Diffusing Innovation: A Case Study Of Care Management In Louisiana
Conclusion The diffusion of innovation in health care doesn’t happen on its own. As we learned in Louisiana, it takes strong support for early adopters and gleaning from their experiences to tailor workflows as implementation efforts are spread to other practices. It also takes a collaborative learning environment, inclusive of both online and in-person forums, and standardized training content that can be tailored to the unique needs of each practice. With local leaders, a dedicated team in the field, support from a growing national value-based care network, and comprehensive population health technology that helps prac...
Source: Health Affairs Blog - October 11, 2017 Category: Health Management Authors: Charisse Hunter, Nadine Robin and Erin Flowers Tags: Diffusion of Innovation Accountable Care Organization chronic care management Louisiana value based care Source Type: blogs

The 340B Program: Mandatory Reporting, Alternative Eligibility Criteria Should Be Top Priorities For Congress
Policymakers have renewed their focus on how the 340B drug discount program functions among “safety net” hospitals, particularly Disproportionate Share  Hospitals (DSH), which qualify for the 340B program because they provide a sufficient amount of inpatient care to Medicaid and low-income Medicare beneficiaries. In June, a leaked executive order from the Trump administration suggested that the program would start to tie the volume of discounted drugs to indigent patient volume. In July, the Centers for Medicare and Medicaid Services (CMS) proposed cuts to physician reimbursements for outpatient drugs covered under Me...
Source: Health Affairs Blog - October 10, 2017 Category: Health Management Authors: Sayeh Nikpay, Melinda Buntin and Rena Conti Tags: Costs and Spending Drugs and Medical Innovation Hospitals Medicaid and CHIP Medicare 340B 340B program disproportionate share hospitals DSH Source Type: blogs

Sessions Outlines Religious Liberty Principles To Guide Government Actions
On October 6, 2017, Attorney General Jeff Sessions released a memorandum on religious liberty protections for all executive departments and agencies and guidance to Department of Justice staff on how to implement this memorandum. The memorandum outlines 20 principles of religious liberty to guide the federal government in accommodating religious observance and practice in federal employment, contracting, and programming. The principles themselves refer to the Constitution and federal laws, such as the Religious Freedom Restoration Act of 1993 (RFRA), in a general way, but much of the detailed legal analysis is found in the...
Source: Health Affairs Blog - October 10, 2017 Category: Health Management Authors: Katie Keith Tags: Following the ACA ACA section 1557 contraceptive coverage mandate free exercise of religion Religious Freedom Restoration Act Title VII of the Civil Rights Act Source Type: blogs

CMS Beefs Up Enforcement On QHP Coverage Of Abortions Outside The Hyde Amendment
On October 6, 2017, the Center for Consumer Information and Insurance Oversight (CCIIO) released a new bulletin regarding the coverage of abortion by qualified health plans (QHPs) sold through the ACA marketplaces. The bulletin provides additional guidance on how rules and restrictions on abortion coverage will be enforced by federal officials beginning in plan year 2018. The ACA And Abortion Coverage Coverage of abortion was one of the most contentious and last resolved issues in the debate over the ACA. The final Senate compromise, which was adopted as part of the ACA, largely reinforces the Hyde Amendment, which has bee...
Source: Health Affairs Blog - October 7, 2017 Category: Health Management Authors: Katie Keith and Timothy Jost Tags: Following the ACA Insurance and Coverage Abortion Hyde Amendment qualified health plans Source Type: blogs

Trump Administration Regulatory Rebalancing Favors Religious And Moral Freedom Over Contraceptive Access
On October 6, 2017, the Departments of Health and Human Services, Labor, and Treasury, released two interim final rules addressing religious and moral objections to the coverage of contraceptives under the preventive services requirement of the Affordable Care Act, as well as accommodations for those objections. Treasury released with the interim final rules two accompanying proposed rules (here and here) apparently required for technical reasons because Treasury released temporary rules. HHS also updated the Health Resources and Services Administration women’s health guidelines to reflect the rule change. Finally, HHS a...
Source: Health Affairs Blog - October 7, 2017 Category: Health Management Authors: Timothy Jost and Katie Keith Tags: Following the ACA Insurance and Coverage Uncategorized contraceptive coverage contraceptive mandate Preventive Services Mandate Religious Freedom Restoration Act Source Type: blogs

Nearly One-Third Of New Drugs Are No Better Than Older Drugs, And Some Are Worse
A Focus On Expediting Drug Development Congress has instructed the Food and Drug Administration (FDA) to expedite the development and review of promising new drugs through the creation of four programs: accelerated approval, fast-track, breakthrough, and priority review. In a recent Health Affairs article, James D. Chambers and colleagues reported that drugs approved under one or more expedited programs were, on average, associated with larger health gains than those approved under conventional development and review programs. They concluded that the FDA has prioritized the review of drugs that offer the largest clinical a...
Source: Health Affairs Blog - October 6, 2017 Category: Health Management Authors: Jonathan Darrow and Aaron Kesselheim Tags: Drugs and Medical Innovation expediting drug development Food and Drug Administration Prescription Drugs QALY quality-adjusted life years Source Type: blogs

Calling All Wonder Women —The US Health System Needs Strong Leaders, Healthy Mothers
Legend has it that the creation of Wonder Woman—the super hero and pop culture icon who has saved us from imminent doom since World War II—was inspired by real-life women’s health activists from the early twentieth century. These were women who bucked convention and championed causes like reproductive rights and suffrage. Women who saw opportunities for collective action where others saw insurmountable obstacles. Women who refused to be relegated to second-class status and instead became the driving force for creating a more just, inclusive world. We have come a long way since the days of Margaret Sanger and Susan B....
Source: Health Affairs Blog - October 5, 2017 Category: Health Management Authors: Karen Wolk Feinstein Tags: Featured GrantWatch Health Professionals Population Health Quality community health workers Disparities Health Philanthropy Jewish Healthcare Foundation Latinas maternal mortality pregnancy Women's Health Source Type: blogs

The CHRONIC Care Act Passes Senate, Obstacles Remain
Late last Tuesday night, only hours after Republican leaders announced they were pulling the Graham-Cassidy repeal and replace bill from Senate consideration, the body unanimously passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (the Act). Aiming to improve care for seniors with chronic conditions, the Act first passed the Senate Finance Committee in May of this year. A Health Affairs blog post by former Senators Tom Daschle and Bill Frist, along with in-depth analysis from the Bipartisan Policy Committee, helpfully outline the need for a bipartisan effort to add...
Source: Health Affairs Blog - October 5, 2017 Category: Health Management Authors: Billy Wynne Tags: Costs and Spending Insurance and Coverage Medicaid and CHIP Medicare Organization and Delivery ACA ACO bipartisanship chronic CHRONIC Care Act dual eligibles Long-Term Care Medicare Advantage Telehealth Source Type: blogs

Reducing The Externalities Caused By Limited Benefit Plans
Limited benefit or non-Affordable Care Act (ACA)-compliant health insurance products are much discussed of late, since a proposal to ease restrictions on short-term health plans is currently under consideration. Critics have argued that these plans hurt both consumers and the individual market, while defenders have suggested that those who can benefit from this competitively priced option should be free to do so. That these plans may be harmful to at least some consumers is difficult to dispute. In its comment letter, the National Association of Insurance Commissioners supported increased disclosure requirements, noting th...
Source: Health Affairs Blog - October 5, 2017 Category: Health Management Authors: Katherine Hempstead Tags: Insurance and Coverage ACA-compliant market individual market stability limited benefit plans short-term plans skinny plans state insurance regulation Source Type: blogs

Community Approaches To Improving Children ’s Health: Addressing Childhood Obesity And ACEs In Kentucky
Investing in children’s health is a sound economic decision with a long-term impact on achieving sustainable human, social, and economic development. The Foundation for a Healthy Kentucky’s Investing in Kentucky’s Future initiative was designed as a partnership with local community health coalitions to reduce the risk that today’s children will develop chronic diseases as they grow into adults. Background The Foundation for a Healthy Kentucky is a statewide nonprofit organization working to address the unmet health needs of Kentuckians. In 2012 the foundation launched a six-year, $3 million initiative called Invest...
Source: Health Affairs Blog - October 4, 2017 Category: Health Management Authors: M. Amalia Mendoza Tags: GrantWatch Public Health ACEs adverse childhood experiences Children chronic disease prevention equity Health Philanthropy Health Promotion and Disease PreventionGW Kentucky Nonmedical Determinants Obesity Prevention resiliency S Source Type: blogs

ACA Round-Up: Bipartisan Proposal To Revamp Employer Reporting Requirements And More
Throughout a summer of intensely partisan efforts to repeal and replace parts of the Affordable Care Act, there have been flickers of bipartisanship, including a sustained effort by Senators Alexander (R-TN) and Murray (D-WA) and the Senate Health, Education, Labor, and Pensions Committee to find bipartisan consensus for a short-term market stabilization package. On October 3, 2017, another bipartisan effort emerged from another quarter. Senators Portman (R-OH) and Warner (D-VA) introduced a bill that is surprising in that it emerged out of nowhere (at least as far as I am aware) and addresses a problem that obviously need...
Source: Health Affairs Blog - October 4, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Source Type: blogs

The 2017 ACO Survey: What Do Current Trends Tell Us About The Future Of Accountable Care?
This article presents an overview of the results from the inaugural 2017 Annual ACO Survey and provides important insights into the current and future state of the ACO industry. Overall, we found that a large number of ACOs are currently considering or have firm plans to participate in future risk-based contracts (47 percent planning for shared savings/shared risk and 38 percent planning for capitation), although care management strategies are largely unchanged. This and the data below suggest that ACOs are slowly becoming willing to accept increased financial risk, but they are largely still learning how to actually manag...
Source: Health Affairs Blog - October 4, 2017 Category: Health Management Authors: Kate de Lisle, Teresa Litton, Allison Brennan and David Muhlestein Tags: Medicare Payment Policy Quality Accountable Care Organizations delivery reform NAACOS Payment Reform Source Type: blogs

Is Paid Family And Medical Leave Inevitable? Perhaps, But There ’s A Long Way To Go From Here
The push for paid parental, family, and medical leave is gaining traction. But legislative action in Congress is still iffy and could easily be eclipsed by events or partisan rancor over the next year. This blog is an update to a Health Affairs Policy Brief that I wrote last year on paid family and medical leave policies. The brief, published November 21, 2016, provides an overview of the basic issues, research, and policy options. Those remain relevant 10 months later. But some things have progressed. The Trump administration and lawmakers on both sides of the aisle in Congress have released competing paid-leave proposals...
Source: Health Affairs Blog - October 3, 2017 Category: Health Management Authors: Steven Findlay Tags: Elsewhere@ Health Affairs Long-term Services and Supports Quality employee benefits maternity leave paid family leave paid medical leave paid parental leave paternity leave unpaid leave Source Type: blogs

Health Affairs October Issue: Emergency Departments, Behavioral Health & More
The October issue of Health Affairs includes several studies relating to the ultimate health care safety net: the emergency department (ED). Additional content in this variety issue focuses on behavioral health, spending, clinician satisfaction, and more. A DataGraphic spotlights aging and health. US emergency department visits for firearm-related injuries, 2006–14 According to the Centers for Disease Control and Prevention (CDC), firearm-related deaths accounted for more than 36,000 deaths in the United States in 2015. However, due to the politicized environment surrounding gun violence, Congress has yet to appropriate...
Source: Health Affairs Blog - October 2, 2017 Category: Health Management Authors: Health Affairs Tags: Elsewhere@ Health Affairs journal Source Type: blogs

California Takes On Drug Pricing: Real Progress Or Illusion?
Californians and others around the country following the California legislature’s multiyear debate on prescription drug pricing may have stood up and taken notice on September 13 when the state Senate followed the Assembly in passing SB-17 to facilitate greater transparency in brand-name and generic drug pricing. While sponsors often make grandiose claims about the potential impact of their legislation, California senator Ed Hernandez may have set a new standard when he declared that the passage of SB-17 was “a monumental achievement for the entire nation” and “one of the most transformative pieces of health legisl...
Source: Health Affairs Blog - October 2, 2017 Category: Health Management Authors: Ian Spatz Tags: Costs and Spending Drugs and Medical Innovation California California SB-17 prescription drug pricing Source Type: blogs