Health Affairs ’ July Issue: Advanced Illness & End-of-Life Care
The July issue of Health Affairs explores topics related to advanced illness and end-of-life care. Often when needs are 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.
The July issue of Health Affairs was supported by the Gordon and Betty Moore Foundation.
Medical spending in last year of life is lower than previously reported
Shedding new light on end-of-life medical spending, data from eight countries and the Canadian province of Quebec suggest that high costs associated with the fina...
Source: Health Affairs Blog - July 5, 2017 Category: Health Management Authors: Lucy Larner Tags: Elsewhere@ Health Affairs Source Type: blogs
Scaling Career Pathways For Entry-Level Health Care Workers
Imagine a job-creation initiative in which an employee with just a high school diploma has a realistic chance of more than doubling his or her original salary while working for the same employer. Now imagine that the careers this initiative supports also provide some of the most in-demand skills sought by employers in the future workforce.
This opportunity and the immense potential it represents to help build the middle class exist in the health care sector today. That is why, about a year ago, more than 20 major health care systems from communities across the nation joined together to capture this possibility, and the Hea...
Source: Health Affairs Blog - July 5, 2017 Category: Health Management Authors: Alefiyah Mesiwala, Jennifer Stewart and Michele Chang Tags: Health Professionals Quality Advisory Board Company Health Career Pathways Task Force Hope Street Group Source Type: blogs
CMS Releases 2016 ACA Marketplace Reinsurance And Risk Adjustment Data
On June 30, 2017, CMS released the results for the third year (2016) of the reinsurance and risk adjustment programs, two of the Affordable Care Act’s “three R” premium stabilization programs. The 2016 results from the risk corridor program, the “third R” will be announced later this year.
ACA’s “Three R” Progams Are Modeled After Medicare Part D, But Are Weaker And More Controversial Than Their Part D Counterparts
The ACA’s three R programs were modeled after similar premium stabilization programs that have operated for about a decade for Medicare Part D prescription drug plans. The Part D pr...
Source: Health Affairs Blog - July 1, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Payment Policy Medicare Part D premium stabilization programs reinsurance risk adjustment risk corridors Three R's Source Type: blogs
State Single Payer And Medicaid Buy-In: A Look At California, New York, And Nevada
Rising insurance premiums, lack of access, uncertainty, and commotion around Affordable Care Act (ACA) repeal, have all contributed to the growing discontent and unease surrounding health care reform. Pressure to act continues to mount. Insurance titans Humana, United Healthcare, and Aetna have all rolled-back participation on the ACA Marketplaces. Anthem recently announced that it would exit the Ohio health insurance Marketplace, potentially leaving at least 18 counties without an exchange plan next year. Missouri and Washington State are also facing similar Marketplace participation issues. States such as Alabama, Arizon...
Source: Health Affairs Blog - June 30, 2017 Category: Health Management Authors: Douglas Hervey, Sean Mullin and Austin Bordelon Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Payment Policy California individual markets Medicaid buy-in nevada New York state single-payer systems Source Type: blogs
Democratic Ideas On ACA Improvements; More From CBO On BCRA Medicaid Cuts
On June 28, 2017, the New York Times reported that Senate Majority Leader Mitch McConnell, facing difficulty in corralling 50 Republican Senators to unite behind a version of the Better Care Reconciliation Act, has suggested he might turn to the Democrats for help in shoring up the deteriorating situation under the ACA if he cannot get Republicans in line. If he does so, he may find that Democrats have both a proposed diagnosis and cure for the most immediately pressing problems facing the individual insurance market.
On June 28, 2017, the Democratic staff of the House Committee on Energy and Commerce and of the Senate Com...
Source: Health Affairs Blog - June 29, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Congressional Budget Office cost-sharing reduction payments reinsurance Source Type: blogs
How Health Care And Community-Based Human Services Organizations Are Partnering for Better Health Outcomes
While the headlines focus on the latest twists and turns of health care politics and policies, a tectonic shift is happening in America’s approach to health, with innovations that show promise in terms of better outcomes, better quality of care, and lower costs.
Health care organizations and community-based providers of human services are now collaborating to address the crucial social—as well as the clinical—determinants of health. This movement recognizes the important role that factors like housing, food security, education, employment, and so forth play in the overall well-being of people and communities. It take...
Source: Health Affairs Blog - June 29, 2017 Category: Health Management Authors: Quiana Lewis Tags: Featured GrantWatch Organization and Delivery Population Health Center for Health Care Strategies community-based organizations Health Philanthropy human services organizations Nonmedical Determinants Robert Wood Johnson Foundation Soc Source Type: blogs
Transforming Tragedy Into Effective Maternal Mortality Prevention Efforts
Making her way to her baby’s crib at the end of naptime, a 29-year-old, first-time mother falls to the ground unconscious. She never recovers.
Until that day, despite the exhaustion that inevitably accompanies life with a newborn, the young woman appeared to be recovering well from childbirth. Even though she’d battled hypertension throughout her pregnancy, after delivery, her blood pressure readings were normal and she was discharged.
Her family is bewildered and distraught. It will be several confusing and agonizing weeks before they learn what took the life of this young, vibrant mother.
While this may sound like th...
Source: Health Affairs Blog - June 29, 2017 Category: Health Management Authors: Wanda Barfield Tags: Featured Public Health Quality CDC maternity care postpartum care Source Type: blogs
What Makes Covering Maternity Care Different?
The United States has a higher maternal mortality rate than any other developed country, but federal policy makers are considering reducing access to insurance coverage for pregnancy care. Last week, the US Senate released the Better Care Reconciliation Act of 2017, following the passage of the American Health Care Act in the US House of Representatives. Both pieces of legislation would allow states to waive out of the requirement that insurance plans in the individual market cover maternity and newborn care, as part of efforts to repeal and replace the Affordable Care Act (ACA).
The ACA requires that all individual market...
Source: Health Affairs Blog - June 29, 2017 Category: Health Management Authors: Dania Palanker, Kevin Lucia and Dimitra Panteli Tags: Following the ACA Insurance and Coverage Population Health ACA repeal and replace Amerian Health Care Act Essential Health Benefits Health Reform maternity care pregnancy 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
Making Investments In Rural Health: What Are The New And Old Challenges?
Fairly early in the day of November 9, 2016, the frenzy began. It was the day after Election Day 2016.
Enormous swaths of rural Americans had helped to deliver a presidential candidate over the finish line who promoted ideas and plans that were antithetical to the sensibilities of a majority of health foundation boards and staff. So what were those funders going to do now? Who were these rural voters, and what were they saying?
More immediately, what were foundations supposed to do to get past the election surprise and to start thinking about being useful to a rural America that can seem very “out-of-sight and out-of-min...
Source: Health Affairs Blog - June 28, 2017 Category: Health Management Authors: Allen Smart Tags: GrantWatch Health Equity 2016 election Health Philanthropy Office of Rural Health Policy Politics Source Type: blogs
Growth Of ACOs And Alternative Payment Models In 2017
Conclusion
Alternative payment models that feature increasing accountability for improving patient care and lowering costs continue to expand. Their impact will likely grow as providers are subject to greater risk and develop the competencies to succeed. But, the payment model is not an end in itself. To achieve better value across the American health care system, more progress is needed to refine and align alternative payment models, and to help all types of health care providers develop the capabilities needed to succeed in them.
Note 1
Numbers vary slightly from previous estimates due to revised tracking and estimation ...
Source: Health Affairs Blog - June 28, 2017 Category: Health Management Authors: David Muhlestein, Robert Saunders and Mark McClellan Tags: Costs and Spending Featured Hospitals Organization and Delivery Payment Policy Population Health Quality ACOs Alternative Payment Models Source Type: blogs
How Could The 21st Century Cures Act And The Joint Commission Improve Eating Disorder Care?
Approximately 30 million individuals have experienced a diagnosable eating disorder at some point in their life. People with an eating disorder are more likely to have comorbid physical and psychological conditions, higher annual health care costs, and experience reduced quality of life. Moreover, eating disorders are among the deadliest of psychological conditions, with anorexia nervosa in particular having an especially high mortality rate. While the burden is significant, there has long been a lack of access to eating disorder prevention, identification, and intervention services.
Parity of behavioral health care with g...
Source: Health Affairs Blog - June 28, 2017 Category: Health Management Authors: Morgan Shields Tags: Featured Following the ACA Insurance and Coverage Payment Policy Public Health 21st Century Cures Act American Health Care Act eating disorder treatment Essential Health Benefits The Joint Commission Source Type: blogs
CMS Highlights Counties With Limited Or Zero Marketplace Insurance Options
On June 27, 2017, the Centers for Medicare and Medicaid released an updated map showing availability of insurers through the exchanges for 2018.
An accompanying CMS press release noted that 49 counties including 36,000 active exchange participants currently have no insurers offering coverage through the exchanges for 2018. These counties are apparently located in Ohio, Indiana, and Missouri. 1300 counties with 2.4 million exchange participants currently only have on insurer available for 2018.
The press release asserts that HHS is working together with state insurance regulators to explore all options under current law to ...
Source: Health Affairs Blog - June 27, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage ACA Marketplaces exchanges Source Type: blogs
A Health Care War On The Poor
Many criticisms have been leveled against the House-passed American Health Care Act (AHCA) and the Better Care Reconciliation Act- the new Senate health bill offered by Majority Leader Mitch McConnell. The unmistakable hallmark of these bills, however, is that they constitute a very cruel war on the poor. By far, no demographic group would be hurt more by these legislative proposals than low-income people. They are the bulls-eye!
This war on the poor began with the debate about payments for cost-sharing reductions that help low-income people afford health insurance deductibles and co-payments. President Trump won’t commi...
Source: Health Affairs Blog - June 27, 2017 Category: Health Management Authors: Kathleen Sebelius and Ron Pollack Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Medicaid and CHIP AHCA Trumpcare Source Type: blogs
Actuarial Value and the Importance of Bipartisanship in Health Care Reform
In 2009 and 2010, Congress wrote a bill with the goal of providing health care coverage for the uninsured in America. With the decision to include the individual mandate, Congress decided to include a requirement in the Affordable Care Act (ACA) that penalizes people who do not purchase insurance (with a few exceptions). In 2017, through a continuous coverage requirement in the American Health Care Act and the proposed Better Care Reconciliation Act, Congress still considers it important to require insurance coverage, albeit through different means. If the proposed ACA replacement includes a requirement to purchase ins...
Source: Health Affairs Blog - June 27, 2017 Category: Health Management Authors: Rodney Whitlock Tags: Costs and Spending Following the ACA ACA repeal and replace Actuarial Value Politics Trumpcare Source Type: blogs
