Photo: Gulkana WSR via photopin (license)Alaska’s dramatic landscape, seen here at Gulkana River, a popular sportfishing river known for its salmon and other fish.
President Barack Obama’s trip to Alaska this week is aimed at highlighting climate change and the environment, but his health care overhaul has turned up in the news, too.
This particular story by Alaska Public Media’s Annie Feidt paints the Alaskan health landscape in full relief, profiling the state’s top health official amid wrangling over the expansion of Medicaid under the Affordable Care Act, or so-called Obamacare. Continue reading
Fred Schulte of the Center for Public Integrity took a look at the Patient-Centered Outcomes Research Institute (PCORI). Created by the Affordable Care Act, it’s supposed to spend $3.5 billion by the end of the decade to fund research to figure out what medical treatments work, or don’t work. That would be useful information as we try to figure out how to tame the nation’s $3 trillion health care bill. [Note: PCORI helps fund some of AHCJ’s health journalism training programs. See more at the bottom of this post.]
Late last month we wrote about criticism leveled at the federal government’s latest bundled payment proposal.
Since then, other experts have come forward to criticize not only the Comprehensive Care for Joint Replacement (CCJR) proposal announced last month, but also the Bundled Payments for Care Initiative (BPCI) program that began in April 2013. Both programs come from the federal Centers for Medicare & Medicaid Services.
You can find detailed criticism of CCJR from Harold Miller, president of the Center for Healthcare Quality and Payment Reform, on the CHQPR’s blog, and from Suzanne Delbanco, executive director of Catalyst for Payment Reform, and Francois de Brantes, executive director of the Health Care Incentives Improvement Institute (HCI3), on the Health Affairs blog. For an explanation of how CMS can improve the BPCI program, see this HCI3 blog post from de Brantes. Continue reading
Vox’s Sarah Kliff, who has an AHCJ Reporting Fellowship on Health Care Performance, is writing a series about fatal, preventable medical errors.
Not the inevitable tragic things that can happen to a patient – but the ones that we know how to avoid, the lives that should not be at risk. Kliff spent several months on one story – actually a story and accompanying video and graphics – that combined insights about how hospitals think central line infections and a gripping narrative about the death of a 3-year-old girl. You can find the story here.
Kliff wrote a “How I did It” essay for AHCJ that addresses a lot of the nuts and bolts of a vast project like this. She outlines how she reached out to patients/families, how she organized the voluminous – initially not searchable – medical records, how she found researchers who could elucidate things she did not fully understand in those records.
And she talks about the power of a good analogy to both organize a 5000-word narrative and give readers an accessible entry point to her work. Read about how she did it.
Quality measures are good, right? We all want our doctors and hospitals to follow best practices and be held to them.
It’s not so simple.
Put aside for the moment whether the measure is accurate – we don’t always know or agree on what the best thing is in health care (Exhibit A: mammograms).
There’s another quality problem.
There too many quality measures. Oodles and oodles of quality measures. Continue reading
The Center for Medicare & Medicaid Innovation, created by the Affordable Care Act, is trying new ways of delivering health care and testing new incentives and payment models. Some ideas are likely, even expected, to fail. Others may lead to new ways of delivering higher quality care for less money.
CMMI also is supposed to help spread new ideas so they’ll take root in the real world. The U.S. Department of Health and Human Services has the authority to expand approaches that reduce spending – and halt those that do not. This is a more flexible approach than officials had with “demonstration projects” prior to the ACA.
The agency’s website is a goldmine of health care innovation. Read more about what CMMI is tasked with doing, how it will do it and how the success or failures of its projects will be determined in this new tip sheet.
Here is an article that stood out amid the tidal wave of media coverage of Medicare and Medicaid’s 50th anniversary this year. It’s a piece about why Medicaid matters, posted on the Health Affairs blog.
As you read, keep in mind that the article is written by two people who strongly support the program: former Denver Health Chief Executive Patricia Gabow, who serves on the Medicaid and CHIP Payment and Access Commission and on the National Governors’ Association Health Advisory Board, and former Senate Democratic Leader Tom Daschle. It is not, by and large, a critique. Continue reading
When drafting the Affordable Care Act in 2010, Congress wanted to foster competition among health insurers. So it offered loans to nonprofit organizations that wanted to start health insurance consumer oriented and operated plans (called co-ops) in the states.
In theory, the co-ops are a great idea to increase competition and consumer choice. Congress included $2.4 billion in the ACA to establish these member-operated health insurance plans. The co-ops are particularly important today because five of the largest health insurers could soon be reduced to three if Anthem acquires Cigna and Aetna merges with Humana. Continue reading
The uninsured rate among all Americans in the first quarter of this year dropped to 9.2 percent, according to the latest report from the Centers for Disease Control and Prevention’s National Center for Health Statistics, released Wednesday.
This is estimated to be the lowest rate of all uninsured Americans, of all ages, since 1972, when the center began reporting on that data from the National Health Interview Survey, Reena Flores reported for CBS News. Continue reading
We’ve all written a lot about the “Medicaid gap” – the low-income people who can’t get coverage under the Affordable Care Act because their states have opted out of Medicaid expansion. The Kaiser Family Foundation has estimated that 4 million people fall in this gap.
According to Moody’s Investors Service, nonprofit hospitals in expansion states have seen their bad debt from unpaid bills drop an average of 13 percent as they treated more patients who have coverage. In non-expansion states, bad debt rose.
Reuters’ Robin Respaut recently looked at how the Medicaid gap has affected two iconic urban safety net hospitals who treat a lot of low income people – Cook County in Chicago and Grady Memorial in Atlanta. Continue reading