Foundation Addresses Critical Need For Palliative Care Workforce And Leadership Development
Philanthropy has provided critical funding for the advancement of palliative care in the United States, complementing support from health systems for clinical services and the federal government for research. To catalyze palliative care leadership development, the Cambia Health Foundation, located in Portland, Oregon, developed the Sojourns Scholar Leadership Program, which promotes the next generation of palliative care leaders by investing in their projects and professional development and providing peer and mentor support.
People are living longer than in previous generations. In the United States, there will be roughly...
Source: Health Affairs Blog - July 13, 2017 Category: Health Management Authors: Peggy Maguire Tags: GrantWatch Health Professionals Hospitals Organization and Delivery Quality Access Aging Cambia Health Foundation Center to Advance Palliative Care Chronic Care End-of-Life Care Health Care Delivery Health Philanthropy Nurses P Source Type: blogs
ACA Round-Up: CMS Approves Alaska 1332 Reinsurance Waiver, Ceases Premium Outlier Reviews
On July 11, 2017, the Centers for Medicare and Medicaid Services announced that the Departments of Health and Human Services and Treasury have approved Alaska’s application for a 1332 state innovation waiver for its reinsurance program. (fact sheet). The approval was no surprise. It had been pending since December of last year and has received very broad support. The HHS Secretary sent a letter to state governors in March encouraging similar waiver applications and HHS issued a checklist in May to assist states in applying for 1332 waivers which encouraged reinsurance waivers.
The program will be administered by the stat...
Source: Health Affairs Blog - July 12, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage 1332 waivers Alaska Marketplace premiums reinsurance risk corridor payments 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
Beyond ‘Repeal and Replace’: Physicians Renew The Call For Delivery System Improvement
The last few months have been an anxious time in health care policy with calls to repeal, replace, repair, and delay repeal of the Affordable Care Act (ACA). Daily, elected officials face angry constituents fearful of losing their coverage. What is clear is that voters want affordable, convenient, technologically enabled, high-quality medical care. We believe such care is possible, but only by leveraging the “doctor-patient” relationship and transforming how medical care is structured, measured, and reimbursed.
We are physicians who have led two of the nation’s highest-performing health care systems: Kaiser P...
Source: Health Affairs Blog - July 12, 2017 Category: Health Management Authors: Robert Pearl and Norman Chenven Tags: Featured Following the ACA Health Professionals Payment Policy Quality ACOs Bundled Payments EHRs value-based payment Source Type: blogs
House, Administration Oppose State Intervention In House v. Price; New Developments In ACA Section 1557 Case
On July 10, 2017, the House of Representatives and the Trump Administration’s Department of Health and Human Services filed briefs opposing the motion by 18 state attorneys general to intervene in the government’s appeal of House v. Price. In addition, courts have recently rendered new decisions in litigation challenging regulatory protections against discrimination on the basis of gender identity and termination of pregnancy under Section 1557 of the Affordable Care Act.
The House brought this lawsuit challenging government reimbursements to insurers for legally required cost sharing reductions (CSRs) for low-income e...
Source: Health Affairs Blog - July 11, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage ACA Marketplaces ACA section 1557 cost-sharing reduction payments gender identity house v. price termination of pregnancy Source Type: blogs
Interest In Early Childhood Health Leads To Three Funders Working Together
For a combined 335 years, United Hospital Fund (UHF), the Altman Foundation, and the New York Community Trust (NYCT) have provided grants to improve the health and well-being of New York City residents. Although the three organizations have different structures—UHF is an independent, nonprofit, research and philanthropic organization; Altman, a private foundation; and the NYCT, a community foundation—over the past nine months, they have united to address the social, environmental, and economic causes of poor health in early childhood.
The resulting effort, Partnerships for Early Childhood Development, holds important l...
Source: Health Affairs Blog - July 11, 2017 Category: Health Management Authors: Suzanne Brundage, Irfan Hasan and Rachael N. Pine Tags: Featured GrantWatch Health Professionals Organization and Delivery Children early childhood Health Care Delivery Health Philanthropy New York City Nonmedical Determinants pediatrics Physicians Primary Care Social Determinants of Source Type: blogs
What Larry Weed Understood About The Medical Profession: A Remembrance
There are courageous innovators in medicine who question conventional wisdom without fear. Dr. Larry Weed—who sadly passed away at the age of 93 on June 3, 2017—was one of those individuals.
His ideas were fresh and important. From my perspective, he was one of the first to really recognize the power of the way that we organize information and its importance to the quality of care we deliver. By the time I met him, he was already an icon for his work organizing medical notes and providing the common structure that we use today. He was also one of the first to recognize our inefficient ability to translate knowl...
Source: Health Affairs Blog - July 11, 2017 Category: Health Management Authors: Harlan M. Krumholz Tags: Featured Health Professionals Quality larry weed Source Type: blogs
End-Of-Life Policy Solutions: A Cautionary Note
In a new special issue of Health Affairs focused on health care around the end of life, we see that health care costs rise as patients approach death and/or after they are diagnosed with a life-limiting disease. This relationship holds across many diseases, ages, and types of health care systems and countries. Whether describing the cost-savings associated with palliative and hospice care, training primary care physicians to have conversations about prognosis and care planning, or the need to better understand patients’ preferences for treatment or comfort, most the papers in the issue take an optimistic stance regarding...
Source: Health Affairs Blog - July 10, 2017 Category: Health Management Authors: Vincent Mor Tags: End of Life & Serious Illness End-of-Life Care Palliative Care 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
Is There Justification For The Contraceptive Rule To Go Into Effect Immediately Upon Issuance?
On May 23, 2017, the Department of Health and Human Services sent to the Office of Management and Budget for review a draft of an interim final rule on “Coverage of Certain Preventive Services Under the Affordable Care Act.” This rule is intended to broaden current accommodations offered to entities that object to the requirement under the Affordable Care Act preventive services rule that insurers and group health plans provide employees access to contraceptives without cost sharing.
The OMB’s Office of Information and Regulatory Affairs (OIRA) is charged with reviewing draft federal rules to ensure that the rules co...
Source: Health Affairs Blog - July 7, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA contraceptive coverage contraceptive mandate Zubik v. Burwell Source Type: blogs
Suing The Food And Drug Administration To Reform Its Oversight Of Food Additives
On May 22, 2017, several organizations, including the Center for Food Safety (CFS), the Center for Science in the Public Interest, and the Environmental Defense Fund, filed a lawsuit against the Food and Drug Administration (FDA) to challenge a final rule issued by the agency on August 17, 2016, regarding the use of substances in food that are “generally recognized as safe,” or “GRAS.”
This is not the first time the Center for Food Safety has sued the FDA over its GRAS policy—the organization filed suit against the agency in February 2014, the settlement of which led to the issuance of the final rule challeng...
Source: Health Affairs Blog - July 7, 2017 Category: Health Management Authors: Diana Winters Tags: Featured Public Health Center for Food Safety food additives Food and Drug Administration generally recognized as safe Source Type: blogs
Medicaid Under Block Grants: Lessons From Welfare Reform
Both proposed versions of the Republican health care bill—the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA)–create an option for states to receive Medicaid funds in the form of a block grant (in the BCRA, the Medicaid Flexibility Program). The lessons from welfare reform can provide valuable insights into the potential impact of Medicaid block grants: namely, states may have a considerable incentive to pursue block grants, because they pose an attractive opportunity to cut state spending and allocate Medicaid dollars for other uses should the state desire that outcome.
In 1996, A...
Source: Health Affairs Blog - July 7, 2017 Category: Health Management Authors: Michelle Ko and Marianne Bitler Tags: Following the ACA Insurance and Coverage Medicaid and CHIP ACA repeal and replace AHCA BCRA Medicaid block grants tanf Source Type: blogs
Beyond “To Close Or Not To Close” Rural Hospitals
About 60 million Americans live in rural areas. And almost every health statistic shows they’re falling behind their fellow Americans who live in urban areas. Rural residents are less likely to have health insurance coverage through a job, have lower incomes, and have higher rates of death from heart disease and stroke.
However, there’s not only a health gap widening between urban and rural areas. There’s also a growing gap between the way systems of health work in different areas of the country.
As reported in a recent study commissioned by the Episcopal Health Foundation (EHF), seventeen rural hospitals in Texas ha...
Source: Health Affairs Blog - July 6, 2017 Category: Health Management Authors: Shao-Chee Sim Tags: Costs and Spending Featured GrantWatch Health Equity Hospitals Organization and Delivery Access Consumers Health Care Costs Health Care Delivery Health Philanthropy hospital closures Rural Health Care Texas Workforce 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
Spurring Provider Entry Into Medicare Advantage
Similar to private health insurance, there is little competition in Medicare Advantage (MA). The US District Court’s recent decision against the Aetna-Humana merger is a strong signal that the current Medicare Advantage market does not favor new entry. According to the Justice Department’s expert testimony in the case, only 5.5 percent of the 284 complaint counties experienced new entry from 2012 to 2016 from plans that were not either Humana or Aetna.
Yet Medicare Advantage does not have to be constrained in this way. Innovative provider groups have shown it is possible to launch an MA plan even when it may not be pos...
Source: Health Affairs Blog - July 6, 2017 Category: Health Management Authors: Travis Broome and Farzad Mostashari Tags: Health Policy Lab Insurance and Coverage Medicare Medicare Advantage value based care Source Type: blogs
