Insurance

Among the many delivery models that have been discussed in the midst of healthcare reform is Accountable Care Organizations (ACOs). The general idea behind the ACO model is to provide something that is currently missing from our healthcare system: an incentive in the form of shared savings for organizations to constrain resources while maintaining (or even improving) quality.

Robert Berenson, MD, FACP, Institue Fellow, Health Policy Center, Urban Institute, states that the development of new care delivery models will not happen overnight. There is time before expectations are put into specific quality metrics and regulations for models such as patient-centered medical homes and accountable care organizations.

Sara Rosenbaum, JD, Harold and Jane Hirsh Professor of Health Law and Policy and Founding Chair, Department of Health Policy, George Washington University School of Public Health and Health Services, says that the purpose of health reform was to provide people a source of affordable coverage so everyone would be attached to a payment system.

Competitive bidding characterizes market-based proposals to control Medicare spending, but in this first empirical study of bidding in Medicare, we find that competition is lacking.

Modest increases in adherence to medication regimens among Medicare patients with heart failure were associated with lower Medicare spending in 3 major drug classes.

The America's Health Insurance Plans (AHIP) Medicare and Medicaid Conference took place in Washington, DC, this past week. Here are some of the highlights.

Juliette Cubanski, PhD, Associate Director, Program on Medicare Policy, Kaiser Family Foundation, believes that the Medicare program overall has as much at stake in the 2012 election. Specifically, Dr. Cubanski says increasing private plan participation in Medicare and whether Medicare should move towards privatization will be some of the greatest challenges moving forward.

Karen Ignagni, President and Chief Executive Officer, AHIP, feels Medicare is right to take on the challenge of hospital readmissions. Ms. Ignagni also discusses how the Medicare Advantage plans have done a better job with traditional fee-for-services programs and tackling high hospital readmission rates.

Robert Berenson, MD, FACP, Institute Fellow, Health Policy Center, Urban Institute, thinks that new healthcare delivery models are inevitable due to the behavior of physicians and providers who have abused fee-for-service. Dr. Berenson says that there has been unacceptable growth in the bias of fee-for-service activities, and new delivery models are necessary to improve quality and costs in healthcare.

Robert Berenson, MD, FACP, Institute Fellow, Health Policy Center, Urban Institute, thinks that new healthcare delivery models are inevitable due to the behavior of physicians and providers who have abused fee-for-service. Dr. Berenson says that there has been unacceptable growth in the bias of fee-for-service activities, and new delivery models are necessary to improve quality and costs in healthcare.

The current movement toward healthcare reform is a multifaceted initiative that attempts to increase healthcare access and improve quality across the nation while balancing budgets and reducing current fiscal deficits. One health program that is a major component in the movement is Medicaid, and in this article, 2 health policy experts share their insight on the impact and future direction of Medicaid reforms.

Juliette Cubanski, PhD, Associate Director, Program on Medicare Policy, Kaiser Family Foundation, believes that the Medicare program overall has as much at stake in the 2012 election. Specifically, Dr. Cubanski says increasing private plan participation in Medicare and whether Medicare should move towards privatization will be some of the greatest challenges moving forward.

The abuse of government programs and misappropriation of limited healthcare resources contribute significantly to, and further complicate, the growing burden of healthcare expenditures and utilization in the United States. Government bodies have demonstrated a paradigm shift, embracing collaborations and implementing evolved strategies, to more effectively combat Medicare fraud.

Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, US Department of Health and Human Services, says that meaningful use sets a foundation for new models to deliver care to an entire population.

As the search continues for effective cost-containment strategies in a landscape of substantial healthcare expenditures, policy authorities are looking at Medicare reform and the Part D model for opportunities and direction. In this discussion, 2 policy experts share their insights on the progress, trends, and possibilities of Medicare Part D.

Although delivery systems are seemingly designed with beneficial intentions and streamlined utilization, a number of current practices and policies have been the subject of criticism and controversy. Two leaders in health policy shared their insights regarding these concerns and discussed the necessary steps to further improve an antiquated delivery system during changing times.