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Resource links

We are gathering the best sources for information about health reform. Click on the resource that interests you to visit that site.

Calculators

Community health centers

Consultants and Legal Groups

Co-ops

Government agencies/commissions

Health care costs

Health insurance exchanges/marketplaces

Health policy issues

Health reform reading list

Innovations

Issue briefs

Medicaid

Organizations with a viewpoint

Overtreatment and screening guidelines

Premium assistance

Preventive care

Primary care

State resources

Subsidy lawsuits

Tax aspects of the ACA

U.S. Supreme Court case

Other resources

Calculators

Some websites and apps can estimate costs of various health plans in the new insurance exchanges. Some are better than others. The Kaiser Family Foundation has a calculator. Zeke Emanuel and Andrew Steinmetz wrote this op-ed describing two fairly sophisticated calculators that do a whole lot of what HealthCare.gov is supposed to do (calculating and shopping options but not all the verification that the government site has to do). One is on the website of Steve Morse. The other is called Value Penguin

Community health centers

National Association of Community Health Centers
Community health centers are expanding, because of the health reform law and funding made available through the 2009 stimulus law.  This site has information about where they are, what policy issues face them, and leads about what some of the more innovative centers are trying to do.

Consultants and Legal Groups

Many HR consultancies, investment groups, and law firms have health policy resources (reports, webcasts, etc.) that are available to reporters, often online. Here are just a few of them:

Co-ops

For background on what a co-op is, and some examples of successful ones that predate the Affordable Care Act, see this 2009 “tool kit” from the Alliance for Health Reform. It was written before the final legislation was passed in the Senate, but is still a useful overview.

Here’ s an HHS fact sheet – it was written before the funds were cut off, but it explains the federal program that applies to those that are going ahead.

While much of the focus has been on rural areas – the Freelancers Union is expanding them through New York, New Jersey and Oregon.

The Urban Institute also did a paper analyzing some of the potential barriers to co-ops’ success.

HHS fact sheet (posted before the funds were slashed, but it explains the federal program that applies to those that are going ahead).

An Urban Institute analysis of the barriers to co-ops success.

Health Affairs and RWJF have published a brief that explains in more detail about how they are set up, and the challenges they face. The brief  gives a  description of several of the co-ops – here are the top three on the list to give a taste of the variety. (There  are more in the brief and the National Alliance of State Health Cooperatives has a full list (PDF).

Government agencies/commissions

Congressional Budget Office: The CBO is the official “scorer” – or estimator – of legislation. The website has a huge trove of data, some more technical than other.

The Director’s blog breaks down some of the ideas into simple English.

  • There is a section on Selected CBO Publications Related to Health Care Legislation 2090-2010

  • There is a section on other health policy, including Children’s Health Insurance Program and Physician Payment.

  • Don’t’ be put off by the daunting title of this March 2011 CBO analysis: “Reducing the Deficit: Spending and Revenue Options.” It has good one- or two-page nonspecialist descriptions of federal programs that could be changed in the ongoing budget debate. Many changes would be felt in local communities.  (This is a link to the PDF)

  • CBO Glossary – Not light reading but still a useful one-stop-shopping for government financial terms.

  • Medicare Payment Advisory Commission: MPAC advises Congress on a broad range of Medicare issues; its reports are posted online.

Government information on the Affordable Care Act provisions: Updated information is at Health.gov, the HHS website (media site) and the CMS website (press page also has link to fact sheets).

MACPAC – the Medicaid and CHIP Payment and Access Commission – was established when the  Children's Health Insurance Program was renewed in 2009 and it was expanded in the health care law.  It reviews state and federal Medicaid and CHIP access and payment policies and makes recommendations to Congress, HHS and the states. Reports are online.

Health care costs

The Altarum Institute’s Center for Sustainable Health Spending has monthly briefs on health care spending, health care prices, and employment in the health care sector.

National Conference of State Legislatures health reform legislation database
The NCSL is tracking new bills filed in response to the Affordable Care Act. With the major features of the federal law in effect as of Jan. 1, 2014, this database includes the latest state measures being considered during 2014 sessions.

Cracking the Code on Health Care Costs: A state-focused health cost and delivery system report from a commission established by the Miller Center at the University of Virginia.

Here’s an updated (early 2014) CBO overview assessment of health reform and health entitlements.

White House report: Trends in health care cost growth and the role of the Affordable Care Act, November 2013
This report analyzes recent trends in health care costs, the forces driving those trends, and their likely economic benefits. It states that health care spending growth is the lowest on record and that, “while the causes of the slowdown are not yet fully understood, the evidence available to date supports several conclusions about the slowdown and the role of the ACA.”

Reference Pricing: Will Price Caps Help Contain Health Care Costs?
On Nov. 18, 2013, a panel of experts addressed a new strategy employers have begun known as "reference pricing" to help reduce health care costs. Under this benefit design, employees get insurance plans that set price caps on certain services and procedures. Enrollees are allowed to use any provider. But if they use providers with fees higher than the "reference price," they must pay the difference between the reference price limit, determined by the employer or insurer, and the actual charge. The transcript and video are available here. The event was sponsored by the Alliance for Health Reform and WellPoint.

The State of the Art of Price Transparency Tools and Solutions
A report released on Nov. 20 by Catalyst for Payment Reform examines the leading price transparency tools and solutions available from health plans and independent vendors and offers insight on where they excel and where they may fall short. A high-level summary can be found in the Health Affairs blog.

Health insurance exchanges

Online tool uses state, federal data to track marketplace enrollments

The federal government plans to release exchange enrollment figures once a month (here’s the first report), and they’re expected to give more demographic information (i.e. age, metal tier) in future updates. States have different timetables for releasing their statistics. To keep track of it all, the Kaiser Family Foundation has a new tool: the State Marketplace Statistics.

It has both the enrollment numbers as well as some other key stats to  watch (when available):

  • Completed applications

  • Eligibility determinations, including how many people can enroll in a marketplace plan with financial assistance and how many qualify for Medicaid/CHIP

  • How many have selected a plan

Insurance premium calculators

These can provide an estimate of what people will pay in premiums for insurance through the marketplaces. For real prices, reporters and consumers need to go through the official marketplaces. Read more about these estimates: “Calculator caution: Using online tools outside marketplaces can be unreliable

Zeke Emanuel and Andrew Steinmetz wrote this op-ed describing two fairly sophisticated calculators that do a whole lot of what HealthCare.gov is supposed to do (calculating and shopping options but not all the verification that the government site has to do). One is on thewebsite of Steve Morse. The other is called Value Penguin. When I plugged in the same scenarios in the two sites, I came up with fairly consistent price quotes and options for families without a subsidy. It was a little harder to compare with the subsidy. One gave actual quotes, while the other gave more general price limits with subsidies. The Kaiser Family Foundation also has a calculator that takes into account ZIP code, income, age, family size and other factors.

Health Insurance Marketplace Premiums for 2014

The HHS Office of the Assistant Secretary for Planning and Evaluation released an issue brief summarizing the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains information, current as of Sept. 18, 2013, on qualified health plans in the 36 states in which the Department of Health and Human Services will support or fully run the Health Insurance Marketplace in 2014. Plan data is in final stages but is still under review, so this information is subject to change. The analysis includes similar information that is publicly available from 11 states and the District of Columbia that are implementing their own Marketplace.  Health Insurance Marketplace Premiums for 2014 Databook

AHCJ Webcast
Recorded Oct. 18, 2012

Experts discuss state decisions on reform

Just days after the November elections, states will have to make decisions about whether they are going to run their own health insurance exchange and what that will look like. States also are grappling with decisions about the essential benefits packages and Medicaid expansion. We talk to three experts who are doing hands-on work with both “red” and “blue” states.

A recording of this webcast is now available for AHCJ members. Log in to this page to access it.

This document (PDF) from the Center for Consumer Information and Insurance Oversight gives a good precise of the role and responsibilities of the exchanges, as well as how the states and federal government may divvy up the tasks. Particularly useful is the charge on page 5 explaining the five key functions of the insurance exchange:

  1. Consumer Assistance

  2. Plan Management/Selection

  3. Eligibililty (who goes into what program, what subsidies may apply)

  4. Enrollment

  5. Financial Management and the timetable on page 15 that shows what states have to do between now and 2014.

Updated CCIIO timeline for health exchange implementation.

Affordable Insurance Exchanges: from the HHS Center for Consumer Information & Insurance Oversight

Health Reform GPS: Health Insurance Exchanges: More technical information about health exchanges from Health Reform GPS.

Congressional Research Service report: Health Insurance Exchanges Under the Patient Protection and Affordable Care Act.

Slashdot.org is a place to track what the self-described tech nerds are saying online about the cyber-infrastructure of the health insurance marketplaces. CAVEAT: We’re listing it here as site you might find interesting – we are not endorsing everything that’s posted on it or asserting that it’s accurate so be forewarned. It isn’t peer reviewed; it’s something that people post on, but those of you who speak tech as well as health might want to peruse it.

Health policy issues

Covering Health Issues, 2011 Update: Written with reporters in mind,"Covering Health Issues" is useful for anyone looking for concise information on health policy issues, and experts from across the political spectrum. Chapters contain fast facts, background, tips for reporters, story ideas and experts with contact information. The book also includes an extensive glossary and ideas for TV and radio reporters.

Guide to health policy acronyms: If there's one thing health policy has in abundance, it's acronyms. So many that CMS (itself an acronym and a truncated one at that; as it stands for the Centers for Medicare and Medicaid Services) has an online acronym guide. There are hundreds of entries, alphabetically arranged. Some are quite obscure. 

Glossary of health policy terms: from the Centers for Medicare and Medicaid Services

Reading list

Health reform topic leader Joanne Kenen has compiled a list of books that journalists might find useful. She says: "Most of these books I’ve read all or part of. A few are new and I haven’t gotten to them yet, and a handful I’m relying on recommendations of others. Disclosure: I know a lot of these authors – friends, colleagues, sources, AHCJ members, even a former professor or two. Finally, there are more books aimed at explaining the new law or providing historical context than there are on how to dismantle or replace it – partly because there’s a larger crop of such books to choose from, and partly because it’s more relevant to this website. But the conservative viewpoint is represented."

Innovations

The New Wave of Innovation: How the Health Care System Is Reforming: This resource for journalists from The Commonwealth Fund looks at emerging innovations, providing examples from different sectors across the country, to inform journalists and others of the ways in which the system is reforming itself. It may also provide ideas for journalists who are interested in exploring the early effects of health reform and the implications for the future.

Latest innovations in Medicare: Don’t look only to Washington policymakers for strategies to control medical costs and improve care for our aging population. New pilot projects that could accomplish these goals, which are at the heart of health reform, are being tested in communities across the country. In this tip sheet, reporter Susan Jaffe provides an overview of projects sponsored by the Center for Medicare and Medicaid Innovation, directs journalists to helpful resources and supplies an extensive list of potential story ideas.

Perspectives: Options for Reforming Medicare: Experts and policymakers in Washington are considering a broad range of proposals for reforming Medicare. Below, we present perspectives from leading experts on some of the more frequently mentioned policy options. Henry Aaron is a Senior Fellow in Economic Studies at The Brookings Institution, Stuart Butler is the Director of the Heritage Foundation’s Center for Policy Innovation, and Avalere Health is a leading health care policy consulting firm.

Issue briefs

The Alliance for Health Reform publishes "Covering Health Issues: A Sourcebook for Journalists," in English and Spanish.

Income, Poverty, and Health Insurance Coverage in the United States: 2012: Report released by the Census Bureau in September 2013 showing that real median household income and the poverty rate were not statistically different from the previous year, while the percentage of people without health insurance coverage decreased.

Health Affairs Issue briefs

Health Affairs and the Robert Wood Johnson Foundation have produced a series of short issue briefs on many of topics related to the Affordable Care Act. 

Kaiser Family Foundation' Health Reform Source: Tracks the latest studies and developments on health care reform.

The Commonwealth Fund's Health Reform Resource Center: Explore the provisions of the Affordable Care Act and find the latest regulations. View the timeline for the highlights of the law, or use the "Find Health Reform Provisions" tool to search for specific provisions by year, category, and/or stakeholder group.

Medicaid

National and State-by-State Impact of the 2012 House Republican Budget Plan for Medicaid

Why Does Medicaid Spending Vary Across States: A Chart Book of Factors Driving State Spending

Primer on Medicaid from the Center on Budget and Policy Priorities

Organizations with a viewpoint

Center on Budget Policy Priorities: CBPP is a well-respected liberal research center with a focus on state and federal fiscal policies and programs that affect low- and moderate-income families and individuals. Issues reports and blog posts on health and entitlements.

Alliance for Health Reform

U.S. Chamber of Commerce: Health care: The U.S. Chamber of Commerce, which can provide a conservative critique of health reform, has a plan to help businesses get health care costs under control, improve the quality of health care coverage and services, and expand meaningful coverage to the uninsured.

Physicians for a National Health Program: This is an organization of more than 18,000 members and chapters that advocates a single-payer national health program.

American Enterprise Institute's Policy Studies on Health Care Reform: The American Enterprise Institute supports free enterprise and can offer a conservative critique of the Affordable Care Act.

Heritage Foundation's Health Care Initiative: This conservative organization contends that health care is one of the most highly regulated sectors of the American economy and that government financing means government control, and government control means less personal freedom.

National Federation of Independent Business: Health Care Reform and Small Business: The National Federation of Independent Business pursues measures that minimize what it sees as the Affordable Care Act's potential harm to small businesses.

Overtreatment and screening guidelines

Choosing Wisely® is a campaign by the American Board of Internal Medicine to help physicians and patients engage in conversations to reduce overuse of tests and procedures, and support physician efforts to help patients make smart and effective care choices. The medical specialty societies, along with Consumer Reports, have identified tests or procedures commonly used whose necessity should be questioned and discussed. The resulting lists of "Things Physicians and Patients Should Question" provides some guidance about the need—or lack thereof—for many frequently ordered tests or treatments.

U.S. Preventive Services Taskforce: This independent panel of experts reviews scientific evidence for a broad range of clinical preventive health care services (such as screening, counseling, and preventive medications) and develops recommendations for primary care clinicians and health systems. The panel is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists).

Premium assistance

Section 1115 of the Social Security Act gives the secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. The waivers give States flexibility to design and improve their Medicaid and CHIP programs.  See a list of waivers by state.

With states thinking about using Medicaid expansion dollars to purchase private health coverage for low income people, this paper from the Kaiser Family Foundation explores how this version of “premium” assistance works under the current law.

FAQ on premium assistance/private plans in Medicaid from the Department of Health and Human Services.

Preventive care

Adult preventive care benefits

Women’s preventive care

Children’s preventive care

Primary care

Primary Care Progress, an advocacy group with chapters at medical schools and other health professional training schools, working to change how care is delivered and how providers are trained.

The Harvard Center for Primary Care, also working to transform primary care delivery.

The Patient-Centered Primary Care Collaborative: A Washington,D.C.-based organization that promotes the patient-centered medical home concept and tracks the outcomes of pilot projects.

State resources

The Robert Wood Johnson Foundation has done a series of nine reports (March 2014), looking at aspects of state implementation of the ACA including the enrollment systems, insurer participation, outreach and the small business market.

Cracking the Code on Health Care Costs: A state-focused health cost and delivery system report from a commission established by the Miller Center at the University of Virginia.

State Health Insurance Exchange Websites: (updated Oct. 7, 2013) This chart, from State Refor(u)m, provides links to the web portals, where consumers can purchase coverage, as well as links to relevant agency websites containing exchange policy and consumer assistance-related information.

KFF State Health Facts: A division of the Kaiser Family Foundation, it is a boon to local reporters, providing free, easy-to-use health data for all 50 states

National Conference of State Legislatures: A bipartisan organization that serves the legislators and staffs of the states and territories. It provides summaries on state implementation of health reform, Medicaid, budgets and other health-related topics.

State Health Reform Assistance Network: A program funded by the Robert Wood Johnson Foundation helping states with technical assistance on coverage expansion under the Affordable Care Act. The network's director, Heather Howard, has contributed useful maps showing where states are on implementing exchanges and the status of funding for each state, as well as a list of resources, as of October 2012.

State Refor(u)m: An online network for health reform implementation that  connects health officials from different states, and with outside experts.

States and the Affordable Care Act: More Funding, More Flexibility: An HHS report on states, related to but not strictly the exchanges. It contains useful information on other aspects of reform's first year.

Health Insurance Exchanges: Key Issues for State Implementation: Key issues for state implementation (RWJF/State Coverage Initiative)

State Health Policy Options: This is a new (Oct 2012) website from the National Governors Association on state options for health reform. It includes names (but not contact info) of key state officials, as well as policy resources on cost and coverage, exchange creation, and delivery system reforms such a medical homes.

Subsidy lawsuits

As you follow the legal fight over whether ACA subsidies can flow through the federal exchanges, or only the state exchanges, these reports from Avalere and RWJF/Urban Institute will help you understand who would be affected. And SCOTUSblog.org can keep you up on the progress of the cases. Use the search box at the top of the site and click on “blog.”

Tax aspects of the ACA

The Internal Revenue Service has released guidance on the tax provisions included in the Affordable Care Act, such as the Premium Tax Credit and the requirement to report the cost of coverage under an employer-sponsored group health plan on an employee’s Form W-2.

U.S. Supreme Court case

The Kaiser Family Foundation has put together this guide to the Supreme Court’s review of the Affordable care Act.

State attorneys general Martha Coakley (Mass.) and Ken Cuccinelli (Va.) debated the Affordable Healthcare Act as a prelude to the Supreme Court’s consideration of the law. National Press Club's "Newsmakers" series hosted the event. The attorneys general addressed several facets of the Supreme Court case, including the health care mandate, the tax basis, the general welfare aspect, expansion of Medicaid, severability, the law’s provisions and other areas.

GAO report: Expert Views on Approaches to Encourage Voluntary Enrollment

America’s Health Insurance Plans (AHIP), the main insurance industry trade group, outlines its views, and summarizes state experiments, at its “The Link” website.

AHCJ has tip sheets, blog posts and a webinar on the topic:

Other resources

Health Care Entitlements: The Road Forward

On the preliminary campaign trail, Republicans vying for their party's president nomination attack Massachusetts' near universal coverage – which was created under then-Republican Gov. Mitt Romney and state Democrats, including the late Sen. Edward Kennedy. In Washington, Republicans are seeking to repeal the national health law that was in part based on the Massachusetts model, while also pushing to turn Medicaid into a block grant, saying they don't have enough flexibility to control costs and innovate. Romney's successor, Democrat Deval Patrick, testified June 23 before the Senate Finance Committee hearing on health entitlements. He addressed all of the above – stressing that his state was able to become a trailblazer within the current parameters on flexiblity.

KidsWell: Children's health insurance coverage: This state and national campaign focused on health care reform implementation on behalf of children, has demographic data on children's health insurance coverage as well as snapshots of key state health care reform implementation and opposition activity.

Three movies about health care – overtreatment, undertreatment, cost, quality, the uninsured, the underinsured, the safety nets – are being launched. Some are being shown in community settings like medical schools – might be a good story to go to one of the screenings and see how it’s received and what people say. “Escape Fire”looks at military medicine too – maybe explore how its message pertains to veteran’s care where you live.

  • Money and Medicine,” shot at UCLA Medical Center in Los Angeles and Intermountain Medical Center in Utah, airs on PBS stations starting Sept. 25. (Dates may vary in other communities.)

  • The Waiting Room” goes inside a safety net, Oakland’s Highland Hospital, and it premieres Sept 26 in New York.

  • Escape Fire” has held a bunch of medical school screenings and goes into wider release next week.

The Cochrane Library (access available through AHCJ or to media by contacting medicalnews@wiley.com)

If you are covering comparative effectiveness research,  trying to assess the validity of  providers’ claims  about treatments, procedures, drugs, “breakthroughs,” vitamins, alternative medicines,  counterclaims of skeptical insurers or other payers (including public payers like state Medicaid programs) a local medical “arms race,” or  patient-centered decision-making (“should I have treatment A or treatment B”), the databases and podcasts in the Cochrane Library can guide you to reviews of the clinical and/or economic evidence.  More detail on how to use it.

The Patient Centered Primary Care Collaborative is one of several groups working on primary-care centered medical homes to provide more seamless and coordinated care.

IRS chart on how employers have to report pre-tax health benefits on W-2 forms

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