An Alternative Path On Health Reform: A Reply To Tim Jost
Tim Jost’s thoughtful analysis of the state of health reform concluded that the only practical means of accomplishing health reform is to find a short parliamentary path to some melded version of the...
View ArticleEight Rules From The Heart Of Power: How Did Obama Do?
Last fall, David Blumenthal and James Morone published a timely history of the presidential handling of health reform from Franklin Roosevelt onward, called The Heart of Power (see my review in Health...
View ArticleHow to Fix Medicare’s Doc Fix Problem
Of all the ghosts that haunt the Medicare program, none has been noisier, scarier or rattled more chains than the Medicare Sustainable Growth Rate (SGR) problem. SGR has required Congress to reset...
View ArticleVirginia Mason’s Clinical Transformation: Hard Work, Big Payoff
In the ten months since the passage of health reform, health care managers, particularly those in hospitals and health systems, have struggled to make sense of an onslaught of change in Medicare...
View ArticleLetting Go Of Employer-Based Health Insurance
Other than the egg-laying exercise surrounding the ACO regulations, 2011 was a quiet year among Washington health policy experts until June 6 when McKinsey released the results of a survey of employer...
View ArticleMedPAC’s SGR Solution: Bad Medicine For A Chronic Problem
The Medicare Payment Advisory Commission (MedPAC) is the closest thing Congress has to adult supervision on important health policy questions. The Commission commands bipartisan respect both for its...
View ArticleBarking Up The Wrong Tree: Affordability, Not Cost Growth, Is The Policy...
A recent spate of commentaries on the continuing health spending moderation raise an important policy question: If the cost curve is well and truly bent, why are we investing so much of our policy...
View ArticleHealth Care: An Alternate Economic Universe
In July, 2012, the US economy produced roughly the same volume of goods and services as it did five years earlier with five million fewer workers. Yet, during the first four years of the recession...
View ArticleBehind The Uninsured Numbers, A Diminishing Sense Of Urgency
After a summer of disappointing economic news, the recent Census report on the uninsured was a rare bit of sunshine. The number of uninsured Americans declined by about 3 percent, or 1.34 million, to...
View ArticleWhere Is Health Spending Headed? Some Reactions To The CMS Report
For the third year in a row, national health spending in 2011 grew less than 4 percent, according to the CMS Office of the Actuary. However, the report said modest rebounds in pharmaceutical spending...
View ArticlePractice Redesign Isn’t Going To Erase The Primary Care Shortage
Most experts agree that primary care needs to be re-invented. There are a lot of promising ingredients of practice redesign: better scheduling, electronic medical records with patient portals,...
View ArticleHealth Industry Price Inflation At Historical Low
One hesitates to make too much of a single report, but the Altarum Institute’s July Report, “Health Care Price Growth at 20+ Year Low,” certainly commands one’s attention. According to Altarum’s...
View ArticlePioneer ACOs’ Disappointing First Year
On July 16, the CMS Innovation Center reported the first year results for the Pioneer ACO program: 13 Pioneers, or about 40 percent of the participants, earned bonuses. The program saved the Medicare...
View ArticlePrimum Non Nocere: Congress’s Inadequate Medicare Physician Payment Fix
Editor's note: You can read other perspectives on the Medicare physician payment reform pending in Congress in Health Affairs and Health Affairs Blog (here, here and here). Partisan gridlock in...
View ArticleHow Much Market Power Do Hospital Systems Have?
Sometimes big game hunters find frustration when their prey moves by the time they’ve lined up to blast it. That certainly appears to be the case with the health policy target de jour: whether...
View ArticleAn Interview With George Halvorson: The Kaiser Permanente Renaissance, And...
For decades, health policymakers considered Kaiser Permanente the lode star of delivery system reform. Yet by the end of 1999, the nation’s oldest and largest group model HMO had experienced almost...
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Pioneer ACOs: Anatomy Of A ‘Victory’
On May 4, 2015 Department of Health and Human Services (HHS) Secretary Burwell announced that the Pioneer ACO program had saved the federal government $384 million and improved quality in its first two...
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Moral Failure And Health Costs: Two Simplistic Spending Narratives
What to do about the seemingly inexorable rise in health spending has been the central health policy challenge for two generations of health economists and policymakers. In 1965, before Medicare and...
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2014 National Health Spending: The Great Moderation Likely Is Not Over
Two weeks ago, the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) released their 2014 US health spending estimate showing the highest national health spending growth rate...
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The Tangled Hospital-Physician Relationship
Together, hospital and physician services account for more than half of national health spending. In its 2014 National Health Expenditures estimates, the Centers for Medicare and Medicaid Services’...
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