Posts for Cost & Quality

NAIC Spring Meeting Recap: Experts and Consumer Groups Sound the Alarm on Limited Benefit Coverage

Products such as health care sharing ministries and transitional plans – including farm bureau plans, which made news this week as Iowa moves to expand these products – all pose cost and quality risks for consumers.

Transparency in Health Care: Clearly Not a Cure-All for What Ails the Health Care System

Last Friday, Community Catalyst submitted comments in response to a request for information from a group of Senators looking to improve transparency in health care. After a year of defending the Affordable Care Act and Medicaid from attacks that would...

State Network Adequacy Advocacy Matters Now More than Ever

It is critical that states step up to the plate to protect coverage and access to care for the millions of consumers who rely on marketplace plans.

The Takeaway: Repeal and Replace Sequel: Health Care Zombie Apocalypse

Movie sequels often fail to live up to the original, and Republicans' effort to repeal the ACA falls into this familiar pattern. As bad as the original was (and it was really bad), the sequel was even worse. Not content...

Non-Emergency Medical Transportation: Pathway to Better Health Outcomes

Even with health care coverage, Medicaid beneficiaries still find themselves facing numerous barriers to accessing the care they need and achieving better health outcomes. One barrier that continues to cause serious access problems is transportation.

The Takeaway: Problems With The House Republican ACA Replace "Plan"? Let Me Count The Ways

After six-plus years of rhetoric and sixty-some repeal votes, the House Republican caucus finally produced a document they refer to as a plan to replace the Affordable Care Act. (To call the plan disappointing would be an understatement. Despite my...

Empowering Consumers in Patient-Centered Medical Homes

(Last year, the Robert Wood Johnson Foundation launched a joint initiative with Community Catalyst called the Value Advocacy Project (VAP). The project is supporting consumer health advocacy organizations in six states in their non-lobbying advocacy efforts to pursue local and...

Washington State Advocates Inserting Consumer Voice Into Accountable Communities of Health

(Last year, the Robert Wood Johnson Foundation launched a joint initiative with Community Catalyst called the Value Advocacy Project (VAP). The project is supporting consumer health advocacy organizations in six states in their non-lobbying advocacy efforts to pursue local and...

With Health Policy Lemons, Florida Advocates Make Lemonade: Protecting Consumers From Unfair Surprise Medical Bills

Despite political opposition to the Affordable Care Act at the highest levels of state government, Florida led the nation as the state with the most people gaining new health insurance through the Affordable Care Act. However, for Floridians with coverage,...

The Takeaway: Efforts To Close The Coverage Gap Inch Forward With Brighter Days Likely Coming

Efforts To Close The Coverage Gap Inch Forward With Brighter Days Likely Coming Despite the health, economic and fiscal benefits of closing the coverage gap for people who fall between state Medicaid eligibility levels and eligibility for subsidized Exchange coverage,...

Why Strengthening America’s Social Structures Is Essential for Health

This post in our Health System Transformation series is an update of the Jan. 26, 2016 blog post titled, “How America’s Social Structures Affect Our Health.”  This updated post adds some key policy prescriptions that are central to the vision...

Using Big Data to Improve Care for Older Adults

This guest blog by Marcus Escobedo, Senior Program Officer at The John A. Hartford Foundation, was originally published February 18 in the foundation’s Health AGEnda blog.

The Takeaway: Stonewalling the President's Budget

President Obama released his final budget this week, containing some familiar health care items, as well as some good new ideas, like offering states three years of 100 percent federal financing whenever they elect to close the Medicaid coverage gap.

The Takeaway - Flint: How Did This Happen And What Does It Mean?

Flint: How Did This Happen And What Does It Mean? In my opinion, the biggest health care story of the week is the continued fallout from the lead contamination of the water supply in Flint, Michigan. The Flint crisis underscores...

The Takeaway 2016 New Year’s Edition

Why Is This News? 2016 opened with yet another vote by the Republican controlled Congress to repeal the ACA coupled with more muttering about a replace agenda — we really really mean it this time. Maybe by the time we are...

The Takeaway: In Search of a Prescription for Runaway Drug Prices

The problem of runaway prescription drug costs continues to make headlines and bedevil consumers, payers and policy makers.

The Takeaway: Has PhRMA PHinally Gone too PHar?

Well, really it’s not just PhRMA, it’s the generic manufacturers, as well. Normally there is a special room deep underground below the capitol where ideas to control excessive prescription drug prices go to die. The drug industry casts a long...

The Takeaway: More Signs of ACA Success but There's Still Work Left to Do

Michael Miller talks insurance merger mania, tackling out-of-pocket costs and more data touting the success of the ACA in this week’s edition of The Takeaway.

The Takeaway: No ACA-Related News (and Few Sparks) in First GOP Presidential Debate

Immigration and the nuclear deal with Iran dominated the first Republican presidential debate last night. Health care issues were decidedly second tier with candidates saying expected things about defunding Planned Parenthood and repealing the ACA. The Fox News moderators pushed...

Closing the Gap Is About More Than Just the Bottom Line, But It Helps

Failing to close the gap is a missed opportunity for consumers, hospitals and states. The uninsured rate in the 30 states (including D.C.) that have closed the gap fell from 18 percent to just below 11 percent.

Measurement That Matters: A Starting Point to Get to “Better, Smarter, Healthier”

In January, we asked “How do we get to better, smarter, healthier?” One of the steps we identified was developing better people-centered health quality measures. The IOM recently released a report that has the potential to be a game changer.

Proposed rule makes huge strides for behavioral health equity in Medicaid

The federal government released a proposed regulation earlier this month spelling out how mental health and substance use disorders parity standards apply to Medicaid and the Children’s Health Insurance Plan (CHIP).

Let's Help Medicaid Nurture Innovation

Everywhere you look these days, more initiatives are sprouting to improve the health system. Medicaid is no exception, it is a program willing and able to help states lead the way toward more effective and efficient care.

Campaigning for Quality

Maryland is implementing innovative changes to how hospitals are paid. At the Maryland Citizens’ Health Initiative, we believe consumer involvement will be essential to achieving the goals of lower costs and better quality care.

Moving CHIP Forward: Discussion Draft Demands Response

Yesterday, Senate Finance Committee Chairman Hatch (R-UT), House E&C Chairman Upton (R-MI), and Representative Pitts (R-PA) released a discussion draft that outlines their vision for the future of CHIP.

How do we get to Better Smarter Healthier? Five Key Steps

From our perspective, the recipe for "better, smarter, healthier" must include these five ingredients.

The Advocate's Dilemma

I recently participated in a panel discussion on medication safety issues with a colleague who serves as a patient advocate. We've been on panels together and make a great team—a doctor and a lawyer who are actually on the same side!

The Smart Shopper's Guide to Medicaid Managed Care Plans

In this season of giving, Community Catalyst has teamed up with the Kaiser Family Foundation to create an online tool that gathers in one place, for the first time, key data on the records of these companies.

Choosing Wisely

Seeing patients at my local health clinic, I recently had a fairly typical day for many doctors.

Transforming Our Health System: Bringing Drug and Alcohol Treatment into the Fold

With more people gaining access to care, this is a crucial time to strengthen the way we provide and pay for health care. Integrating services for drug and alcohol problems with other care can play a big role in transforming the health system.

Closing the Coverage Gap Won’t Accelerate State Medicaid Spending

We covered more people, and spending went up as a result – this isn’t a particularly interesting story. But the data actually tells a far more intriguing story, buried just a little deeper in the report.

How much does your doctor get from drug or device companies?

Last week’s release of nationwide information about drug and device manufacturer payments to doctors was the beginning of a new era of sunshine and transparency. The information, which is made public under a provision of the Affordable Care Act, shows...

Who's Watching the Chicken Coop? The FDA's Flawed Drug-Approval Process

I recently attended a conference entitled "What Evidence is Essential for New Medical Products?" held at the American Association for the Advancement of Science in Washington, D.C., that probed the vexing dilemma of balancing the duty of the Food and...

Use As Advertised Rather Than As Directed?

Who has gone a day without seeing at least one advertisement for drugs or medical devices? These advertisements are part of almost every commercial break during primetime television. It’s big revenue for the stations and a major marketing strategy for...

Better Bang for the Buck

Getting the Health Care Cost Problem Right There are few propositions in the health policy arena likely to command more agreement than that the United States spends too much on health care. But behind this apparent agreement, there is much...

Better Bang for the Buck

Now What? (Part Two) Getting Better Bang for the Buck Now that open enrollment is over, it is time for consumer advocates to consider what comes next in health care reform. In a previous blog, we discussed work that still...

The Time is Now: Maine’s Mid-Level Dental Provider Law a Signal to Industry, the Nation

Yesterday, Maine Governor Paul LePage signed a bill authorizing mid-level dental providers to practice in the state. Mainers, like Americans in every state, face barriers to accessing affordable dental care in their communities. The bill is a step forward to...

Expert Task Force Recommendations: Setting High COI Standards to Protect Patient Care and Medical Education

It’s no secret that medical device and pharmaceutical companies have had long-standing relationships with medical schools, teaching hospitals, and their faculty and clinical staff. But some of these relationships go too far.

Voices for Better Health Cheers Launch of Change AGEnts Initiative!

Recently, Community Catalyst’s Voices for Better Health program released a new video featuring the story of a mother and daughter – Sally and Edna – whose lives have been dramatically improved in the last few years. These improvements came about...

Much Ado about Rates - Part II

A steady stream of news headlines about states’ new health insurance rates for plans under the Affordable Care Act (ACA) have generated buzz and also caused some confusion.

Much Ado about Rates

Lately, we’ve seen a flood of states announcing new health insurance rates for plans under the Affordable Care Act (ACA). So what do they all mean? To start, the new rates are mainly for the individual market, for people who buy insurance on their own.

DOMA Ruling: Better Health Care Access for LGBT Families

If you walked around our office last Thursday morning, you would have found nearly everyone’s eyes glued to SCOTUSBlog, awaiting the Supreme Court’s decision on the Defense of Marriage Act (DOMA) and the Proposition 8 case from California.

Help for Improving Long-Term Services

After a long gestation, the federal government this week birthed new guidance designed to help managed care for Medicaid long-term services and supports (MLTSS) grow up into a more consumer-friendly, homey program.

A Blueprint for Consumer Engagement in Dual Eligible Demonstrations

Building anything new is tough. That’s why we turn to blueprints and experts. The same principle applies to the federal demonstration projects for people eligible for Medicaid and Medicare (dual eligibles) under construction in more than 20 states.

The Fine Print

Building new ways of delivering care to the millions of older adults and people with disabilities who are eligible for both Medicare and Medicaid (dual eligibles) is a daunting task. There is much work to be done.

Greater Than the Sum

April is National Minority Health Month and it is more important than ever to raise awareness about health disparities that continue to affect the health of millions of Americans.

Illinois Rolls Out Details of Duals Demo

On February 22, Illinois became the fourth state to move forward with a demonstration project striving to integrate care for people eligible for both Medicare and Medicaid (dual eligibles). The Memorandum of Understanding (MOU) between Illinois and the Ce

Cross Post: Esquire: The Man Who Killed Osama bin Laden... Is Screwed (updated)

Last September, we wrote about the crisis of uninsured veterans. A national study we helped with found that 1 in 10 veterans are uninsured (for more statistics, see this amazing graphic).

Next Up on the Duals Demos: Ohio

On December 12, Ohio became the third state to move forward with a demonstration project aimed at integrating care for people eligible for both Medicare and Medicaid (“dual eligibles”). Under the Memorandum of Understanding signed with the Centers for Med

Washington State First to Receive Approval to Implement a Managed Fee-for-Service Duals Demonstration Program

Last month, Washington became the second state to sign a Memorandum of Understanding (MOU) with the Centers for Medicare and Medicaid (CMS) to participate in a duals demonstration project. Washington is pursuing a managed-fee-for-service financial model u

Navigating Managed Care’s Strange New World

State Medicaid programs have been moving at warp speed to turn over long-term services and supports (LTSS) to managed care companies. For some states, this marks the first journey into the tricky terrain of mandatory managed care for seniors and people wi

Hospital Emergency Rooms: Last Resort or Failsafe?

Recently, old arguments about the appropriate role of the hospital emergency room (ER) in our health care system have resurfaced as the nation considers its next President. Given the high profile of the issue and the wide array of public opinions on the m

The ACA: Saving Consumers’ Premium Dollars Once Again

Hot off the heels of $1.1 billion in rebates from insurance companies that failed to meet the medical loss ratio (MLR) standard, the ACA is again saving money for consumers. The Department of Health and Human Services (HHS) just released a new report that

Something to Celebrate: Three Big Birthdays, One Short Week

Three programs vital to the health care security to millions of Americans celebrated birthdays last week. Medicaid and Medicare turned 47, and their “little sibling,” the Children’s Health Insurance Plan (CHIP), also marked 15 years of ensuring low-income

Takeaways from “The Dual Agenda: Better Care at a Lower Cost?”

On June 1st, with the generous support of The Atlantic Philanthropies, The John A. Hartford Foundation and the Robert Wood Johnson Foundation, Community Catalyst brought together advocates, providers, policymakers, funders, and technical experts to discus

Basic Health Program: This Wallflower is About to Bloom

The Basic Health Program isn’t the most flashy or popular provision in the Affordable Care Act. But anyone who’s watched a classic – or even a less-than-classic - teen romantic comedy knows that the shy, somewhat awkward wallflowers often have tremendous

Consumers: The Key to Successful Innovation

Last week, Center for Medicare and Medicaid Innovation (CMMI) announced the first group of organizations for Health Care Innovation awards. As readers may already know, CMMI was established by the Affordable Care Act (ACA) to test innovative payment and d

For Seniors the Affordable Care Act is the Gift that Keeps on Giving

This week marks the two year anniversary of the Affordable Care Act. And, while we will devote plenty of space this week to highlighting the many successes of the ACA, we could think of no better place to begin than with the law’s benefits for seniors. Un

A Principled Approach to Better Care for Seniors and People with Disabilities

Efforts to improve care for seniors and people with disabilities across the country are speeding forward as states take advantage of funding and flexibility offered by the federal government. These initiatives to serve people eligible for both Medicaid an

IOM releases its long awaited EHB Guidance: Tough Medicine

As the Institute of Medicine (IOM) unveiled its report on Essential Health Benefits (EHB) on Friday, there were few surprises.  The panel delivered a high level outline for selecting benefits with a strong recommendation that cost consciousness be its gui

Bundle of Hope?

Last week’s announcement by the Center for Medicare and Medicaid Innovation – a.k.a. The Innovation Center – about the launch of the Bundled Payments for Care Improvement Initiative offers hope in the battle against out-of-control health care costs. Docto

The Insider: The Choices We Make

The current political debate in Washington suffers from a narrowing of the political space that is considered “serious.” The problem extends well beyond the relative importance and urgency of reducing the national debt and addressing the persistently high

Paving the Way for New Models of Care

Providing insurance to low-income populations, as Medicaid does, improves their overall health and helps maintain financial stability. A new study by the National Bureau of Economic Research, says that Medicaid recipients, on average, were more likely to

Less pain, more gain: defining an alternative to harmful Medicaid cuts

(please note most links below are pdfs) On Friday, Community Catalyst sent a letter to Secretary Sebelius, outlining eight policies states could implement to cut Medicaid costs. We were inspired to weigh in by a series of letters between the Secretary and

Health Homes: Creating a Stronger Medicaid Program While Reducing Costs

Arizona’s decision to eliminate coverage for some heart, liver, lung, pancreas and bone marrow transplants has received a lot of attention because of its immediate life-and-death implications: potentially denying organs to 100 adults currently on the tran

Stuck in the Middle with You

A few weeks ago, Time magazine included a short essay that caught the eye of several of us here at Community Catalyst. In “The Coping Conundrum,” author Nancy Gibbs gently, but insistently, spotlights the unique issues faced by Americans in the sandwich g

The Future of Health Care

How are we going to change the cost curve in health care and provide the highest quality of care? Dr. Bob Master – one of the country’s leading health care visionaries - has a great answer. Six years ago, Bob came to Community Catalyst as a fellow of the

Insurance-palooza - the NAIC National Meeting in Seattle

The Summer 2010 Meeting of the National Association of Insurance Commissioners (NAIC) in Seattle Washington wrapped up last week. For those of us not lucky enough to spend a long summer weekend with a group of insurance commissioners, some friends of Comm

Are we speaking the same language? The problem with medical jargon

Today, many families are struggling not only with the cost of and access to health care, but also with the quality of care they receive. A recent article in the Wall Street Journal, “Taking Medical Jargon Out of Doctor Visits”, articulates an incredibly i

Case study shows community health workers improve primary care and enrollment

Policy changes in two states to expand and strengthen the workforce of community health workers provide a model for other states as they implement the Affordable Care Act, says a new case study, "Community Health Workers: Part of the Solution," in the Jul

"Show me" gender equity!

Missouri is trying to remain true to its slogan, the "Show Me State," by helping lead the charge in anti-health reform legislation prohibiting abortion services for health insurance obtained through the exchange – (the term used for the health care insura

The Insider: All this could be yours someday

Fuzzy logic As the “tax extenders” bill makes its way through the Senate, a provision to extend COBRA premium subsidies for the unemployed is in jeopardy. Opponents in the Senate and the Blue Dogs in the House who stripped the provision from legislation t

The Insider: A broken record

Health Care Reform = Rationing has been a favorite theme of opponents throughout the debate.  While the circumstances and details change over time, this theme remains constant.  In the past week, opponents have stepped up their attacks on the nomination o

Senate should restore COBRA and Medicaid subsidies

As we said Tuesday, the House removed provisions for federal Medicaid and COBRA subsidies from H.R. 4213, and the Senate departed for Memorial Day recess without taking action. The subsidies are critical to help hurting states that are struggling with bud

The Insider: Proxy War

LINK FIXED Last week, we likened the low-visibility conflicts over regulatory measures to trench warfare. This week, the military metaphor of choice is proxy war. Republicans in the Senate are using the nomination of Dr. Donald Berwick to head the Centers

As Boomers turn 65, better team-based care becomes a must

When Older Americans Month was established 47 years ago, only 17 million living Americans had reached their 65th birthdays. Today, there are nearly 40 million adults age 65 and older. And when the first baby boomers turn age 65 in 2011 they will become e

Academic detailing and the odds at Agincourt

Today we share a post from Community Catalyst's prescription drug blog, PostScript. _______________ We read with interest Merrill Goozner’s blog, “Putting Academic Detailing in Perspective.” See, the Agency for Healthcare Research and Quality recently dis

America needs better care!

Health reform is law. The hard work of fixing our health system begins now. That's the message of  Campaign for Better Care, a recently-launched effort to improve health care coordination and quality for people across the country. (Here’s the ad (pdf) tha

The Point

While we were encouraging folks to write letters to local newspapers, telling stories about what health care reform means for people they know, we realized each of us here knows someone who would be helped by health reform passing.  Who reminds us that wo

The Health Reform Insider

“Health reform is on life support unfortunately”—Sen. Mary Landrieu “The lady doth protest too much, methinks”—Gertrude in Hamlet “Reports of my demise are greatly exaggerated”—Mark Twain A lot of ink has been spilled over repeated pronouncements of those

Fighting the good fight: Two tools to help get reform done

Though health care reform has always been subject to the political tides, the political and legal challenges to reform legislation and its successful passage are rising. As supporters of reform who work with great advocates around the country,  we're risi

All eyes on Massachusetts

In what could be a strange and cruel irony, today’s special election to fill the late Senator Kennedy’s seat may deal a damaging blow to the prospects of passing a the bill that would culminate Kennedy’s life’s work in the Senate.  A surging Republican St

Community Catalyst joins hundreds at Affordability Summit in DC

Maybe you were there? If not, see who was at PICO's flickr page and get the details right here. --Kate Petersen, Health Policy Hub
1 2 3 4 5 6 7 8 9 10