The 2016 Medicare Trustees Report: Is Medicare Doomed?
Published: | 8:51 pm | Posted in: Medicare
The June 22 release of the annual Medicare Trustees Report has, as usual, elicited conflicting responses. Some have focused on the positive—Medicare spending per enrollee has continued to grow at a historically slow rate—while others have emphasized the negative — the Medicare Hospital Insurance Trust Fund is now projected to run out of resources in […]
Early Performance of Accountable Care Organizations in Medicare
Published: | 8:33 pm | Posted in: Health Care Policy and Reform
BACKGROUND In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. We used quasi-experimental methods to assess the early performance of MSSP ACOs. METHODS Using Medicare claims from 2009 through 2013 and a difference-in-differences design, we compared changes in spending and in performance on quality […]
Health Spending Growth: Still Facing A Triangle Of Painful Choices
Published: | 1:21 am | Posted in: Health Care Policy and Reform, Neoliberalism
In the four years immediately following the recession (2010 through 2013), health spending grew at a historically low average annual rate of 3.6 percent, about the same as gross domestic product (GDP). This era was interrupted in 2014 with the advent of expanded coverage under the Affordable Care Act (ACA)—the newly insured used more care […]
Medicare Help At Home
Published: | 1:02 am | Posted in: Medicare
Nine million community-dwelling Medicare beneficiaries—about one-fifth of all beneficiaries—have serious physical or cognitive limitations and require long-term services and supports (LTSS) that are not covered by Medicare. Nearly all have chronic conditions that require ongoing medical attention, including three-fourths who have three or more chronic conditions and are high-need, high-risk users of Medicare covered services. […]
Twenty-First Century Medicaid: The Final Managed Care Rule
Published: | 1:00 am | Posted in: MLTC
With enrollment reaching 74 percent of all beneficiaries, it is clear that managed care has become the standard organizing mechanism for a Medicaid program whose welfare roots are behind it and that now functions as a principal source of public insurance. Given this broad national policy direction, a strong yet flexible regulatory framework for Medicaid […]
Health Affairs Study On Hospital Profitability Gives Us Some Important Factors To Watch Going Forward
Published: | 12:57 am | Posted in: Health Care Policy and Reform
It is important to keep in mind that profits can be high, either because prices are high or underlying production costs are low (relative to each other). The Bai and Anderson study does not decompose profits but rather measures overall accounting profits as reported to Medicare. So, higher profits do not always indicate excess prices. […]
The U.S. Health Disadvantage And The Role Of Spending
Published: | 12:56 am | Posted in: Health Care Policy and Reform
Each week it seems, more evidence emerges regarding the poor health of Americans. We first documented a “U.S. health disadvantage” as chair and study director of the panel on understanding cross-national health differences among high-income countries at the National Academies in 2013. Our panel’s report Shorter Lives, Poorer Health showed that, as long ago as […]
Let’s Stop Making Excuses For Egregious Medical Errors
Published: | 12:52 am | Posted in: Health Care Policy and Reform
To save the life of a child, a zoo sacrifices a prized, endangered gorilla. In exchange for one nearsighted Israeli soldier captured in Gaza, Israel released 1,000 Palestinian prisoners. (This example from the Middle East may not be surprising. In Judaism, it is commanded that “to save a life is as if one saved the […]
Integrating Health Care And Housing To Promote Healthy Aging
Published: | 5:57 pm | Posted in: Archive
One of the most important public health findings over the last several decades has been that there are a number of factors, beyond medical care, which influence health status and contribute to premature mortality. Of these factors, social circumstances and the physical environment (particularly the home) especially impact an individual’s health. Housing takes on even […]
Aging in America: A Profile of Older Adults
Published: | 6:16 pm | Posted in: Archive
The aging population is a heterogeneous group and varies by many social factors. This article illustrates the differences by providing a detailed look at the unique characteristics of older Americans. Knowing the key trends that will shape the following decades is a first step to helping older adults create optimal futures. Read our full paper here by Lisa Rill, […]
Combating Ageism: How Successful is Successful Aging?
Published: | 7:03 pm | Posted in: Archive
The concept of successful aging based on high level of physical cognitive functioning has become dominant in Gerontology since the 1990’s. This article indicates the concept may contribute to negative perception of aging (Ageism) and make older people feel as if they are personally responsible for failing to achieve the restrictive criteria for aging successfully. Purpose: To […]
Paid Caregiving in the 21st Century
Published: | 5:01 am | Posted in: Archive
The quality of availability and long term care services depend most fundamentally on paid caregivers who deserve far more recognition and support than they now receive. Al-Jen Poo is a MacArthur Genesis award winner, which she received for work in organizing home health workers and related efforts to improve the lives of these and other low-wage […]
The U.S. Health Care Crisis Five Years After Passage of the Affordable Care Act A Data Snapshot
Published: | 6:07 pm | Posted in: Health Care Policy and Reform, Medicare
Despite passage of the Affordable Care Act in 2010, the U.S. health care crisis continues. While coverage has been expanded, the reform will leave 27 million people uninsured in 2024, according to the Congressional Budget Office. Much of the new coverage is of low actuarial value with high cost-sharing requirements, creating limitations to access. Choice […]
The Value of Medicaid
Published: | 7:58 pm | Posted in: Health Care Policy and Reform, Medicaid
Medicaid is the largest means-tested program in the U.S., with expenditures of over $425 billion in 2011. The Oregon Health Insurance Experiment, a recent expansion of the Medicaid program in that state that occurred by random assignment, has provided some of the most compelling evidence to date on the program’s effects. A series of previous […]
The Nursing Home Culture-Change Movement: Recent Past, Present, and Future Directions for Research
Published: | 7:33 pm | Posted in: Nursing Home Care
This article uses a retrospective approach to critique the research base underlying the nursing home culture-change movement—an effort to radically transform the nation’s nursing homes by delivering resident-directed care and empowering staff. The article traces the development of the movement from its inception 10 years ago to 2005, when the Centers for Medicare and Medicaid […]
The Oregon Health Insurance Experiment: Evidence from the First Year*
Published: | 7:31 pm | Posted in: Health Care Policy and Reform
In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled […]
Report: Older Adult Population Growth Surges in Certain States
Published: | 6:37 pm | Posted in: Medicare
The pressure that the aging of America places on the nation is not evenly distributed among all states, according to a new report on healthiest states from the United Health Foundation and American Public Health Association. By 2030, it’s projected that more than 20 percent of the population will be age 65 and older, up […]
Deductibles cause sick patients to reduce beneficial care
Published: | 4:06 pm | Posted in: Medicare
Measuring consumer responsiveness to medical care prices is a central issue in health economics and a key ingredient in the optimal design and regulation of health insurance markets. We study consumer responsiveness to medical care prices, leveraging a natural experiment that occurred at a large self-insured firm which forced all of its employees to switch […]
The Value of Medicaid to Older Households
Published: | 3:54 pm | Posted in: Medicaid
Medicaid is an importance source of funding for long-term care for the elderly. While Medicaid is the payer of last resort, contributing only after Medicare and private insurance pay their share and individuals spend their assets down to a relatively low “disregard” amount, the very high cost of nursing home care – on the order […]
The Aging Network and Managed Long-Term Care
Published: | 8:11 pm | Posted in: The Aging Network
Since the early 1980s, service providers and area agencies on aging, that is, the aging network, have developed a number of strengths as they built a community-based long-term-care system in most states. Many area agencies and providers now have the capacity to assess the needs of older persons, identify appropriate services, and administer cost-effective community […]
