Medicare Direct, A Blueprint For Public Option Waivers, Part 3: Waiver Design, Legal Authority, And Conclusion
Perhaps the greatest weakness of the Medicare for All, Medicare for More, and public option proposals issued thus far is the fact that they require Congress to pass new legislation. That is certainly true for Medicare for All, it’s true for a Medicare buy-in, and it’s likely true for federally run public options. The biggest strength of Medicare Direct, by contrast, is that it requires no such action. ...
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Medicare Direct, A Blueprint For Public Option Waivers, Part 2: Benefit Design, Provider Networks, And Reimbursement
In all of the discussion and debate regarding Medicare for All and public option proposals, three essential considerations often get short shrift: the benefits enrollees will receive, the network of providers they will have access to; and the rates providers will be paid for delivering these services. These elements, however, really are the guts of any meaningful initiative of this scope. ...
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Medicare Direct, A Blueprint For Public Option Waivers, Part 1: Introduction, Administration, And Financing
There is a reason that Medicare for All has captured the enthusiastic support of a large majority of the public: The status quo for our health care system is unsustainable economically and unforgiveable morally. An honest assessment of the probability of Congress enacting Medicare for All–related legislation, however, demonstrates it is highly unlikely in the foreseeable future. ...
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A Tell-All on Telehealth: Where Is Congress Heading Next?
The Centers for Medicare and Medicaid Services (CMS) recently enacted modest but important expansions in Medicare’s telehealth policy.
Telehealth, which uses telecommunications to support virtual health care delivery to improve access to and quality of health care, is moving from promise to reality. The benefits are appealing: Patients can interact with their providers remotely, which improves access to care and can help providers manage chronic conditions from afar....
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Public Option 1.0: Washington State Takes An Important Step Forward
On Sunday, the Washington State legislature passed a bill to create standardized health plans in the state’s Exchange and establish new public option-ish plans that contract directly with its Health Care Authority, which operates the state’s Medicaid program. The hallmark of these new plans, and the foundation of their claim to the title “public,” is they are required cap provider reimbursements at Medicare-based levels....
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Accelerating Primary Care Redesign: CMS’ Innovation Center Announces Five New Transformative Models
On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced the Primary Cares Initiative (PCI), a suite of five voluntary payment models aimed at overhauling primary care. Marking the Trump Administration’s latest investment in Medicare value-based reform, PCI focuses on the role of primary care providers as the central coordinators of patient health, with the goal of enhancing patient care while lowering overall Medicare fee-for-service (FFS) costs. Once implemented, CMS estimates that more than a quarter of all Medicare FFS beneficiaries – nearly 11 million individuals – will be included in these transformative primary care delivery models....
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The Drug Pricing Debate: Sizing Up Recent Actions and What May Come Next
What goes up must — or rather, should — come down.
Such is the thinking of the Trump administration when it comes to prescription drug pricing, at least. Over the past five years, 12 of the 20 most commonly prescribed brand-name drugs have seen price increases of more than 50 percent.
To date, most of what we’ve seen from the federal government is messaging and some initial proposals, with the majority coming from the administration. Congress, for its part, has initiated a series of drug pricing hearings and begun introducing meaningful legislation. The result is a wide array of policy alternatives, some of which stand a chance of being enacted....
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Medicare For All Can Begin In 2021: Here’s How
While Democratic presidential candidates and the newspaper headlines hash out the ideological nuances of a Medicare-based single payer coverage scheme, work is underway to consider how coverage can be expanded to those in need within a realistic timeframe at minimal cost or disruption to the existing system....
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What to Expect in Health Policy Under a Divided Congress
The 2018 midterm elections were powered by a “blue wave” that flipped control of the House of Representatives from the GOP to the Democrats but left the Senate in Republican hands, meaning the two chambers of Congress will be divided at least until 2020. In the Senate, Republicans have a 53 to 47 majority and will continue to be led by Senator Mitch McConnell of Kentucky, while House Democrats gained a 235 to 199 majority....
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What the 2018 Midterm Elections Means for Health Care
The fundamental shift in the balance of power in Washington will have substantial implications for health care policymaking over the next two years. In this post, I’ll take a look at which health care issues will come to the fore of the Federal agenda due to the outcome Tuesday, as well as state expansion decisions. And it should of course be noted that, in addition to positive changes Democrats are likely to pursue over the next two years, House control will allow them to block legislation they oppose, notably further GOP efforts to repeal the Affordable Care Act (ACA)....
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The 660-Page Opioids Bill Is Now the Law. Here’s What’s in It.
Opioids killed an estimated 49,000 Americans in 2017, including nearly 2,200 Californians. They harmed many more, including children forced into the foster care system, babies born with neonatal abstinence syndrome, young adults who overdosed from dangerous new street drugs like fentanyl, and countless others who became addicted to opioids while trying to manage chronic pain....
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Immigrants and the New Proposed “Public Charge” Rule
On September 22, the Department of Homeland Security (DHS) released the text of highly anticipated proposed changes to “public charge” rules that could disqualify many immigrants from gaining permanent residency in the US.
Public charge is the determination that evaluates whether someone is likely to become reliant on public benefits, and consequently whether he or she may enter the country or modify his or her immigration status to become a permanent resident (a “green card” holder). ...
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