08/31/10

Shared Decision-Making: Ensuring the PPACA Really Makes Health Care Affordable and Sustainable

When administration officials tout the cost savings potential of the Patient Protection and Affordable Care Act in a lead New England Journal of Medicine article (NEJM.org Aug. 12, 2010), one has to wonder if the statute adequately addresses the core drivers of poor health and excessive health care costs in a way which is understandable and actionable by patients and their doctors. Because if it doesn’t, we’re all in trouble. My fear is that much of the non value-added bureaucracy of health insurance and the “more-and-newer-is better-at-any cost” medical-industrial practices ...
08/24/10

Special Contributor | Can Cost Outcome Research Really Deliver Savings?

Given that the United States has the highest health care costs in the world relative to the size of our economy, it would be hard to argue against the utility of examining where and how our health care dollars are being spent. Finding ways to decrease the cost and burden of health care benefits both patients and the economy. It’s little surprise, then, that cost reduction was a major purpose of and selling point for the Obama administration’s recently past health reform legislation. Unfortunately, many Americans equate scrutinizing health care costs ...
08/17/10

Special Contributor | Building Medical Homes for Medicaid

Care Oregon, the state’s main Medicaid managed care plan, had two choices a few years ago, after many commercial partners in the Oregon Health Plan decided to get out of the money-draining business. It could go broke. Or it could change its world. It opted for the latter. Today, the Portland-based nonprofit CareOregon is a bit savvier about the business end of its mission. And it’s still trying to change its world. I started hearing about CareOregon here and there over the last year, and I heard several of its leaders—including CEO Dave ...
08/09/10

“Viewpoints: Health Innovation” | Health Care Reform and Long-Term Care–The Beginning of System Redesign

There are substantial economic and personal costs that accompany aging with functional impairment. The majority of long-term care costs are publicly financed. Medicaid currently pays for half of all long-term care in the United States at a cost of more than $100 billion a year to taxpayers. As a result, state and federal budgets are collapsing under the weight of these skyrocketing expenditures. Population aging combined with chronic health conditions and a decline in the ability to function will only increase demand and cost for these services. A paradigm shift ...
08/03/10

Special Contributor | Learning from Health Care Reform Abroad — More Lessons from the British National Health Service

Unlike in the U.S., where it’s exceedingly difficult to pass health care legislation, sweeping health care reforms are commonplace in Britain. Because of their parliamentary, winner-takes-all political system, when each new government arrives in power, they almost always introduce broad changes to the National Health Service. The latest coalition government has not been an exception to this trend. On May 11, David Cameron became prime minister of Britain. Nearly two months later, Andrew Lansley, his newly appointed health secretary, released proposals for sweeping changes to the NHS. The policy-package outlined by ...
07/27/10

Special Contributor | The Uncertain Impact of Health Reform on Hospitals

Even before President Barack Obama signed the Patient Protection and Affordable Care Act (H.R. 5390) into law in March, there was much consternation among health care professionals who believed the results from health reform would negatively affect their bottom line. Hospitals and safety-net health care providers, in particular, are expecting a greater use of health care services by individuals who become newly insured. At the same time, they are facing the prospect that changes to Medicare and Medicaid might result in lower reimbursements for treating those same millions of newly ...