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More Than 1 Million Young Caregivers Live In the United States, But Policies Supporting Them Are Still ‘Emerging’
Being a family caregiver today is a demanding responsibility. If caregiving is stressful for the “typical” caregiver—a 49-year-old woman—think how much more is at stake when the caregiver is a child or teenager. Yet more than a million youngsters ages 8–18 take on challenging tasks to help a parent, grandparent, sibling, or other relative. While that number is undoubtedly an underestimate, it does not even include an emerging subgroup—children whose parents are struggling with opioid addiction.
If we have limited information about the young people taking care of those with diabetes, cancer, and ...
Source: Health Affairs Blog - August 7, 2017 Category: Health Management Authors: Carol Levine Tags: Featured Population Health Public Health Quality Agnes Leu child caregivers family caregivers National Alliance for Caregiving Saul Becker United Hospital Fund Source Type: blogs
Professional Athletes And Back Surgery: A Teachable Moment On Overuse In Health Care?
After four back surgeries, Tiger Woods still is not back on the golf course. Steve Kerr, the coach of the Golden State Warriors, missed most of last season and even much of this year’s playoffs with headaches and recurrent pain after back surgery. These two high-profile patients, and their very public surgery results, should encourage us all to ask whether “more is always better” in health care.
The Institute of Medicine National Roundtable on Health Care Quality coined the term “overuse” to describe the provision of health care services for which potential harms outweigh potential benefits. Overuse in health car...
Source: Health Affairs Blog - August 1, 2017 Category: Health Management Authors: William Shrank, Donna Keyser and Anthony Delitto Tags: Costs and Spending Featured Payment Policy Quality chronic pain Source Type: blogs
The Skinny On The Senate ACA Debate, Day Three
Editor’s note: This post is part of ongoing Health Affairs Blog coverage by Tim Jost of the Senate debate over repealing and replacing—or maybe just repealing, or maybe just minimally repealing, or maybe retaining—the Affordable Care Act. See Tim’s earlier post and updates for more coverage.
Update: Medicare-for-All And Abortion
At about 2:30, the Senate voted on an amendment put forward by Senator Daines (R MT) incorporating the House Medicare-for-All bill. His intent was to embarrass and perhaps divide the Democrats by forcing them to vote on a proposal that some of them embrace, but some do not. In fact,...
Source: Health Affairs Blog - July 27, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Following the ACA Insurance and Coverage 1332 waivers Congressional Budget Office employer mandate individual mandate medical device tax skinny ACA repeal Source Type: blogs
We Need To Raise The Bar To Improve Cancer Treatments. What ’s The Best Way To Do It?
Over the past 20 years, we have witnessed an unprecedented development of new life-science technologies. Although clinical outcomes have also improved, the benefits often remain out of reach for many patients. Translating scientific and technological gains into clinically meaningful outcomes that are accessible and affordable to all who need them is one of the great challenges of our time.
Several prominent voices have called on the field to “raise the bar” and aim higher in research efforts, to measurably and meaningfully lengthen and improve patients’ lives. The American Society of Clinical Oncology (ASCO), for exa...
Source: Health Affairs Blog - July 26, 2017 Category: Health Management Authors: Jacqueline Zummo Tags: Drugs and Medical Innovation clinical trials Source Type: blogs
Senate GOP Wins Vote To Debate Health Care, Then Loses Vote On ACA Replacement Bill
On July 25, 2017, the United States Senate began its long-awaited debate on repealing the Affordable Care Act. At around 2 in the afternoon, Senate Majority Leader McConnell called up a motion to proceed on consideration of the American Health Care Act, which the House of Representatives had passed on May 4, with a 217 to 213 vote. A motion to proceed on a budget reconciliation bill needs only to pass by a bare majority, but the Republicans hold only 52 of the chamber’s 100 votes, and Republican Senators Collins (ME) and Murkowski (AK) voted against proceeding.
What’s Happened So Far
There was high drama as Senator McC...
Source: Health Affairs Blog - July 26, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage abortion coverage ACA repeal and replace employer mandate individual mandate Planned Parenthood Source Type: blogs
Introducing A New Series Of Health Affairs Policy Primers: Prescription Drug Pricing
For policy makers at every level of government it is easy to recognize the deep impact of soaring prescription drug prices. Bold headlines, countless hearings, and recent legislation have all raised the alarm about, and floated policy solutions to address, sharp price spikes, sudden shortages, growing out-of-pocket costs, and other serious obstacles to patients’ access.
Much more difficult is the work required to untangle the complicated interplay of forces that are driving prices so high. Health Affairs has long published the work of researchers doing the critical work of identifying, evaluating, and measuring those for...
Source: Health Affairs Blog - July 24, 2017 Category: Health Management Authors: Rob Lott Tags: Elsewhere@ Health Affairs Source Type: blogs
Orphan Diseases Or Population Health? Policy Choices Drive Venture Capital Investments
The US exhibits a remarkable pipeline of biopharmaceutical innovation, with 170 new drugs and biologics launched into the market between 2011 and 2015 and another 22 drugs approved in 2016. A striking feature of the pharmaceutical pipeline is the large percentage launched for the treatment of small “orphan” indications, defined by the Food and Drug Administration (FDA) as including fewer than, often many fewer than, 200,000 patients in the United States. Almost half (74) of the products approved by the FDA between 2011 and 2015 were for orphan indications, twice the number (36) approved during the same period by the Eu...
Source: Health Affairs Blog - July 21, 2017 Category: Health Management Authors: Dayton Misfeldt and James C. Robinson Tags: Costs and Spending Drugs and Medical Innovation Orphan Drug Act orphan drugs venture capitalism Source Type: blogs
Eliminating The Medicaid Expansion May Cause More Damage Than Congress Realizes
The American Health Care Act (AHCA) and the Senate’s ill-fated Better Care Reconciliation Act (BCRA) attempted to deliver on two promises: 1) protecting patients with preexisting conditions, and 2) eliminating the Medicaid expansion. Though repeal efforts seem to have stalled for the time being, future GOP attempts to replace the ACA will undoubtedly involve the delicate task of appeasing conservative party members while maintaining provisions of the ACA that remain immensely popular with voters. While others have already discussed the failings of the proposed legislation with respect to the Medicaid expansion and preexi...
Source: Health Affairs Blog - July 20, 2017 Category: Health Management Authors: Justin Puckett and Jalpa Doshi Tags: Featured Following the ACA Medicaid and CHIP HIV/AIDS medicaid expansion states Source Type: blogs
FDA User Fee Reauthorization Poised To Pass House of Representatives
On Monday, the House of Representatives released the latest version of the proposed Food and Drug Administration (FDA) user fee reauthorization bill. The House is expected to vote on the must-pass bill as early as today, but the Senate has not yet set forth its own timeline for voting on the bill. I have previously written here about the version of the bill marked up in the Senate, and about the committee staff’s valiant efforts to keep the bill free of politically controversial provisions.
In this post, I review some of the key provisions in the newly released bill and consider its implications for the FDA.
Widespread A...
Source: Health Affairs Blog - July 12, 2017 Category: Health Management Authors: Rachel Sachs Tags: Drugs and Medical Innovation FDA orphan drugs user fees Source Type: blogs
The Messenger Also Matters: Value-Based Payment Can Support Outreach To Vulnerable Populations
With the proliferation of value-based payment initiatives and implementation of the Affordable Care Act’s (ACA’s) coverage expansions, states have had many opportunities in recent years to improve the health of vulnerable populations through health promotion, prevention, and care coordination. We believe value-based payment models can and must support accountable health care delivery systems in partnering with community-based “messengers” to engage vulnerable individuals in health education and promotion. We explore one such messenger program, ACCESS, a Brooklyn-based project of the Arthur Ashe Institute for Urban ...
Source: Health Affairs Blog - July 10, 2017 Category: Health Management Authors: Ruth C. Browne, Marilyn Fraser, Judith Killen and Laura Tollen Tags: Health Equity Medicaid and CHIP Population Health Arthur Ashe Institute for Urban Health New York New York State Social Determinants of Health value-based payment vulnerable populations Source Type: blogs
Have Employer Coverage? GOP Proposals Will Affect You Too (Part 2)
As Senate Republican leaders continue to craft their bill to repeal and replace the Affordable Care Act (ACA), most attention has been focused on the number of individuals who would lose coverage if the legislation is enacted. To be sure, the ACA coverage expansions—through Medicaid and subsidized Marketplace plans—have been a lifeline for millions of people, particularly those who are low income, and have reduced the number of individuals without coverage to record lows. But the legislation that passed the House and the bill now under consideration in the Senate could also affect the more than 150 million peop...
Source: Health Affairs Blog - July 6, 2017 Category: Health Management Authors: JoAnn Volk and Sabrina Corlette Tags: Following the ACA Insurance and Coverage ACA repeal and replace employer-sponsored coverage Employer-Sponsored Insurance Essential Health Benefits Source Type: blogs
Health Affairs Briefing: Advanced Illness and End-of-Life Care
Few areas of health care are as personal, or as fraught, as care for people with serious illnesses who are approaching death. At a point in their lives when their needs are often as much social and spiritual as they are medical, people are confronted with a fragmented, rescue-driven health care system that produces miraculous results but also disastrous failures.
As the nation’s population of individuals over the age of 65 is expected to reach 84 million by 2050, addressing these challenges becomes increasingly important, requiring coordination across multiple sectors and levels of government. Innovations are needed to p...
Source: Health Affairs Blog - June 28, 2017 Category: Health Management Authors: Health Affairs Tags: Elsewhere@ Health Affairs Featured Advanced Illness End-of-Life Palliative Care Source Type: blogs
Amended Senate Bill Includes Waiting Period for Those Who Let Coverage Lapse
On June 26, 2017, the Republican Leadership released an amended version of the Senate Better Care Reconciliation Act. It is very similar to the version they released on June 22, but includes two changes.
First, it amends a couple of provisions of the stability and innovation funds section to allow both short and long-term funds to be used to purchase health insurance benefits. This was apparently done to align the program more closely with the CHIP program. The stability and innovation fund is being created through the CHIP program, reportedly so as to incorporate CHIP’s abortion funding restrictions.
Second, it ma...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: Timothy Jost Tags: Featured Following the ACA Insurance and Coverage ACA repeal and replace coverage gap waiting period Source Type: blogs
Sounding The Alarms On Children ’s Health Coverage
We reported on this trend in a recent Health Affairs article, in which we found that in 2013, nearly one-third of children in low-income working families above the poverty line got their health coverage through Medicaid or CHIP, up 8 percent from just six years earlier.
Today, more than 40 percent of children and adolescents in this country are now covered by Medicaid and CHIP, second only to employer-sponsored insurance. As a result, children are disproportionately vulnerable to health care reforms that cut public programs. In making any changes, caution is needed, as is an awareness of the many factors leading to familie...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: David Rubin Tags: Following the ACA Medicaid and CHIP Public Health Quality ACA repeal and replace AHCA Source Type: blogs
ACA Round-Up: QHP Application Deadline Passes, House v. Price, Special Enrollment Periods
June 21, 2017, was the last day for insurers to file qualified health plan applications in the 39 states that use HealthCare.gov, including federally facilitated marketplace (FFM), plan management, and state-based marketplace-federal platform states. There were reportedly a few additional defections, including Anthem from Wisconsin and Indiana, but most insurers are back from last year, and a there are a few new entrants, notably Centene in several states.
According to slides posted at the CMS REGTAP.info website, insurers may make any changes they wish to their plan filings until August 16, 2017, except for adding plans...
Source: Health Affairs Blog - June 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage house v. price special enrollment periods Source Type: blogs
