News this week on the progress of ACOs, a new payment model that the ACA is experimenting with. The idea is that health care providers makes something like a flat rate for taking care of a given set of patients. If they do so for less money than expected, they get to keep the difference; if they spend too much, then they lose money. Obviously, the goal here is to cut health care costs by moving away from the fee-for-service payment model that incentivizes increased spending. Several ACOs have been up and running, and results on their performance are starting to come in.
Austin Frakt at TheUpshot reports on two recent studies here. Continue reading Health Policy Updates: July 5 2015
First this week, the big big news in the world of health policy was the Supreme Court’s decision in the King vs Burwell case. The ruling results in keeping in place the subsidies for insurance exchanges, one of the central parts of the ACA/Obamacare.
What does this mean? In short, the Obamacare is here to stay. The consensus I have been reading was that this was the last court case with the realistic potential to open up a big hole in the law. If anything is to change from here on out, it will need to go through the legislature, which is much harder to do. Continue reading Health Policy Updates: June 28 2015
An update on the Relative Value Update Committee (RUC), a group of mostly subspecialist physicians that tells Medicare how much to pay doctors for their services (and tends to heavily favor specialists over primary care). The Government Accountability Office has released a very critical report of how the RUC does things, and is recommending to Medicare that it stop relying on the RUC to set its reimbursement rates:
“Given the process and data-related weaknesses associated with the RUC’s recommendations, such heavy reliance on the RUC could result in inaccurate Medicare payment rates.” Continue reading Health Policy Updates: June 21 2015
The Supreme Court’s decision on the King v Burwell case – determining the future of the ACA’s insurance subsidies – is upcoming. What is going to happen if insurance subsidies get struck down? Besides chaos, or course…the Obama Administration is doubling down and has stated that it is NOT planning for this scenario. Meanwhile, the Republicans have a variety of proposals to fill in the gaps. Here is a (fairly critical) appraisal of the leading 5:
“Most of the plans would extend the availability of subsidies, while dismantling other parts of Obamacare. The result would likely be a world that looks much more like America before Obamacare – where fewer people are enrolled in coverage and are paying higher premiums.”
Continue reading Health Policy Updates: June 13 2015
Megan McArdle on the high prices of cancer drugs:
“There are lots of reasons that cancer drugs cost so much, but one reason is, ironically, that they don’t work very well.”
Continue reading Health Policy Updates: June 6 2015