Thursday, March 26, 2015

Supreme Court Subsidy Decision; Quality Focus; Jobs

2) NQF Honors Consumers’ CHECKBOOK Founder Robert Krughoff with Inaugural Consumers and Patients for Quality Award

I have previously written about the advantages of Checbook's comparison of Illinois' ACA plans. I hope that this model spreads to all the other states.  Glad to see that not only have they been recognized by RWJF for this new product, but that NQF also has honored them. 

This sounds good. The devil is in the specifics.  

4) ACA-related Jobs Grow Faster in Medicaid Expansion States - Forbes Magazine andCenter for American Progress.

7) Test Your Knowledge of the Affordable Care Act’s Tax Provisions                     
With the tax filing deadline approaching, Americans for the first 

time are confronting several Affordable Care Act tax requirements 

as they fill out their returns.  A new interactive quiz from the 

Kaiser Family Foundation tests people’s knowledge about what the 

individual mandate means for taxpayers, what penalties may apply, 

and how those who receive premium subsidies through the ACA's 

Marketplaces will reconcile the amounts based on actual income.
I got only 5 of 10 correct. Tough quiz.  

Saturday, March 21, 2015

5th ACA anniversay: Many gains; Shopping apps

1) Some useful summaries 

In Its Five Years, The Affordable Care Act Has Transformed Health Care

The article puts together a well stated summary of all the key accomplishments.  Paints quite a positive picture. 

Report says there are enough doctors. 

2)  Many of you have seen much of the information below already.  However, I am extremely excited that Washington Consumer Checkbook took first place in the RWJF competition.  RWJF is one of the top health policy foundations.  Checkbook is talking about doing a webinar soon to introduce states to this tool.  I highly recommend States adopt it.  Welcome ideas on getting states involved and help with that. 

In my blog on 1/24/15 Complex: Premium Credits and Cost-Sharing Reductions; Latinos , I described how complex the calculations were for counselors (navigators) and consumers had in making plan selections.  I then showed how Checkbook solves this challenge.   Here is more from RWJF.  

Apps to Use When Shopping for Health Insurance Win National Competition


Princeton, N.J.—The Robert Wood Johnson Foundation has named Washington, D.C.-based Consumers’ CHECKBOOK as the winner of its first ‘Plan Choice Challenge,’ a nationwide competition facilitated by Health 2.0 to design a technology application that helps people evaluate their health insurance options.

“The direct-to-consumer insurance market is in its infancy, and developers can add a tremendous amount of value by helping consumers make better decisions,” said Katherine Hempstead, PhD, who directs coverage issues at the Robert Wood Johnson Foundation. “The response to this challenge has been overwhelming, and the creativity and talent on display in these applications confirms that developers will play a vital role in moving this market forward.”
The winning application, Consumers’ CHECKBOOK’s Plan Compare tool, enables consumers to scroll through all available plans on a single webpage and compare for each plan: 1) estimated average total yearly cost (premium plus out-of-pocket) for people of the same family size, ages, health status, and other characteristics as the user, 2) risk (the total cost in a very high health-care-usage year), 3) an overall quality rating that the user can personalize based on what quality dimensions matter most to the user; and 4) which of a list of preferred doctors the user has identified participate in the plan. Users can drill down for much more detail, but CHECKBOOK’s research has found that 60 percent make their choice based on these four key elements.
“We’ve been helping federal employees compare health plans for more than 35 years,” said Robert Krughoff, president of Consumers’ CHECKBOOK. “We know if they don’t get quick answers, ideally in less than five minutes, they’ll take shortcuts—like choosing based on lowest premium alone or lowest deductible—and end up wasting thousands of dollars.”

I have been collaborating with Checkbook on this initiative.  
3) new CBPP report explains why a compromise House Republican and Democratic leaders have worked out to fix the Medicare payment formula (SGR) and extend the Children's Health Insurance Program (CHIP) deserves support.

Wednesday, March 11, 2015

Failing Older Patients, New Round on ACOs

Necessary Steps: How Health Care Fails Older Patients, 

And How It Can Be Done Better  

Medicare Announces New Models For Accountable Care Programs 

CMS plans a new set of ACOs. Do not know enough details, but I have been unimpressed with the Innovation Centers bypassing of Experimental Designs.  When I was at CMS, the use of such designs lead to many very successful projects that resulted in major progress through legislation.  Several of my projects have made an incredible difference, resulting in many billions of dollars in savings and major benefits to many lives.  

Mental Health Providers Look For Federal Incentives To Go Digital, Too  

What are the effects of not expanding Medicaid?

Enroll In Clinical Trials Through Your IPhone 

The Wall Street Journal: Health-Care Deductibles Climbing Out Of Reach 

More Young People But Fewer Minorities Pick ACA Plans 


Saturday, March 7, 2015

Racial disparities; AHR briefing; Death with Dignity +

1) Closing the Gap: Past Performance of Health Insurance in Reducing Racial and Ethnic Disparities in Access to Care Could Be an Indication of Future Results

2)  AHR: ACA 101: What You Need to Know 

I attended this excellent forum on the ACA sponsored by the Alliance for Health Reform.  It was the first in a series of four sessions.  Sponsored by Kaiser Family Fdn. On C-span. With Ed Howard, Diane Rowland and Sabrina Corlette.  Had a good discussion with Sabrina re Consumer Checkbook. AHR will post a video in a couple of days as will KFF.  

3) Supporters of Death With Dignity Rally in Annapolis

4) Digital Dilemma For Medicine: How To Share Records

We have a long way to go with digital records.  This is a major barrier that I hope gets solved soon.

5) Health Affairs: Safety-Net Hospitals More Likely Than Other Hospitals To Fare Poorly Under Medicare’s Value-Based Purchasing

6) They Called Obamacare A Job-Killer. Were They Wrong? 

Tuesday, March 3, 2015

Medicare Pay Reform, Nursing Home and Hospital Quality

1)Medicare Payment Reform

2) Nursing Home Quality studies from Vince Mor

I asked Vince Mor of Brown University the following question: 

A speaker the other day stated that Nursing Homes that accept Medicaid only patients have lower quality of care than homes that accept those that have insurance or sufficent resources to pay for nursing home care at the time of admission.  The above link provides a list of studies he supplied in response to this question.  

3) Is Your Data Safe at

4) Workers' Costs Grow Despite Slowed Health Spending

5)   The Diseases We Spend Our Health Dollars On

6) Here are a number of articles from Health Affairs latest issue. 

National Hospital Ratings Systems Share Few Common Scores And May Generate Confusion Instead Of Clarity

KHN had an report on the above article: 
Groups That Rate Hospitals Often Disagree On Rankings

Medicare’s Bundled Payment Initiative: Most Hospitals Are Focused On A Few High-Volume Conditions

English National Health Service’s Savings Plan May Have Helped Reduce The Use Of Three ‘Low-Value’ Procedures

Safety-Net Hospitals More Likely Than Other Hospitals To Fare Poorly Under Medicare’s Value-Based Purchasing

Medicaid Beneficiaries In California Reported Less Positive Experiences When Assigned To A Managed Care Plan

Use Of Intelligent Assignment To Medicare Part D Plans For People With Schizophrenia Could Produce Substantial Savings

Comparing Employer-Sponsored And Federal Exchange Plans: Wide Variations In Cost Sharing For Prescription Drugs

Despite The Spread Of Health Information Exchange, There Is Little Evidence Of Its Impact On Cost, Use, And Quality Of Care

US Hospitals Experienced Substantial Productivity Growth During 2002–11

Narrative Matters: Necessary Steps: How Health Care Fails Older Patients, And How It Can Be Done Better