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Past Briefings

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The following is a list of all previous briefings for the year 2015. For briefings from other years, select from the list below.

Health Care Consolidation: Trends, Impact and Regulation
Friday, November 20, 2015

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 briefing discussed the driving forces behind this recent increase in consolidation; 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.

Taking the Right Meds at the Right Time: Medication Adherence, Health Outcomes and Costs
Monday, November 16, 2015

Evidence shows that medication adherence—the extent to which a person takes medications as prescribed by their health care providers—is associated with improved health care outcomes for many costly chronic conditions, including heart disease, diabetes, and asthma. However, only 50% percent of Americans are estimated to take their medications as prescribed, and non-adherence is estimated to result in added direct and indirect costs to the healthcare system of over $300 billion per year. The challenges and policy questions surrounding medication adherence affect Medicare, Medicaid, and the private sector – and offer a window into broader questions surrounding the ability of our health care system to coordinate care, particularly for people with multiple chronic conditions. In this briefing, top experts from the public and private sectors explored key policy, practical, and research questions surrounding medication adherence and management of medications:

High-Need, High-Cost Patients: The Role of Behavioral Health
Friday, October 30, 2015

Behavioral health conditions, including mental health issues and substance use disorders, affect nearly one in five Americans and account for $57 billion in health care costs annually. This briefing discussed current initiatives to integrate behavioral and physical health care services in order to improve quality of care and reduce overall health care costs.

Medicare Open Enrollment Preview
Wednesday, October 14, 2015

With Medicare Medicare Advantage (Part C) and prescription drug (Part D) open enrollment beginning October 15th, this briefing took a close look at what to expect, including trends in premiums and cost sharing, plan availability and benefit design.

Home and Community-Based Services: System-wide Coordination to Improve Care, Hold Down Costs
Friday, October 09, 2015

The movement toward home and community-based, long-term services and supports (LTSS) continues to grow, resulting in increased demand for these services. The goal is to help people live in the community independently, yet many barriers to offering HCBS still exist. This briefing will examine the potential of HCBS to reduce health care costs and improve quality of care. It will explore the intersection of HCBS, the broader health care delivery system and Medicaid, which is the largest payer of LTSS.

Health Insurance Marketplaces in 2016: What to Expect
Monday, October 05, 2015

With the third open enrollment period for health insurance marketplaces launching November 1st, this briefing took a detailed look at what consumers can expect regarding premiums, health plan availability and affordability.

Tools for Patients: Data, Technology, and Communication in Patient-Centered Care
Monday, September 21, 2015

This briefing, the third in a series on creating a more consumer-friendly and patient-centered health care system, will delve into the issues that patients face as they make decisions about their health care. It will explore questions such as: What does it mean for patients to be engaged in their care? What information and tools are available to empower patients to make treatment decisions and manage their care? What are the respective roles of technology, the doctor-patient relationship, and the health care system as a whole in helping patients navigate their care?

Prescription Drug Costs: Trends and Tradeoffs in the Pipeline from Lab to Market
Friday, September 18, 2015

Innovative drugs have brought about significant progress in treating costly and complex conditions. While there is agreement among many stakeholders that some of these breakthrough drugs have had a positive impact on Americans’ health and life expectancy, increasing prices have also caused some confusion about the methods by which drug prices are determined. The goal of this briefing is to discuss recent prescription drug price trends, as well as demystify the pricing process. It will identify contributors to the rising prices of many drugs, including shareholder interests and R&D costs, in addition to explaining possible future pricing-related challenges for manufacturers, providers, and consumers.

The Intersection of Health and Housing: Opportunities and Challenges
Friday, August 07, 2015

This briefing, the first in a three-part series exploring the intersection of health and social policy, will focus on Medicaid and housing policy. What does evidence say about the relationship between stable housing and health outcomes for various populations? What financial impact can housing have on Medicaid costs, and what potential role can Medicaid play regarding housing policy? What funding sources are state and local officials currently leveraging to provide housing resources? Are there barriers to innovative health and housing approaches?

Empowering the Consumer as the Ultimate Health Care Stakeholder
Friday, July 24, 2015

This briefing, the second in a three-part series on the role of consumers and patients in our health care system, will discuss the role of consumers in today’s health care coverage market, exploring questions such as: How is the evolving insurance marketplace affecting the choices consumers have when selecting a health plan, whether through a health insurance exchange, employer, or other mechanism? What information do consumers need to select a plan that is right for them? Are consumers well informed regarding health insurance matters, and do they know how to make use of their coverage once they have it?

The ACA: Experiences in Health Care Coverage and Access
Wednesday, July 01, 2015

In advance of the third open enrollment period for health coverage under the Affordable Care Act, this briefing examined coverage trends, who has gained coverage and who remains uninsured, and why those uninsured individuals have not obtained coverage.

Workplace Wellness: Promises, Challenges, and Legal Questions
Monday, June 22, 2015

Employers have long been advancing a variety of efforts to engage their employees in their health care, reduce absenteeism, and decrease the cost of employee health benefits. Recently, however, some employer wellness programs offering significant incentives for participation--or penalties for nonparticipation--have raised legal issues regarding privacy and discrimination and are the subject of a recent proposed rule from the Equal Employment Opportunity Commission (EEOC).

The Evolving Coverage Landscape for Small Businesses: Opportunities and Challenges
Friday, June 12, 2015

The Affordable Care Act (ACA) created new health insurance marketplaces for small businesses, known as Small Business Health Options Program (SHOP) marketplaces, and made substantial changes to the regulation of health insurance for small businesses. For purposes of health insurance regulation, small businesses have traditionally been defined by states as businesses with up to 50 employees. The ACA defined the small group market as employers with 1-100 employees, while allowing states to limit small group participation to employers with 50 or fewer workers from 2014 through 2016. Every state chose to do so, but, for plan years beginning in 2016, the definition of small business is set to expand to include those with 100 or fewer employees—with potentially significant consequences for the small group health insurance market and the SHOP marketplaces.

King v. Burwell: The Facts and Implications
Friday, June 05, 2015

This briefing told you what you need to know about a major Supreme Court challenge to the Affordable Care Act (ACA). The Court is expected to make a decision in June, and a ruling for the King petitioners could mean that individuals will no longer be able to receive subsidies to purchase health insurance through the federal marketplace. The federal government is operating insurance marketplaces in more than 30 states. Currently, subsidies to buy health insurance are available to individuals with incomes between 100 percent and 400 percent of the federal poverty level (i.e., those with annual incomes between $11,770 and $47,080).

Biosimilars in the U.S.: Current & Emerging Issues
Wednesday, May 20, 2015

With Congress focused intently on the discovery, development, and delivery pipeline for innovative drugs and devices – and in the wake of the first-ever U.S. approval of a biosimilar medication– key policy and regulatory questions are being actively debated, with important implications for industry, patients, and the health care system.

Issues and Future Directions for Medicare
Friday, May 15, 2015

Per capita spending growth in Medicare has slowed over the last few years, although economists disagree about whether that trend will continue. Meanwhile, the number of Medicare beneficiaries continues to increase. Medicare has made systematic changes over the course of its first 50 years, addressing everything from benefits and eligibility to quality of care measurement and provider payment.

Improving Health Care Delivery: Innovation in the Private and Public Sectors
Friday, April 24, 2015

This event examined innovative efforts in both the private and public sectors to move toward a health system that is more patient-centered, cost-efficient and delivers better outcomes. It will address efforts underway at the Center for Medicare and Medicaid Innovation (CMMI) and other federal agencies to spur innovation and prioritize a shift toward higher quality care, as well as the progress made by the private sector in improving quality and reducing costs through innovation.

Health Care Costs: What You Need to Know
Wednesday, April 01, 2015

The briefing explored the trends in health care costs in both the public and private sectors. It will explain recent moderate growth rates, along with possible reasons and prospects for the future. This session will be especially helpful to congressional staff members new to the issue, but it will also be a useful review for anyone working on health care policy.

Medicare 101: What You Need to Know
Friday, March 27, 2015

Medicare provides health insurance coverage to 54 million people aged 65 and over and younger people with permanent disabilities. In 2013, Medicare spending accounted for 14 percent of the federal budget.

Medicaid 101: What You Need to Know
Friday, March 20, 2015

With some states grappling over whether to expand Medicaid, and Congress facing big decisions about the future of the Children’s Health Insurance Program (CHIP), this briefing reviewed the basics about both programs and discuss current issues.

Chronic Care Management: Is Medicare Advantage Leading the Way?
Wednesday, March 11, 2015

Efforts are underway throughout the Medicare program to better manage beneficiaries’ chronic conditions, with the goal of improving quality and lowering the costs of care. With an estimated 31 million Medicare beneficiaries suffering from a chronic condition such as cardiovascular disorders, diabetes and cancer, many still do not receive the coordinated services they need to manage their chronic conditions, and beneficiaries with multiple chronic conditions incur higher-than-average spending. However, traditional fee-for-service Medicare, Medicare Advantage, and newer models such as Accountable Care Organizations (ACOs) differ in the tools and methods available to manage chronic care.

ACA 101: What You Need to Know
Friday, March 06, 2015

This session was especially helpful to congressional staff members new to the issue, but is also a useful review for anyone dealing with the Affordable Care Act (ACA). The briefing took place just as the second marketplace enrollment period ended and the Supreme Court heard oral arguments in a case challenging the law’s subsidies.

Preparing the Nursing Workforce for a Changing Health System: The Role of Graduate Nursing Education
Wednesday, January 21, 2015

The nursing profession, with nearly 3 million licensed and practicing nurses in the U.S., comprises the largest segment of the nation’s health care workforce. There is consensus among experts that nursing education should be modernized to train a greater percentage of nurses at the graduate level and provide the skills nurses need as today’s health care delivery system continues to evolve towards more team-based, data-driven, and coordinated care. What does the nursing workforce look like now, and how does it need to change to meet current and future health needs in the U.S.? How are nursing education and training currently financed? What is the role of federal policy in training a 21st century nursing workforce? How does the nursing workforce fit into today’s primary care workforce and the evolving health care delivery system?

AHCJ San Francisco
Wednesday, January 21, 2015

With the ACA’s second enrollment period underway, health plans are increasingly offering consumers networks that exclude certain doctors, hospitals and other medical providers. Several court cases against insurers are now pending in California. Some claim that these networks hamper provider access and choice; others contend that this approach, if done the right way, helps consumers by creating competition and controlling costs, without compromising the quality of care.


Toolkit: Emergency Preparedness in the U.S.: The Ebola Threat

Is the U.S. prepared for a potential virulent pandemic? This new Alliance toolkit examines public health infrastructure, funding and policy levers that deal with these kinds of health crises in America.

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Mike Leavitt Video: Consolidation and Control-The Evolving Health Care System

Mike Leavitt, chairman of Leavitt Partners and former HHS secretary, addresses the aggressive repositioning of players in the evolving health care system in a new Alliance for Health Reform video.

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Telemedicine Toolkit: The Promise and Challenges

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.

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Toolkit on Long-Term Services and Supports (LTSS)

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.

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Experts Discuss Workplace Wellness Programs

In a new interview video, Karen Pollitz, senior fellow, private insurance and health reforms, The Kaiser Family Foundation and Dan Newton, vice president, product/solutions development and behavior economics, Anthem Care Management discuss the impact of workplace wellness programs. They address questions about regulations and program design and analyze the scope of wellness programs.

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Alliance Search for New CEO

WASHINGTON, DC (Aug. 3) – Edward F. Howard, founding executive vice president and CEO of the Alliance for Health Reform in Washington, DC, will retire in March 2016. A nationwide search is underway for his successor.

Over the years, the Alliance has presented hundreds of seminars on Capitol Hill and elsewhere, has organized briefings for reporters around the country and has prepared dozens of issue briefs and “toolkits,” as well as a series of highly-regarded sourcebooks for reporters on health policy topics.

Dr. Robert Graham, Chairman of the Board, noted that the search for a new CEO is being coordinated by Association Strategies of Alexandria, Va. Those interested in learning more about this opportunity should email or call 703/ 683-0580. You can also view the position profile on their website. The deadline for applications is Monday, October 12. 

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Position Profile

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Toolkit on Biosimilars

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.

Biosimilars are similar – but not identical – to biologic drugs, and cost less. Unlike traditional pharmaceuticals, biologic drugs are derived from living organisms and tissues, making them more complex and expensive to produce.

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Toolkit on Connection Between Health and Housing

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.

Attempts to tie health and housing policy are gaining momentum, amid evidence that housing, a social determinant of health, is an important factor in the health status of various populations. 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, according to the Department of Housing and Urban Development.

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Video from Reporter Roundtable on Open Enrollment III

On October 5, speakers at a reporter roundtable held at the National Press Club on open enrollment III provided the latest information about premium trends and drivers, health plan availability and new comparison tools for consumers to use in choosing health plans. They discussed trends in the role of navigators and brokers, and increasing consumer expectations, particularly around the ease of the process.

Click here for video.

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