Deploying The Cascade Of Care Framework To Address The Opioid Epidemic Means Taking A Closer Look At Quality Measures
In a March 13, 2017, Health Affairs Blog post, Arthur Robin Williams, Edward Nunes, and Mark Olfson propose repurposing the “Cascade of Care” framework, once used to combat the HIV/AIDS crisis, to fight the opioid epidemic.
Williams and colleagues propose developing performance measures to track the success of the state grants across the five framework stages:
Diagnosis among those affected
Linkage to care among those diagnosed
Medication initiation among those entering care
Retention for at least six months among those initiating medication
Continuous abstinence among those retained
We applaud Williams and colleague...
Source: Health Affairs Blog - June 21, 2017 Category: Health Management Authors: Mady Chalk and Tami Mark Tags: Featured Health Policy Lab Population Health Public Health Quality Cascade of Care data collection systems opioid epidemic Substance Use Disorders tracking and delivery system Source Type: blogs
Finding Common Ground On Medicaid Reform For Dual Eligibles
Editor’s Note: This is the final post in a five-part Health Affairs Blog series, produced in conjunction with the Bipartisan Policy Center, examining current issues and care models in the delivery system reform effort. Each post is jointly authored by Democratic and Republican leaders in health policy. Read all of the posts here.
Medicaid is the primary source of health insurance for families and children that meet the income and program eligibility requirements. It is also the largest single source of financing for long-term services and supports (LTSS), which help individuals who need it engage in the activities of dai...
Source: Health Affairs Blog - June 15, 2017 Category: Health Management Authors: Cindy Mann and Avik Roy Tags: Featured Medicaid and CHIP Medicare Payment Policy Quality bipartisan delivery system reform dual eligibles Source Type: blogs
Could Medicaid for all be the answer?
Putting it all together
The Affordable Care Act is a complex law, but for a major piece of legislation that actually made it all the way through a very open legislative process, it’s remarkably coherent. Republicans have tried to sabotage it since before it was passed, and yet it still managed to succeed while a Democratic Administration remained in power. I have predicted in the past that if Republicans actually managed to poison Obamacare that they would come to regret it, because it would lead eventually to the rise of a single payer (i.e., truly socialist) system.
I assumed that the move toward single payer would...
Source: Health Business Blog - June 14, 2017 Category: Health Management Authors: dewe67 Tags: Health plans Policy and politics AHCA Medicaid obamacare Source Type: blogs
Iowa Submits 1332 Waiver Request, Claiming It Is Necessary To Avoid An Individual Insurance Market Collapse
Perhaps the most immediate problem facing federal and state health policymakers—and consumers—is what can be done for marketplace consumers in “bare counties” for 2018. As of early June, 2017, there are 47 counties in Ohio, Missouri, Kansas, and Washington where there are currently no insurers offering to provide marketplace coverage for 2018. Approximately 38,000 Affordable Care Act marketplace enrollees live in these counties (only 0.3 percent of the total), but under current law they have no access to the ACA’s premium tax credits and cost-sharing reduction payments that make health care affordable for lower-i...
Source: Health Affairs Blog - June 12, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage bare counties 1332 waivers advance premium tax credits cost-sharing reduction payments high-risk pools reinsurance Source Type: blogs
Would ACOs Work if They Were Turned into HMOs?
By KIP SULLIVAN, JD
CMS has now conducted three demonstrations of the “accountable care organization,” and all of them have failed. The Physician Group Practice (PGP) Demonstration, which ran from 2005 to 2010, raised Medicare costs by 1.2 percent. [1] The Pioneer ACO program, which ran from 2012 through 2016, cut Medicare spending by three- or four-tenths of a percent on average over its first four years. And the Medicare Shared Savings Program (MSSP), which began in 2012 and may lumber on indefinitely, has raised Medicare costs by two-tenths of a percent on average over its first four years.
It is way past time for C...
Source: The Health Care Blog - June 8, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The Private Sector Can Lead In Delivery System And Payment Reform
Editor’s Note: This is the fourth in a five-part Health Affairs Blog series, produced in conjunction with the Bipartisan Policy Center, examining current issues and care models in the delivery system reform effort. Each post will be jointly authored by Democratic and Republican leaders in health policy. Check back for more posts in the series.
Employers and other private purchasers of medical services have played an important role in spurring health care delivery system and payment reform. The development of managed care has been accelerated by federal and state policies over the years but originated with private sector...
Source: Health Affairs Blog - June 8, 2017 Category: Health Management Authors: Chris Jennings and James Capretta Tags: Costs and Spending Featured Organization and Delivery Payment Policy bipartisan delivery system reform CalPERS reference pricing shoppable services Source Type: blogs
The Solution Never Works If You Haven ’ t Identified the Problem
This study concluded that “For our study sample, unintentional non-adherence does not appear to be random and is predicted by medication beliefs, chronic disease, and sociodemographics. The data suggests that the importance of unintentional non-adherence may lie in its potential prognostic significance for future intentional non-adherence. Health care providers may consider routinely inquiring about unintentional non-adherence in order to proactively address patients’ suboptimal medication beliefs before they choose to discontinue therapy all together [sic]” (emphasis added]
Reading further in the paper I...
Source: The Health Care Blog - June 7, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized chronic disease Dark Goddess of Replevin Non-adherence Patients PBM REMIND Source Type: blogs
Supreme Court Endorses Broad Government View Of ERISA ‘Church Plan’ Definition
On June 5, 2017, the Supreme Court released Advocate Health Care Network v. Stapleton, unanimously (with Justice Gorsuch not yet participating) accepting the federal government’s interpretation of the Employee Retirement Income Security Act’s (ERISA) definition of “church plan.” The Court rejected a challenge brought by employees covered by defined-benefit pension plans offered by entities that qualified as “church plans” under the government’s interpretation.
Separately, on the same day, the Department of Justice filed a brief in Texas v. United States in support of the federal government’s motion for summ...
Source: Health Affairs Blog - June 6, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA ERISA Source Type: blogs
5 myths about emergency physician groups
Independent physician groups and solo physicians have been the historic bedrock of medical practice. While it is true that there is intense pressure on the single-physician group, and this market is shrinking, independent physicians are here to stay. Some single practice physician groups may merge with larger groups, some physicians will break off from the large contract groups, but there is no plan on them becoming extinct.
Independent physician groups have been staffing hospitals for decades. For these physicians, their practice and hospital is their home and community. They have worked at the same hospital serving the s...
Source: Kevin, M.D. - Medical Weblog - June 6, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/roneet-lev" rel="tag" > Roneet Lev, MD < /a > Tags: Physician Emergency Source Type: blogs
This Intervention Helps Underserved Women Access Needed Postpartum Care
Pregnancy and childbirth can exacerbate many health risks, especially among underserved women or those who have a hard time getting health care. Diabetes, hypertension, and depression are all serious health conditions that occur frequently during pregnancy and childbirth, and are more common (during pregnancy and overall) among racial and ethnic minority women. Many women with these conditions have worsened health throughout their life course.
Yet pregnancy and the postpartum period also present an opportunity for providers to intervene and improve the health trajectories of these women by connecting them to health care, h...
Source: Health Affairs Blog - June 5, 2017 Category: Health Management Authors: Elizabeth A. Howell Tags: Health Equity Medicaid and CHIP Payment Policy Quality maternal depression Maternal Health postpartum care Primary Care Women's Health Source Type: blogs
ERISA: A Bipartisan Problem For The ACA And The AHCA
The Supreme Court has once again been called on to mediate the boundaries of a far-reaching, infamously complex, federal employee benefits law. And once again this law may have an important and unanticipated effect on health care.
The main goal of this law, the Employee Retirement Income Security Act of 1974 (ERISA), was to provide uniform, federal regulation of pensions and employee benefit plans (including health care). But the law has had a far more dramatic impact on health policy beyond what Congress ever contemplated. Because ERISA pushes aside state regulation of these plans, it has impeded the states’ ability to ...
Source: Health Affairs Blog - June 2, 2017 Category: Health Management Authors: Abbe R. Gluck, Allison K. Hoffman and Peter D. Jacobson Tags: Following the ACA Insurance and Coverage Advocate Health Care Network v. Stapleton AHCA All-Payer Claims Database church plans ERISA Essential Health Benefits Gobeille v. Liberty Mutual Insurance Co. SCOTUS States Zubik v. Burwell Source Type: blogs
For Patients With Multiple Chronic Conditions, Improving Care Will Be A Bipartisan Effort
Editor’s Note: This is the third in a five-part Health Affairs Blog series, produced in conjunction with the Bipartisan Policy Center, examining current issues and care models in the delivery system reform effort. Each post will be jointly authored by Democratic and Republican leaders in health policy. Check back for more posts in the series.
While federal policy makers are undertaking controversial and divisive debates over the future of the Affordable Care Act, Republicans and Democrats have had a good track record of working together to improve health care delivery and payment frameworks. Most recently, the bipartisa...
Source: Health Affairs Blog - June 1, 2017 Category: Health Management Authors: Thomas Daschle and Bill Frist Tags: Costs and Spending Insurance and Coverage Long-term Services and Supports Medicaid and CHIP Medicare Payment Policy Alternative Payment Models bipartisan delivery system reform Bipartisan Policy Center Chronic Care CHRONIC Care Act i Source Type: blogs
Health Wonk Review - upcoming hosts
June 22, 2017 - Joe Paduda - Managed Care Matters
July summer edition - date & host TBD
August summer edition - date & host TBD (Source: Health Wonk Review)
Source: Health Wonk Review - June 1, 2017 Category: Health Management Source Type: blogs
California ’s Coverage Expansion: Fiscal And Political Risks
Young people growing up in California lived under the dark shadow of the risk of a cataclysmic earthquake (also known as “The Big One”) that would destroy their homes and lives. Two significant earthquakes—the 1971 Sylmar quake in the Los Angeles’ suburban San Fernando Valley (6.6 on the Richter Scale) and the 1989 Loma Prieta quake (6.9 on the Richter Scale) in the southern mountains of the San Francisco Bay Area—killed dozens, reminding residents of nature’s frightening hidden power. But these quakes left the rest of California intact. So far, the Big One has not arrived.
On May 4, 2017, with the pass...
Source: Health Affairs Blog - May 30, 2017 Category: Health Management Authors: Jeff Goldsmith Tags: Costs and Spending Following the ACA Insurance and Coverage Payment Policy ACA repeal and replace American Health Care Act California Covered California Medi-Cal Source Type: blogs
