Health Affairs (blog)

Health Affairs (blog)
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Health Affairs (blog)

 •  June 28

Accountable care is an important mechanism used by public and private payers to align health care provider payments with efficient care for defined patient populations. Leavitt Partners, in partnership with the Accountable Care Learning Collaborative, tracks the growth and spread of accountable care organizations (ACOs) and other alternative...

On May 17, 2017, the Centers for Medicare and Medicaid Services released a guidance outlining a new “proxy direct enrollment pathway” that will be available for the 2018 individual market open enrollment period. The press release accompanying the guidance states that the new process “reduces needless regulatory burden for businesses that provide...

Health Affairs (blog)

 •  April 26

Medical spending has resumed its long-term rise. After several years of deceptive stability in the last, deep recession’s wake, health spending rose by 3.7 percentage points more than general inflation in 2014, then by 5.8 percentage points more in 2015, to a 17.8 percent share of the US economy. Not only does this spending rise threaten the United...

Health Affairs (blog)

 •  April 10

Secretary of Health and Human Services (HHS) Dr. Tom Price and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma face significant decisions across a range of programs in the first half of 2017. Decisions regarding how the new Administration will approach the health insurance marketplaces rightly command the most attention,...

Health Affairs (blog)

 •  March 7

On March 6, 2017, the House Republican leadership introduced Affordable Care Act repeal and replacement budget reconciliation bills in the Ways and Means (W&M) (summary) and Energy and Commerce (E&C) (summary) committees. The bills, collectively titled the American Health Care Act, are the committees’ responses to the instructions they received in...

Health Affairs (blog)

 •  June 2, 2016

Patients like Gay Miller, a North Carolina resident who paid almost $900 more than her typical $60 co-pay for a routine 30-minute echocardiogram, are feeling the angst of increased out-of-pocket (OOP) costs solely attributable to a change in site of care. Gay received her echocardiogram at a hospital outpatient department (HOPD) as opposed to her...

Health Affairs (blog)

 •  May 2, 2016

Implementing Health Reform. On April 29, 2016, the Centers for Medicare and Medicaid Services posted in the Federal Register and at its Paperwork Reduction Act (PRA) website its final proposal for Transparency in Coverage Reporting for Qualified Health Plans (QHPs). This release is a revised version of a proposal CMS released in August of 2015 and...

Health Affairs (blog)

 •  April 15, 2016

A large national payer recently announced the opportunity for Accountable Care Organizations (ACOs) to share in 100 percent of the savings they create for the payer’s largest book of business. Providers will have complete autonomy in how they manage the health of their population, and the payer will ensure the timely flow of datasets needed to...

Health Affairs (blog)

 •  March 25, 2016

The patient-centered medical home (PCMH) has received attention as an improved care delivery model for primary care physicians — and possibly also for specialists who serve as principle physicians for patients with particular chronic conditions. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) identified the PCMH model as a...

Health Affairs (blog)

 •  February 17, 2016

Implementing Health Reform. On February 17, 2016, the Centers for Medicare and Medicaid Services (CMS) released a final updated list of over 19,000 essential community providers (ECPs) to assist insurers in complying with the ECP requirements that apply to qualified health plans (QHPs). CMS also published a guidance describing how the list is to be...