Commonwealth Fund | The Massacusetts Health Insurance Connector: Structure & Functions

May 30, 2009

Amy M. Lischko, Sara S. Bachman, and Alyssa Vangeli, The Massachusetts Commonwealth Health Insurance Connector: Structure and Functions, The Commonwealth Fund, May 28, 2009. Full text of issue brief.

The Commonwealth Health Insurance Connector Authority is the centerpiece of Massachusetts’ ambitious health care reforms, which were implemented beginning in 2006. The Connector is an independent quasi-governmental agency created by the Massachusetts legislature to facilitate the purchase of affordable, high-quality health insurance by small businesses and individuals without access to employer-sponsored coverage. This issue brief describes the structure and functions of the Connector, providing a primer to policymakers interested in exploring similar reforms at the state and national level. The authors describe how the Connector works to promote administrative ease, eliminate paperwork, offer portability of coverage, and provide some standardization and choice of plans. National policymakers looking to achieve similar policy goals may find some of the structural components and functions of the Connector to be transferable to a national health reform model, say the authors. More at: The Massachusetts Commonwealth Health Insurance Connector: Structure and Functions – The Commonwealth Fund.

Commonwealth Fund | An Update on Health Reform in Massachusetts

May 28, 2009

Sharon K. Long, Ph.D., and Paul B. Masi, Access and Affordability: An Update on Health Reform in Massachusetts, Fall 2008, Health Affairs Web Exclusive, May 28, 2009, w578–w587. Full text.

More than two years after implementation of its landmark health insurance reforms, Massachusetts had achieved historically high levels of coverage and widespread improvements in access to care, according to this study—the latest in a series of updates, funded by the Blue Cross Blue Shield of Massachusetts Foundation, The Commonwealth Fund, and the Robert Wood Johnson Foundation, on implementation of the state’s reforms. The authors find, however, that constraints on provider capacity and rising health care costs—trends that predate reform—have eroded some of the gains. Massachusetts is now seeking ways to contain costs and expand provider capacity, including a proposal to shift from fee-for-service provider payments to global fees that emphasize care coordination and collaboration. More at: Access and Affordability: An Update on Health Reform in Massachusetts, Fall 2008 – The Commonwealth Fund.

Book | Ethical Issues in Rural Health Care

May 27, 2009

Ethical Issues in Rural Health Care. Edited by Craig M. Klugman and Pamela M. Dalinis. Baltimore, MD, Johns Hopkins University Press, 2008. 224 pp, $50. ISBN-13: 978-0-8018-9045-1

Are ethics different in rural areas than in the big city? This collection of 12 essays provides a careful look at how ethical issues are perceived, noticed, ignored, or dealt with in rural health care. The contributors make clear that perceptions of ethics that come from urban and academic health care centers may need to be adjusted in dealing with the rural environment.

The book is divided into 3 sections. The first provides an overview of what is meant by rural and general ethical issues in rural health care. The second section consists of 3 essays by rural health practitioners. The third and final section examines specific ethical issues in the rural setting. The book provides an illuminating look at questions of culture, character, regulation, social justice, and organizational response. As a reader who has predominantly practiced medicine and taught ethics in urban medical environments, I found the book fascinating . . . [Full Text of this Article]

Myles N. Sheehan, SJ, MD, Reviewer
Leischner Institute for Medical Education
Stritch School of Medicine
Loyola University Chicago
Maywood, Illinois

Source:  JAMA — Ethical Issues in Rural Health Care, May 27, 2009, Sheehan 301 (20): 2162.

CBO Brief | Budgetary Treatment of Health Reform Proposals

May 27, 2009

The Congress is currently considering various approaches for instituting major changes in the nation’s system of health insurance. Some of those proposals would significantly expand the federal government’s role in that system, thus raising the question of how such changes might be reflected in the federal budget. CBO has just released a brief describing the approach that CBO will take in judging the appropriate budgetary treatment.

Source: Director’s Blog » Blog Archive » Budgetary Treatment of Health Reform Proposals.

Study: Lower legal drinking age increases likelihood of poor birth outcomes

May 26, 2009

Amid renewed calls to consider reducing the legal drinking age, a new University of Georgia study finds that lower drinking ages increase unplanned pregnancies and pre-term births among young people. “Our findings suggest that a lower drinking age increases risky sexual behavior among young people, and that leads to more unplanned pregnancies that result in premature birth and low birth weight,” said study author Angela Fertig, assistant professor in the UGA College of Public Health. “The take-home message is that when it’s easier for young people to get alcohol, birth outcomes are worse.”

via College of Public Health: Health Policy and Management News.

Health Wonk Review | Upcoming Hosts

May 25, 2009

Submit entries for material to consider to Blog Carnival

June 11, 2009 – Joe Paduda at Managed Care Matters
Deadline: 9 am Wednesday June 10, 2009

June 25, 2009 – Jason Shafrin at Healthcare Economist
Deadline: 9 am Wednesday June 24, 2009

July 9, 2009 – Ken Terry at BNET Healthcare
Deadline: 9 am Wednesday July 8, 2009

July 23, 2009 – Paul Testa at New Health Dialogue Blog
Deadline: 9 am Wednesday July 22, 2009

August 6, 2009 – Jaan Sidorov at Disease Management Care Blog
Deadline: 9 am Wednesday August 5, 2009

August 20, 2009 – David Williams at Health Business Blog
Deadline: 9 am Wednesday August 19, 2009

Sept. 3, 2009 – Jared Rhoads at The Lucidicus Project
Deadline: 9 am Wednesday September 2, 2009

Sept. 17, 2009 – Richard Elmore at Healthcare Technology News
Deadline: 9 am Wednesday Sept. 16, 2009

SourceHealth Wonk Review: Health Wonk Review – upcoming hosts.

U Georgia, College of Public Health | Head: Health Policy & Management

May 25, 2009

The College of Public Health at the University of Georgia invites applications and nominations for Head of the Department of Health Policy and Management. Click here for more information.

JAMA | Regulating the Safety of Pharmaceuticals: The FDA, Preemption, and the Public's Health, May 20, 2009, Gostin 301 (19): 2036

May 24, 2009

Lawrence O. Gostin, JD. Regulating the Safety of Pharmaceuticals:  The FDA, Preemption, and the Public’s Health. JAMA. 2009;301(19):2036-2037.

In 2008, the US Supreme Court held that the Medical Device Amendments (MDA) bar common law claims challenging the safety or effectiveness of a medical device approved by the US Food and Drug Administration (FDA).1 Riegel v Medtronic Inc2 had broad implications for patient safety because it removed all means of judicial recourse for most consumers injured by defective medical devices. At that time, the Supreme Court agreed to hear Wyeth v Levine,3 which consumer safety advocates feared would similarly preempt pharmaceutical lawsuits with far-reaching effects. There are 11 000 FDA-regulated drugs, with nearly 100 more approved each year,4 and patients would have no safety net in the event the FDA fails to detect and correct safety hazards. In a recent 6-3 decision, the Supreme Court ruled that the FDA’s approval of a drug label does not preempt a state law product liability claim charging the . . . [Full Text].  Source: JAMA — Regulating the Safety of Pharmaceuticals: The FDA, Preemption, and the Public’s Health, May 20, 2009, Gostin 301 (19): 2036.

CBO’s Health Team

May 24, 2009

CBO’s Health Team
Because CBO believes that its estimating methodology should be as transparent as possible, perhaps our estimating team should be transparent as well. In that spirit, here are the previously anonymous analysts at CBO who deserve a great deal of credit for their fine work analyzing health reform and related legislative proposals (I realize this list has more than 50 names; that’s because some of these people have other responsibilities beyond health reform):

Christi Anthony, David Auerbach, David Austin, Colin Baker, Elizabeth Bass, Jim Baumgardner, Patrick Bernhardt, Tom Bradley, Paul Burnham, Stephanie Cameron, Sheila Campbell, Jodi Capps, Michael Carpenter,Julia Christensen, Mindy Cohen, Anna Cook, Paul Cullinan, Sunita D’Monte, Noelia Duchovny, Sean Dunbar, Philip Ellis, Pete Fontaine, Carol Frost, Mike Gilmore, Matt Goldberg, Heidi Golding, April Grady, Stuart Hagen, Holly Harvey, Jean Hearne, Janet Holtzblatt, Lori Housman, Paul Jacobs, Sarah Jennings, Daniel Kao, Jamease Kowalczyk, Susan Labovich, Julie Lee, Leo Lex, Joyce Manchester, Kate Massey, Noah Meyerson, Alex Minicozzi, Carl Mueller, Carla Murray, Athiphat Muthitacharoen, Keisuke Nakagawa, Kirstin Nelson, Lyle Nelson, Andrea Noda, Ben Page, Allison Percy, Lisa Ramirez-Branum, Lara Robillard, Matt Schmidt, Kurt Seibert, Sven Sinclair, Julie Somers, Robert Stewart, Julie Topoleski, Bruce Vavrichek, David Weiner, Ellen Werble, Chapin White, Rebecca Yip. Source: Director’s Blog » Blog Archive » CBO’s Health Team.

Commonwealth Fund | Extra Payments to Medicare Advantage Plans to Total $11.4 Billion in 2009

May 24, 2009

B. BilesJ. Pozen, and S. Guterman, The Continuing Cost of Privatization: Extra Payments to Medicare Advantage Plans Jump to $11.4 Billion in 2009, The Commonwealth Fund, May 2009.  [Full text]

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, MA plans have, for the past six years, been paid more for their enrollees than they would be expected to cost in traditional fee-for-service Medicare. Payments to MA plans in 2009 are projected to be 13 percent greater than the corresponding costs in traditional Medicare—an average of $1,138 per MA plan enrollee, for a total of $11.4 billion. Although the extra payments are used to provide enrollees additional benefits, those benefits are not available to all beneficiaries—but they are financed by general program funds. If payments to MA plans were instead equal to the spending level under traditional Medicare, the more than $150 billion in savings over 10 years could be used to finance improved benefits for the low-income elderly and disabled, or for expanding health-insurance coverage. More at The Commonwealth Fund.