:46:25 +0100 2958957 http://www.medworm.com/index.php?rid=2943748&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F10%2F29%2Fthe-ahip-report-beneath-questionable-numbers-is-a-serious-concern%2F On October 12 America’s Health Insurance Plans (AHIP) released a commissioned report by Price Waterhouse Cooper (PWC), “Potential Impact of Health Reform on the Cost of Private Health Insurance Coverage.”   The study reported that health care reform as envisioned by the Senate Finance Committee would raise the cost of private health insurance by 23 percent above the costs projected for the current system from 2009-2016.  The timing of the report–released one day before the vote of the Senate Finance Committee of its bill–brought an immediate and sharp response by the mainstream media, congressional Democrats, and the Obama administration.  Besides its timing, other issues impaired the study’s credibility.  First, the report did not include potential savings brought... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2943748 Thu, 29 Oct 2009 19:43:33 +0100 2943748 http://www.medworm.com/index.php?rid=2939263&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F10%2F28%2Fa-narrative-on-narrative-matters%2F Narrative Matters recently brought together 80 writers, journalists, and academics to celebrate the Tenth Anniversary of Narrative Matters.  There was much to celebrate: over 150 Narratives published in Health Affairs that covered a spectrum of human stories set in the increasingly institutionalized health care system.  We came to celebrate the power of stories and storytelling in the human drama of health.  A diverse group of men and women from a variety of backgrounds attended; the common denominator was a dedication to the health narrative. It was a needed function.  There is an often-unarticulated human side to every profession, but the healing professions have a special need for articulate writing.  No other profession is as complex; no other profession finds us as needy and vu... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2939263 Wed, 28 Oct 2009 22:14:20 +0100 2939263 http://www.medworm.com/index.php?rid=2934656&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fd_bzqlCCZZ8%2F Dear members of Congress: If you’re not going to read the bills you pass,  at least read the Constitution. Don’t fret; it’s short and written in plain English. Richard Rahn: Pay members of Congress more. (Or less, depending on their performance.) NYC: “The city that never smokes.” A proposal to ban lighting up in New York’s parks has exposed the puritanical agenda behind the crusade against smoking. Tyler Cowen: With health care costs high and rising, government mandates to buy insurance would make many people worse off. Podcast: “Pay Czar Cuts Checks“ (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2934656 Tue, 27 Oct 2009 20:31:41 +0100 2934656 http://www.medworm.com/index.php?rid=2912150&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F10%2F20%2Fare-higher-value-care-models-replicable%2F Discussion Employers such as Boeing typically lack a sufficient population with severe chronic illness in any one location to power a statistically robust analysis of change in total per capita health care spending. However, the 20% magnitude of spending reduction, net of the supplemental fees paid to participating physician groups, aligns with peer-reviewed findings recently reported for similar care models by Geisinger, Johns Hopkins, and other researchers. Taken together, these reports support the proposition that judicious intensification of primary care for the severely chronically ill can both improve health and lower total per capita health care spending. Boeing’s results carry three important implications for lowering per capita health care spending while improving the health of... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2912150 Tue, 20 Oct 2009 20:24:59 +0100 2912150 http://www.medworm.com/index.php?rid=2908731&cid=t_99592_114_f&fid=35410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fletstalkhealthcare%2F%7E3%2FwGDAKEscggE%2F Last week’s New York Times editorial entitled “Reforms and Your Premiums” perpetuates the myth that the Senate Finance Committee health reform bill in its current form is affordable and misrepresents the findings of a PricewaterhouseCoopers (PWC) study commissioned by America’s Health Insurance Plans (AHIP) to assess the impact of the bill. Characterizing the PWC study as “inflammatory” the Times asserted that it ignores components of the Finance Committee bill that would drive down costs. If only this were the case. The study found that individuals and small groups would see premium increases of 28-49% because the bill’s universal access provisions are unaccompanied by a strong individual mandate to purchase insurance. Those who don’t have an immediate need for health care... HPHC blogs http://www.medworm.com/rss/comments.php?id=2908731 Mon, 19 Oct 2009 18:05:59 +0100 2908731 http://www.medworm.com/index.php?rid=2876021&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fymn1_XTNQfs%2F The Congressional Budget Office released a report this week that revealed that the proposed health care bill would not increase the deficit.  But is it that simple? Cato health care policy experts have examined the bill and added up the costs. Here are a few things they have found: Congress has been cooking the books: “When it comes to the health care reform debate…honest budgeting is nowhere to be seen.” Costs will only decrease if we give market forces room to breathe. How some in Congress are hiding the true costs of the health care overhaul. Healthy Competition: What’s Holding Back Health Care and How to Free It Podcast: Do You Smell the Books Congress is Cookin’? (Source: Cato-at-liberty) Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2876021 Thu, 08 Oct 2009 16:33:40 +0100 2876021 http://www.medworm.com/index.php?rid=2876024&cid=t_99592_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fz3uyza6fyC4%2F The CBO report that said the health care bill won’t raise deficits makes it clear that the Baucus bill’s reduction in future budget deficits comes not from controlling government spending or reducing health care costs, but because of a rapid escalation in tax revenues. The bill imposes a 40 percent excise tax on health-insurance plans that offer benefits in excess of $8,000 for an individual plan and $21,000 for a family plan. Insurers would almost certainly pass this tax on to consumers via higher premiums. As inflation pushes insurance premiums higher in coming years, more and more middle-class families would find themselves caught up in the tax. In fact, overall, the tax increases in the bill are more than double the amount of deficit reduction. This isn’t a health care effici... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2876024 Thu, 08 Oct 2009 14:55:32 +0100 2876024 http://www.medworm.com/index.php?rid=2855534&cid=t_99592_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F10%2F01%2Fmassachusetts-health-reform-employer-coverage-from-employees-perspective%2F As Congress and the Administration debate health care reform, it is instructive to look at the Massachusetts model, now in its third year. Health Affairs today released a study of workers in the Bay State who were interviewed in fall 2008 about their employer-sponsored health care coverage, following up on similar surveys in 2006 and 2007. Despite predictions that employers could reduce coverage or benefits under health reform, the results suggest the opposite, although premiums and out-of-pocket costs have increased for some employees in smaller companies. These findings are the latest in a series of updates on implementation of the Massachusetts reforms funded by the Blue Cross Blue Shield of Massachusetts Foundation, The Commonwealth Fund, and the Robert Wood Johnson Foundation. The res... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2855534 Thu, 01 Oct 2009 20:33:25 +0100 2855534