Failure To Approve Oklahoma Waiver Undermines Trust Between HHS And States
By failing to follow through on repeated assurances to Oklahoma that its 1332 reinsurance waiver would be approved on an expedited timeline, the federal government dealt a devastating blow to Oklahoma consumers and magnified suspicions that the Department of Health and Human Services (HHS) is more interested in undermining the Affordable Care Act than partnering with the states to stabilize the individual market for the nearly 20 million Americans who depend on that market for their health security.
Oklahoma’s Governor Lambasts The Federal Government For Breaking A Promise To His State
In a blistering letter to now forme...
Source: Health Affairs Blog - September 30, 2017 Category: Health Management Authors: Joel Ario Tags: Following the ACA Insurance and Coverage 1332 waivers Oklahoma reinsurance Source Type: blogs
ACA Round-Up: CMS Acts To Aid Hurricane Victims; Oklahoma Withdraws 1332 Wavier Application; And More
On September 29, 2017, the Centers for Medicare and Medicaid announced several measures that it is taking with respect to federal health care programs to aid people affected by hurricanes Harvey, Irma, and Maria. Several of these measures that will affect people who are covered or eligible for coverage through the Federally Facilitated Exchange (FFE) will be covered here. CMS also announced steps it is taking with respect to the Medicare program, including creating special Medicare enrollment periods and other public health emergency measures.
Individuals who experienced an event that would have qualified them for a specia...
Source: Health Affairs Blog - September 29, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage 1332 waivers Hurricane Harvey Hurricane Irma Hurricane Maria special enrollment periods state marketplaces Source Type: blogs
Advancing The Mental Health And Well-Being Movement Through Grant Making: Engaged Philanthropy
Investing in the health of a nation requires thoughtful deliberation and vision. Grantmakers, especially those with a focus on health, play a unique role in helping support community innovation that can advance health. However, without a clear focus on what they are trying to effect, the direction they want to go with their investment, and how to accomplish their goals, how will the grant-making community ever know if it is making a difference and if it is improving health?
The United States, now more than ever, needs clear direction to create more comprehensive solutions to fragmented problems. Grantmakers play an essenti...
Source: Health Affairs Blog - September 28, 2017 Category: Health Management Authors: Benjamin F. Miller and Tyler Norris Tags: GrantWatch Population Health costs Health Philanthropy Health Promotion and Disease PreventionGW Mental Health Policy Social Determinants of Health substance use wellness Source Type: blogs
De-Medicalizing Death
There’s been an unexpected, and excellent, consequence to California’s new medical aid-in-dying law. For many terminally ill patients, immersion in the process of securing lethal drugs ultimately renders them unnecessary. How did this come about?
Passed by the California legislature in late 2015, the End of Life Option Act allows physicians to prescribe a lethal concoction of drugs to some patients with terminal illnesses who meet certain criteria. The law, commonly described as providing “medical aid in dying,” took effect on June 9, 2016. It stipulates only that the requesting patient be considered terminal (less...
Source: Health Affairs Blog - September 28, 2017 Category: Health Management Authors: Jessica Nutik Zitter Tags: End of Life & Serious Illness California critical care End of Life Option Act intensive care unit medical aid in dying Palliative Care Source Type: blogs
ACA Round-Up: Graham-Cassidy ’ s Demise, Pressures On 2018 Open Enrollment, And New HHS Draft Strategic Plan
On September 26, 2017, the Republican Senate leadership announced that the Senate would not hold a vote on the Graham-Cassidy bill, the last attempt to repeal or amend the Affordable Care Act under the 2017 budget resolution. After Senator Collins announced that she would not support the legislation, joining Senators Paul and McCain who had already announced their opposition, it became clear that it lacked the 50 votes necessary to pass. There is some discussion of trying again to address health reform in the 2018 budget resolution, which would otherwise be devoted solely to changes in the tax code.
CMS Decisions On Renewa...
Source: Health Affairs Blog - September 27, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage ACA repeal and replace freedom of religion guaranteed issue and renewal open enrollment period Source Type: blogs
Real-World Evidence Complements Randomized Controlled Trials In Clinical Decision Making
Randomized controlled trials (RCTs) are considered the gold-standard study design for comparative effectiveness research, which involves directly comparing the effectiveness of one treatment to another. Despite their many benefits, RCTs have important limitations that can reduce their utility for certain types of comparative effectiveness research and limit the external validity of their findings. For this reason, real-world evidence—data about outcomes in actual patients who are receiving a treatment in a usual care setting—is gaining traction as a key source of evidence for comparative effectiveness research....
Source: Health Affairs Blog - September 27, 2017 Category: Health Management Authors: Daniel Blumenthal, Kristina Yu-Isenberg, John Yee and Anupam Jena Tags: Drugs and Medical Innovation chronic disease comparative effectiveness research efficacy-effectiveness gap health care innovation measuring care value randomized controlled trials real-world evidence Source Type: blogs
To Improve Health Care, How Do We Build Trust And Respect For Patients?
Over the past several years, there has been a proliferation of health insurance benefit designs and tremendous growth in new care delivery settings that have moved health care beyond the traditional brick-and-mortar physician offices to retail and even virtual settings. In the face of these rapid changes, consumers encounter many more choices when they are shopping for their health insurance and health care.
To better understand this evolving landscape, the Robert Wood Johnson Foundation (RWJF) awarded grants for eleven research studies in 2015, under a funding opportunity managed by AcademyHealth. These studies are conclu...
Source: Health Affairs Blog - September 26, 2017 Category: Health Management Authors: Megan Collado, Tara Oakman and Mona Shah Tags: Featured GrantWatch Insurance and Coverage Quality AcademyHealth Consumers cost-conscious behaviors doctor patient relationship Employer-Sponsored Insurance Health Philanthropy Mental Health patient perspective patient satisfaction Source Type: blogs
What Makes A Hospital The “Best”?
U.S. News & World Report recently published its annual “Best Hospitals” issue, which the magazine claims is the “global authority in hospital rankings.” That may be no exaggeration, given the more than two million Google results that appear with the search term “U.S. News hospital rankings” along with the flurry of self-congratulatory tweets posted and banners hung each year by the hospitals whose names appear at the top of the list. While the top-ranked hospitals were patting themselves on the back, we wondered if the magazine’s ranking system actually measures what matters to patients, or for that matte...
Source: Health Affairs Blog - September 26, 2017 Category: Health Management Authors: Judith Garber and Shannon Brownlee Tags: Hospitals Quality higher-value care hospital rankings U.S. News & World Report best hospital ranking Source Type: blogs
Fighting For Breath: Access To Oxygen Therapy Should Not Be A Matter Of Location Or Luck
In June, the World Health Organization (WHO) updated its Model List of Essential Medicines and List of Essential Medicines for Children to include an additional indication for oxygen therapy, specifying that it should be used to treat patients with dangerously low levels of oxygen in the blood (hypoxemia). The new indication is the result of a proposal led by my organization, PATH (an international nonprofit organization leading in global health innovation), in collaboration with partners and expert advisers. It helps prioritize oxygen therapy for patients with this dangerous condition.
The decision—and the need for ...
Source: Health Affairs Blog - September 26, 2017 Category: Health Management Authors: David C. Kaslow Tags: Health Equity Public Health hypoxemia Model List of Essential Medicines oxygen therapy PATH United4Oxygen World Health Organization Source Type: blogs
CBO Projects Graham-Cassidy Would Reduce Spending And Coverage
Late in the day on September 25, 2017, the Congressional Budget Office and Joint Committee on Taxation staff released their report on the Graham-Cassidy bill. Their analysis was apparently of an earlier version of the bill than the one released on September 24, 2017, but the provisions described and analyzed in the CBO report are virtually the same.
The CBO found that the Graham-Cassidy meets Senate budget reconciliation rules. It would reduce the deficit over ten years by at least $133 billion, the amount that the CBO concluded that the House American Health Care Act would reduce the deficit; each title of the bill would ...
Source: Health Affairs Blog - September 26, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Source Type: blogs
Medicaid Redux: Graham Cassidy Again
Where Medicaid is concerned, the latest version of Graham Cassidy, made public on September 24, 2017, retains the contours of the earlier version. There are a couple of narrow changes, one of which adds to the list of potentially significant legal complications with the draft bill.
What Stays The Same
Like its predecessor, the draft would fundamentally alter the federal/state financial relationship Medicaid. The two most obvious changes from current law involve capping federal contributions to the traditional program and ending the Affordable Care Act’s federal Medicaid funding for the expansion population. But the sc...
Source: Health Affairs Blog - September 25, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Costs and Spending Following the ACA Insurance and Coverage Medicaid and CHIP Source Type: blogs
Graham-Cassidy Continues Efforts To Bar Private Insurance Coverage of Abortion
Across all of the major House and Senate Republican proposals in 2017 to repeal and replace major portions of the Affordable Care Act (ACA), one thing that has been consistent is their inclusion of language barring federal money from being used to support private insurance plans that covers abortion. The latest proposal, from Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI), continues that trend.
The Graham-Cassidy proposal has abortion coverage provisions in common with the American Health Care Act (AHCA), which passed the House in May, and the Better Care Reconciliation Act (BCR...
Source: Health Affairs Blog - September 25, 2017 Category: Health Management Authors: Adam Sonfield Tags: Featured Following the ACA Insurance and Coverage abortion coverage Graham-Cassidy Source Type: blogs
New Graham-Cassidy Draft: States With Hold-Out GOP Senators Favored, Potential Higher Costs Remain For Those With Preexisting Conditions
Late on the night of Sunday, September 25, 2017—only 72 hours before a final vote on the bill is expected–a new version of the Graham-Cassidy bill was released. Although much of the bill is the same as the draft released earlier, there are significant changes. On initial review, these seem to be aimed primarily at two purposes:
undergirding the argument of the bill’s sponsors that it does not exclude coverage for people with preexisting conditions and,
substantially increasing funding for states represented by some of the GOP Senators who have expressed concerns about the bill.
This post analyzes the non-Medica...
Source: Health Affairs Blog - September 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Source Type: blogs
ACA Round-Up: 1332 Waiver News From Iowa And Minnesota; Big Blow To Graham Cassidy
Iowa has submitted a supplement to its application for a state innovation waiver under section 1332 of the Affordable Care Act. One of the issues raised by its application, as noted in an earlier post, was that its proposed waiver would eliminate cost-sharing reductions for low-income enrollees. This raised concerns as to whether the proposal satisfies a section 1332 requirement that a waiver program “will provide coverage and cost-sharing protections against excessive out-of-pocket spending that are at least as affordable” as ACA coverage.
Under the supplement it submitted, Iowa offers to compensate insurers for re...
Source: Health Affairs Blog - September 22, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Source Type: blogs
The Graham-Cassidy Plan: Sweeping Changes In A Compressed Time Frame
Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) have proposed a new plan for rolling back key provisions of the Affordable Care (ACA). It is possible that the Senate will vote on this plan in the coming days. The plan has many similarities to the Better Care Reconciliation Act (BCRA), which Senate Majority Leader Mitch McConnell assembled during June and July and which failed when considered in the Senate by a vote of 43 to 57.
The Graham-Cassidy plan is built on the premise that the federal government should remove itself from many of the difficult policy decisions concerning how health insurance is subsidized and ...
Source: Health Affairs Blog - September 22, 2017 Category: Health Management Authors: Joseph Antos and James Capretta Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Medicaid and CHIP ACA repeal and replace Bill Cassidy block grants Lindsey Grahm preexisting conditions state waivers Source Type: blogs
