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Past Briefings

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The following is a list of all previous briefings for the year 2013. For briefings from other years, select from the list below.

Medicare-Medicaid Coordination for Dual Eligibles: What’s it All About?
Monday, May 13, 2013

Over nine million Americans receive benefits from both Medicare and Medicaid costing over $315 billion in health care services in the two programs combined. The dual eligibles account for 15 percent of the Medicaid population and almost 40 percent of all Medicaid expenditures for medical services; and 20 percent of the enrollees in Medicare, but 30 percent of the expenditures. Who are the dual eligibles? How does the Patient Protection and Affordable Care Act (ACA) address cost and quality of health care issues for this population? What is the office of duals? What federal initiatives are helping to improve quality, integrate care and align financing? How are the states involved in serving dual eligibles? In improving their care and coping with the high cost of care? What do the demos hope to show?

Patient-Centered Medical Homes: Do They Work?
Friday, May 03, 2013

The patient-centered medical home (PCMH), also referred to as the primary care medical home, is a model that aims to transform the organization and delivery of primary care. Why are we investing in testing the patient-centered medical home model? What does current evidence say about the impact of PCMH models? Can these models generate savings for the health care system down the road? Do primary care practices have the capacity and time to develop these models? What resources are necessary to ensure a functioning PCMH? What is the status of the demonstration projects run under CMMI? What are some successes and challenges that active PCMHs have encountered? How else does the ACA provide support for patient-centered medical homes? A distinguished panel of experts addressed these and related questions.

ACA 101: What You Need to Know
Friday, April 26, 2013

States and the federal government must be ready to begin enrolling millions of people in insurance marketplaces in October of this year. By January 1, most Americans will have to have health coverage or pay a penalty. Most states are also expected to draw new federal money to significantly expand their Medicaid programs. Insurers, meanwhile, face new rules, and doctors, hospitals and other medical providers will experiment with payment models intended to encourage quality instead of volume when it comes to care. This briefing will be especially helpful to congressional staff members and others with limited knowledge of the Patient Protection and Affordable Care Act (ACA), but it will also be a useful review for anyone dealing with the complex issues leading up to major changes scheduled to take effect in 2014.

Price and Quality Transparency: Tools for Informing Health Care Decisions
Friday, April 19, 2013

The Patient Protection and Affordable Care Act (ACA) calls for increased consumer involvement in health care decision-making. Transparency in price and quality as a tool for consumer engagement is a critical component of that process. One does not buy food, clothing or housing without comparison shopping. Yet in health care, equally important and typically a large part of the family budget, consumers have not had the tools to compare prices and quality of the product they are buying. The data are spotty and the little data that are available are not consumer friendly. What tools are needed to compare price? Quality? What does the ACA require with regard to transparency? Will consumers have the information they need to compare products on state-based insurance exchanges? Are the data available? In a consumer friendly format? What kinds of information in addition to price do consumers need to make choices between various treatment options or to choose a care provider?

The Health Care Workforce: Prescription for the Future
Friday, March 22, 2013

The Patient Protection and Affordable Care Act (ACA) has the potential to greatly increase the number of insured people and change how health care services are delivered. What the additional coverage will mean regarding access to providers, who those providers will be and what services they will deliver are issues that affect all segments of the health care workforce.

The Doc Fix: What Happens Next?
Friday, March 15, 2013

Proposals to fix the Sustainable Growth Rate (SGR) abound and there is agreement that policy makers must take action, but the question of how to reach a permanent solution remains. The SGR originated as part of the Balanced Budget Act of 1997 to control federal Medicare spending. Congress began overriding the SGR in 2002 and has continued to delay scheduled physician reimbursement cuts ever since. Medicare physician payments were maintained at their current rates in 2012 as a result of The Middle Class Tax Relief and Job Creation Act of 2012. Most recently, Congress extended payment rates until January 2014 as part of the “fiscal cliff” negotiations.

Medicaid 101: What You Need to Know
Friday, March 01, 2013

A March 1 briefing, Medicaid 101: What You Need to Know, was especially helpful to congressional staff members and others new to the issue, but was also a useful review for anyone dealing with Medicaid issues, particularly as many states prepare to expand their programs.

Medicare 101: What You Need to Know
Monday, February 11, 2013

A February 11 briefing, Medicare 101: What You Need to Know, was especially helpful to congressional staff members and others new to the issue, but it was also a useful review for anyone dealing with Medicare issues, particularly as pressure intensifies to slow the growth of program spending. Medicare provides health care coverage to 50 million individuals ages 65 and over, and to younger people with permanent disabilities. The federal government currently devotes 15 percent of its budget to the program. This Medicare 101 answered basic questions about the program.

Approaches to Bending the Health Care Cost Curve
Monday, January 28, 2013

While health spending as a share of GDP remained steady at 17.9 percent from 2009 through 2011, some analysts warn that, as the economy improves and the population ages, cost increases could again accelerate. Are there changes to the health law that could slow down health care spending growth? How can the public and private sectors collaborate to effectively address the problem? What role can market-based incentives and reforms play in a solution? Are there examples of provider payment or delivery innovation that could help? Should spending targets be established? If so, how? What are other approaches to stabilizing health care spending? Stu Guterman of The Commonwealth Fund, Karen Ignagni of America’s Health Insurance Plans and Robert Galvin of Equity Healthcare at the Blackstone Group addressed these questions.

 


Sister Carol Keehan on Health Law Enrollment Challenges this Year


Video 3:00

A new Alliance for Health Reform video features Sister Carol Keehan of the Catholic Health Association of the United States addressing the challenges of quickly enrolling millions of Americans for health insurance this fall. Open season begins October 1 of this year, yet she says that up to 85 percent of those who will be newly eligible for Medicaid or for subsidies to buy private insurance in state-based exchanges don't know it.  FULL TRANSCRIPT

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Jonathan Blum on CMS Efforts to Keep Medicare Spending Growth Down


Video (2:54)

Jonathan Blum, acting principal deputy administrator and director of the Center for Medicare at the Centers for Medicare and Medicaid Services (CMS), addresses the slower growth of Medicare spending over the last few years, and what his agency is doing to try and continue the trend. “There are promising signs that this strategy to change the payment system, to change the payment models, to focus on waste and abuse, is paying off," he said. "We are taking a whole new approach to addressing fraud in the program. Much more data resources, much more on the ground reaction. We have seen dramatic spending declines in areas of spending, such as home health and durable medical supplies that historically fueled lots of the fraud.”  FULL TRANSCRIPT

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Updated Toolkit -- The Sustainable Growth Rate: Seeking a ‘Doc Fix’ at the Edge of a Fiscal Cliff


A new Alliance toolkit tells you what you need to know about the current policy debate about the $138 billion Medicare physician payment problem – the "doc fix." 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.

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Illinios Health Law Implementation: Race to the Starting Line


Health care experts recently kicked off a series of briefings for reporters addressing complex issues that states face leading up to major 2014 health law changes. Illinois will have a federal partnership insurance exchange next year, but may take more control after that, Deputy Gov. Cristal Thomas said at the first briefing in Chicago. Georgetown University insurance expert Sabrina Corlette, hospital leader David DiLoreto and journalist Bruce Japsen also spoke at the briefing, held Dec. 12 at Columbia College, and sponsored by the Association of Health Care Journalists, the Alliance for Health Reform and the Robert Wood Johnson Foundation.

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Douglas Holtz-Eakin: Health Care Spending Lull Only Temporary


Video (3:11)

A new Alliance for Health Reform video features Douglas Holtz-Eakin of the American Action Forum, and a former director of the Congressional Budget Office, arguing that recent slower spending growth in health care won’t continue.

"We also saw a slowdown in the mid-90s, and we all declared victory and it came right back. I think next year we’ll see a noticeable uptick. There will be lots of new people entering the insurance markets because of the exchanges and the subsidies that come along with them, and those subsidies are very generous. … These are an invitation for people to get coverage and to buy more health care. I think that’ll place a lot of pressure on spending."

FULL TRANSCRIPT

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Uwe Reinhardt Questions Bundled Payment Savings Prospects


Video (2:58)

A new Alliance for Health Reform video features Princeton’s Uwe Reinhardt questioning whether bundling payments for medical services might actually lead to higher – not lower – costs.

"The ACO's, the accountable care organizations, could create local monopolies that could dictate to you what that bundled price would be, and some of us fear that bundled prices might be even more than what the fee-for-service for that bundle would be today. … You really should align all the payers and say, 'Let us jointly negotiate with the ACOs what those bundles should be so that they cannot divide and rule and sort of make us on the buy side weak.'"

FULL TRANSCRIPT

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