If Senate Republicans were hoping that this week’s new CBO score of their revamped House health bill was going to make life easier for them … Not so much.
House leaders had worked hard to revise American Health Care Act when they couldn’t get the votes. But the Congressional Budget Office found that the projected impact of the amended version, which narrowly passed the House in early May, wasn’t all that different than the original.
The old bill would have led to 24 million fewer Americans having coverage in a decade. The new bill, according to CBO, would mean 23 million would not be covered. Continue reading →
Mark Taylor is an independent health care journalist based outside Chicago. Taylor was legal affairs reporter for Modern Healthcare magazine and writes for newspapers, as well as Medicare NewsGroup and Hospitals & Health Networks. He is a former Kaiser Media Fellow and a founding member of AHCJ.
It’s long been known that 5 percent of all Medicare patients account for more than half of Medicare spending.
In addition, the top 1 percent of the sickest and most vulnerable Medicare patients consume 23 percent of Medicare resources, largely because of the severity of their illness but also because their conditions frequently are not managed well. Repeatedly they travel a painful journey among hospital emergency departments, nursing homes and hospital readmissions, in the process racking up huge medical bills, exposing themselves to hospital-acquired infections and bedsores. In the process, they often lose control of their lives. Continue reading →
President Donald Trump has spoken about the cost of drugs frequently. Though not always clearly and consistently, he has called for government negotiation of prices. Drug prices also have caught Congress’s eye, although we’re not quite sure what (if anything) legislators are willing to do about it.
Paul Levy, former chief executive of Boston’s Beth Israel Deaconess Medical Center, recently made a compelling argument in a blog post about why value-based pricing for hospital services ultimately will fail.
In “The Game That Shows Why Value-Based Pricing Is Doomed” on AthenaInsight, Levy argues that the incentives in value-based pricing are all wrong. As a payment model, value-based pricing promotes selfishness but at the same time requires all parties to cooperate, he writes.
It’s not often that anyone criticizes value-based care, and why would they? That would be like opposing the use of grocery coupons. Continue reading →
Given the ACA’s uncertain future, some experts have said that another law, MACRA, could lead the way on provider payment reform and accountable care innovations.
At the AHCJ’s Health Journalism 2017 conference in Orlando, a panel of providers will discuss their implementation of MACRA rules so far (reporting began on Jan. 1), and what the law means for their practices and their patients. A trade group representative from Washington, D.C., will give an overview of the law and where regulations stand in the Trump administration. Continue reading →