Explore the latest in health care reform, including innovations in health care delivery and payment models, the politics of reform, and more.
Because a “Medicare for all” policy is likely to pay physicians and health systems lower unit prices than commercial insurance, this Viewpoint anticipates responses of the community, including possible increases in service volume and billing intensity and movement of care to more highly reimbursed settings, and it suggests ways the policy may be designed to minimize disruptions for clinicians and patients.
This analysis of current data from the Physician Compare website assesses the volume of quality data submitted and whether the information is comprehensive enough to differentiate the performance of included physicians.
This study describes the characteristics of hospitals participating vs not participating and remaining vs leaving the 2018 CMS Bundled Payments for Care Improvement–Advanced Program (BPCI-A), a payment reform model that reimburses for a 90-day episode of care rather than for individual services.
This cross-sectional analysis of data from more than 2.5 million Medicaid-eligible US adults in states that enacted and did not enact Medicaid expansion under the Patient Protection and Affordable Care Act evaluates the association of Medicaid expansion with health insurance coverage among persons with a disability.
This Viewpoint proposes an array of approaches state governments might take to lower health care prices paid by private insurance, including rate setting using reference pricing; scrutiny of hospital mergers; expanding scope-of-practice laws to increase workforce; and investing in alternative payment models.
This cross-sectional study uses data from the US National Survey of Accountable Care Organizations to assess the association between accountable care organization–reported care management and coordination activities and outcomes in older adults with complex needs.
This observational study uses Blue Cross Blue Shield claims and clinical registry data to evaluate whether payment reform that provided quality bonuses and a global budget shared savings incentive was associated with changes in health care quality measures, utilization, or spending in the first year of system implementation.
This difference-in-differences analysis investigates the association of Medicaid expansion with cardiovascular mortality rates for middle-aged adults using data from 48 states and Washington, DC.
This case-control study of emergency medical service dispatch data in New York, New York, examines changes in dispatches of ambulance transports for minor injuries compared with other injuries before and after the implementation of the Patient Protection and Affordable Care Act.
In this Viewpoint, Woolhandler and Himmelstein review the potential benefits of single-payer health care reform, including savings on administrative costs and lower drug prices, and argue against partial solutions that might expand coverage without reducing costs and waste.
This ecological study evaluates whether US Medicaid expansion was associated with state-level changes in physical abuse and neglect rates among children younger than 6 years compared with states that opted out of Medicaid expansion.
Following CMS’ 2018 expansion of supplemental benefits available to HMO and PPO Medicare Advantage enrollees, this study assesses enrollee adoption by type of benefit (eg, caregiver support, in-home personal care, palliative nursing, and social work) and specific plan characteristics in the first year.
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