This report summarizes the three-part series "The Future of Medicare," which explored the basics of the Medicare program.
The Food and Drug Administration (FDA) was first authorized to collect user fees in 1992 under The Prescription Drug User Fee Act to provide funding to the agency during a period of federal budget cuts. Over the past 30 years, user fee programs have helped finance the FDA’s review of human medical products such as drugs and medical devices.
While significant attention has been paid to shifts in federal health policy, it is equally important to understand the promises, tradeoffs, and impacts of state policies on the health care system.
The authorization for the Patient-Centered Outcomes Research Institute (PCORI) is set to expire sometime this year. A decade after the creation of the institute, conversations around CER, health care value, patient-centered care, and real-world evidence continue. This Alliance toolkit seeks to ensure policymakers are informed about CER and its potential impact by providing the basics of CER, facts on PCORI, and links to additional resources.
In 2014, there were a total of 1,299 mergers and acquisitions in the health care sector – a record number, up from 1,035 the year before. This toolkit explores the driving forces behind this trend; the scope and extent of consolidation among doctors, hospitals and insurers; implications for consumers and other stakeholders; and the roles of the Department of Justice and the Federal Trade Commission.
Evidence is growing that housing, a social determinant of health, is an important factor in the health status of various populations. According to the Department of Housing and Urban Development (HUD), more than 610,000 people experience homelessness in the U.S., and over 250,000 individuals within that population have a severe mental illness or a chronic substance use disorder. A new Alliance toolkit, “The Connection between Health and Housing: The Evidence and Policy Landscape,” provides a detailed look into federal, state and local initiatives, as well as cost implications for health and housing programs.
The Alliance for Health Reform has released a new toolkit, “Biosimilars: Unpacking Complex Issues.” The Affordable Care Act created an expedited licensure pathway for biosimilars, and, in March 2015, the U.S. approved the first biosimilar, leaving policy makers, regulators, providers and stakeholders to grapple with regulatory and financial questions.
The aging of the baby boomers and the increase in the number of old-old persons (those 85 and older) are predictors for the increasing need for long-term services and supports (LTSS). Among persons age 65 and over, an estimated 70 percent will use LTSS. A new Alliance for Health Reform toolkit, “Long-Term Services and Supports: Changes and Challenges in Financing and Delivery,” provides a background on LTSS and discusses policy issues surrounding the topic.
A new Alliance for Health Reform toolkit will help you prepare for and understand the Supreme Court’s King v. Burwell decision, which could come as early as Friday. A major challenge to the Affordable Care Act (ACA) is before the Supreme Court, which is expected to make a decision in the King v. Burwell case by the end of its term in June 2015. The case concerns the legality of health insurance tax credits offered through a federally run health insurance marketplace, as opposed to a marketplace established by an individual state.
The integration of technology and health care is on the rise. Although evidence shows that telemedicine has improved access to health care and resulted in lower costs in rural and underserved areas, challenges to expansion include reimbursement policies and acceptable security measures. A new Alliance for Health Reform Toolkit, “Telemedicine: The Promise and Challenges,” addresses the effectiveness of telemedicine as a tool for communication, as well as the expected outcomes and challenges ahead.
Despite new private insurance coverage over the past year, many people do not understand the very terms and concepts necessary to make informed choices, according to recent studies. A new Alliance for Health Reform Toolkit, “Health Literacy and Health Insurance Literacy: Do Consumers Know What they are Buying?” addresses the extent and significance of both health literacy and health insurance literacy for Americans buying and using health insurance.
Preparing The Nursing Workforce For A Changing Health System- The Role Of Graduate Nursing Education
The nursing profession, with approximately 3 million licensed and practicing nurses in the U.S., comprises the largest segment of the nation’s health care workforce. However, efforts are underway to rethink nursing education and training so that it meets the needs of an aging population with increasingly complex chronic diseases. This toolkit is intended to provide policymakers with a primer on today’s nursing workforce, expert views on how nursing education should evolve to meet the needs of a changing health system, and the role of federal policy in advancing nursing education.
Is the U.S. prepared for a potential virulent pandemic? This toolkit examines public health infrastructure, funding and policy levers that deal with these kinds of health crises in America.
Questions about how to best prepare health professionals to practice in an evolving health care delivery system are receiving increased attention. Graduate medical education (GME)—the training that medical school graduates receive as residents, typically in teaching hospitals—has been an ongoing focal point in the discussion about how health care workforce training is conducted and financed. This issue brief provides an overview of the GME system, highlights core policy issues, identifies new training strategies and provides a synthesis of key resources.
With the cost of repealing the Sustainable Growth Rate for Medicare Physician Payment lower than ever, many suggest that 2014 is the year that permanent change may finally be realized. This toolkit provides a brief summary of the history of the SGR, including the recent actions by the House Energy and Commerce, House Ways and Means, and Senate Finance committees to repeal and reform the flawed physician payment system.
The pace of health care consolidation is accelerating. Over half of hospitals were exploring a possible merger in 2013, and half were also planning to purchase physician practices. The dollar value of those acquisitions declined, however, as recent purchases have been less about megamergers and more about smaller entities as the newer targets of acquisition.
The Toolkit, available here, details the ACA’s employer requirements and penalty. It also includes information about the delay in the mandate to 2015, and analysis about its impact on employer-based coverage. The Toolkit includes: key facts about the employer mandate; data about trends in employment-based health coverage; links to news articles and reports explaining and analyzing the issue; health care experts who understand the issue and its implications, along with contact info.
The Alliance for Health Reform answers key questions about the insurance marketplaces that opened for enrollment October 1 in this new FAQ, available here. The document also provides links to websites that go into detailed explanations of how the law and the exchanges work. Some links point directly to state marketplaces and other government resources.
Beginning October 1, insurance marketplaces open for enrollment, and millions of people will be eligible to purchase plans. To guide them in the application process, the federal government has invested in programs to train community organizations and hired staff. Most of the money has gone to so-called navigators and assisters, which are tasked with helping individuals, families and small businesses compare and contrast plans, identify what type of financial assistance may be available and help complete and send application forms for insurance.
Medical malpractice reform has been a contentious area of debate among health care policymakers. The resources in this new Toolkit, co-written by Shane Durkin and Erin Buchanan of the Alliance, will help you understand why this has been a partisan debate throughout the years and describe the research behind traditional tort reform. It will also help you understand the more innovative approaches being tested and what we should look forward to in the effort to reform the medical liability system.
Beginning on Oct. 1, 2012, hospitals for the first time faced a financial penalty for readmitting a Medicare patient whom they had already cared for in the past month. Data shows that readmissions have already fallen, although the policy remains controversial.
The public is keeping a close eye on federal budget deficit reduction efforts this year, including potential automatic spending cuts initially mandated by the Budget Control Act of 2011. Yet one component of the debate has been largely ignored - the Sustainable Growth Rate (SGR). Indeed, because of the SGR, physicians in January 2013 faced a 26.5 percent cut in Medicare reimbursement rates. Last-minute congressional intervention delayed the cut until January 2014 as part of the American Taxpayer Relief Act of 2012. Without intervention, physicians will receive a 25 percent reimbursement cut in January 2014. At the same time, according to the most recent Congressional Budget Office (CBO) estimates, if Congress and the president agree to permanently eliminate the SGR, the deficit will grow by another $138 billion over 10 years. The cost of repealing the SGR has fallen significantly since last year, spiking a new interest in permanently fixing the problem.
Health care is an increasingly important issue in this year's close presidential election, but sorting out what the candidates are proposing - and what it all means - is difficult. The resources in this new Toolkit will help you to move beyond the rhetoric. The debate can be boiled down to three central questions. Should the country continue to implement the Patient Protection and Affordable Care Act, should states receive federal block grants to run Medicaid as they wish, and how can the federal government lower costs in Medicare, the health care program for seniors and the disabled?
It is projected that 260,000 additional nurses will be needed by 2025 to care for the increased population, the increase in insured population and the explosive care needs for chronic diseases in the population and geriatric care in older age groups. This toolkit, written by Deanna Okrent of the Alliance, aims to provide an array of resources and perspectives that describe numerous challenges to assuring an adequate physician workforce and some of the proposed solutions under consideration. Supported by the Robert Wood Johnson Foundation.
A shortage of more than 90,000 physicians is predicted to occur within the next 10 years--including 45,000 primary care physicians and 46,000 surgeons and specialists. This toolkit, written by Beeta Rasouli of the Alliance, aims to provide an array of resources and perspectives that describe numerous challenges to assuring an adequate physician workforce and some of the proposed solutions under consideration. Supported by the Robert Wood Johnson Foundation.
Health care providers are scrambling to find their way in the fast-paced world of technology, and the federal government is making billions of dollars available to help them do it. But while cost has traditionally been the big hurdle, the lack of a qualified workforce now poses a significant barrier, according to major surveys. This toolkit offers links to many resources. Includes a list of experts and websites. Supported by the Robert Wood Johnson Foundation.
In the move to increase access and coverage while enhancing the value of the health care dollar, the direct care workforce provides an important contribution to coordinated care in a high quality system. This toolkit, co-written by Bill Erwin and Deanna Okrent of the Alliance, aims to provide an array of resources and perspectives that describe numerous challenges to assuring an adequate workforce and some of the proposed solutions by the ACA. Supported by the Robert Wood Johnson Foundation.
Mental health problems have been rising in the public consciousness -- with recent mass shootings, with the recession and with the passage of the health reform law. This toolkit offers links to many resources on the scope of the nation's mental health problems and promising ways of addressing them. Includes a list of experts and websites. Supported by the Robert Wood Johnson Foundation.
Now that health reform is law, reporters covering this subject have a new challenge: keeping readers, viewers and listeners engaged through the long implementation process. This toolkit will help. Features story ideas from seasoned reporters and links to dozens of resources. Also included: a list of experts with contact information and helpful websites.
Constitutional challenges health reform were already in the works before President Obama signed the new reform law on March 23. On what grounds are states objecting? Are any of the lawsuits filed likely to succeed? This toolkit, written by Kevin Arts, addresses both questions.
Health reform passed in March 2010 thanks, in part, to a budget reconciliation bill that made changes to the Patient Protection and Affordable Care Act. This toolkit explains how reconciliation works, and offers links to resources that go into more detail on subjects such as the “Byrd rule” and the important role of the Senate parliamentarian.
The coverage of abortion in a reformed health care system has become a topic generating considerable emotion in health reform debates. This resource list will help readers better understand what drives the positions of those taking sides on abortion within health reform.
Health insurance cooperatives, or co-ops, have drawn attention as an alternative way for Americans to buy health insurance. Owned by their members, co-ops are seen by some as more palatable than a government-run public plan. What exactly are health insurance co-ops? What’s been their track record? Why do they succeed, or fail? Why do proponents like them, and what objections do opponents have? This new toolkit from the Alliance for Health Reform addresses these questions and others and also includes fast facts, links to 31 resources including case studies, story ideas for reporters, 34 selected experts with contact information, links to 17 selected websites, and a glossary.
This toolkit, supported by the Robert Wood Johnson Foundation, will help you understand trends in U.S. health spending, and some of the reasons why spending is going up. We also cover some ideas for restraining health care costs. In addition, this resource offers story ideas, selected experts with contact information, selected websites, and a glossary.
This toolkit, supported by the Robert Wood Johnson Foundation, will help you understand how health information technology (IT) is slowly changing health care, and how analysts disagree about the value of some technologies. We offer an introduction to issues such as protecting patient privacy and the cost of new technologies. This resource also offers story ideas, selected experts with contact information, selected websites of interest and a glossary.
This toolkit, supported by the Robert Wood Johnson Foundation, offers links to resources that will help you understand how children in the U.S. get health coverage, and the importance of employer-sponsored coverage and public programs to children. We offer an overview of the State Children’s Health Insurance Program (SCHIP), with an update on congressional reauthorization of the program. This resource also offers key facts, story ideas for reporters, selected experts with contact information, selected websites, and a glossary.
A Reporter’s Toolkit: Medicaid This toolkit, supported by the Robert Wood Johnson Foundation, will help you understand who the Medicaid program covers, how it is financed, how it differs from Medicare, how states can alter Medicaid through federal waivers, and what the future holds for the program. This resource also offers key facts, brief background, story ideas, selected experts with contact information, selected websites and a glossary.
This toolkit, supported by the Robert Wood Johnson Foundation, is designed for reporters covering health issues during Campaign 2008, but will be useful for others looking for up-to-date resources on the uninsured. The toolkit features dozens of links to useful websites and articles, including links to websites tracking presidential candidates’ health reform plans. It also includes key facts, background, story ideas, lists of experts and websites, and a glossary.
Congress and the White House are gridlocked on SCHIP reauthorization beyond November. President Bush has vetoed the first SCHIP bill to cross his desk. CMS has issued tough new rules governing when states can open up their SCHIP programs to children above 200 percent of the federal poverty. One reason for all of the above: crowd-out – the phenomenon of people dropping private health coverage when public coverage becomes more easily available. This toolkit, supported by the Robert Wood Johnson Foundation, helps explain why crowd-out occurs and offers links to late-breaking developments affecting SCHIP enrollment. A list of experts and websites is also included.
Many policy experts believe that sweeping general reform to our national health system is not likely to happen without success stories from state-level reforms. Yet many state reforms may be in conflict with the federal statute known as the Employee Retirement Income Security Act, or ERISA. This toolkit, supported by the Robert Wood Johnson Foundation, covers the basics and ERISA and presents expert opinion on both sides of the ERISA vs. state reform issue.
Over the past three years, enrollment in Medicare private fee-for-service (PFFS) plans has increased significantly. These plans offer a potentially greater choice of providers than beneficiaries will find in Medicare HMOs or PPOs. They often provide extra benefits not found in traditional Medicare. Beneficiaries attracted to the plans hope to lower their out-of-pocket costs compared to what they would pay in traditional Medicare. However, the plans have drawn the interest of federal budget cutters since they cost more per beneficiary than traditional Medicare. Moreover, beneficiaries have been reporting confusion about the plans and sometimes, enrollment fraud. Some private fee-for-service beneficiaries have been denied services by physicians who previously accepted their traditional Medicare coverage. This toolkit, supported by the Robert Wood Johnson Foundation, contains resources that describe the basics of PFFS plans, advantages and incentives included in the plans, and the challenges that PFFS enrollees have encountered along the way.
Starting July 1, every adult in Massachusetts is required to have health coverage (except for 60,000 people exempted by the state). This toolkit, supported by the Robert Wood Johnson Foundation, is designed to help you understand the state's pace-setting near-universal coverage plan and its implications, with links to representative articles and documents from across the ideological spectrum. You will also find a list of selected experts and websites. We recommend these articles and experts to you, and welcome your suggestions for additions to our list. You may email those to email@example.com