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As the nation’s largest payer for health care services, the Medicare program has a major effect on payments to providers. Its ability to align incentives through pay-for-performance will have implications for the health delivery system at large. A recent Institute of Medicine report made recommendations for implementation of “P4P” under Medicare. Proper implementation will require […]

Suddenly, Capitol Hill is talking about health issues again. Incoming House Speaker Nancy Pelosi promises that Democrats will roll back the prohibition against the federal government negotiating drug prices on behalf of Medicare beneficiaries. (A Kaiser Family Foundation poll released today found broad bipartisan support for this idea.) Incoming Senate Majority Leader Harry Reid says […]

Come January, we can expect to see some new approaches to health legislation. Sen. Harry Reid, incoming Senate majority leader, says one of his top three priorities will be more funding for stem cell research. House Speaker-to-be Nancy Pelosi wants a vote early on to roll back the prohibition against the federal government negotiating prescription […]

The growing complexity of our health care system, and time demands on providers, can cause patients’ non-obvious needs to get lost in the shuffle. Sometimes, the result can be less-than-optimal care. In response, providers are trying to be more responsive to patients’ cultural traditions, family situations, personal preferences and values. Some have tagged this movement […]

Polls consistently show that addressing problems in our health care system remains a top concern for most Americans. But while major health care reform efforts have stalled in Washington, many states are attempting to address the rising number of uninsured on their own. This briefing focused on such efforts in three states – Massachusetts, Vermont […]

The Long-Term Care Partnership Program allows purchasers of private long-term care insurance to qualify eventually for Medicaid coverage of long-term care services without having to meet the same asset requirements as other Medicaid applicants. Partnership programs began in 1987 in four states – New York, California, Connecticut, and Indiana. The 2005 Deficit Reduction Act (DRA) […]

The Census Bureau’s recently released figure on the number of uninsured in 2005 is 46.6 million, an increase of 1.3 million people over 2004. Two new studies by John Holahan and Bowen Garrett of the Urban Institute offer in-depth analyses of the economic and demographic factors that underlie this troubling statistic. Who are the uninsured? […]

A new assessment by The Commonwealth Fund finds that deficiencies in the nation’s health care system cost 100,000 to 150,000 lives and $50 to $100 billion annually. The scorecard compares national averages for the U.S. to national and international benchmarks for 37 indicators. The U.S. received a composite score of 66 out of 100. On […]

Biotechnology accounts for only one percent of insurers’ costs, but those costs are growing at a double digit rate. As science produces increasingly sophisticated and expensive medical products and procedures based on the manipulation of living organisms, payers will increasingly struggle with managing their use. In the private sector today payers are responding to the […]

Some Medicare beneficiaries receive significantly more hospital-based services during the last two years of life than do other beneficiaries. The number of physician visits for Medicare beneficiaries can also vary greatly. What accounts for this variation? Do patients receiving more services tend to get better care, or not? Should policymakers take steps to more closely […]

The Medicare prescription drug program offers coverage for prescription drugs through competing private plans, within a framework established by law and through rules established by the Centers for Medicare and Medicaid Services. In contrast, other countries, including Australia, the UK, and Canada, provide similar prescription drug programs, but within different regulatory structures. How do key […]