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Video: Uwe Reinhardt, Princeton Economist, Questions Bundled Payment Savings Prospects (2:58)

Over nine million Americans receive benefits from both Medicare and Medicaid costing over $315 billion in health care services in the two programs combined. The dual eligibles account for 15 percent of the Medicaid population and almost 40 percent of all Medicaid expenditures for medical services; and 20 percent of the enrollees in Medicare, but 30 percent of the expenditures. Who are the dual eligibles? How does the Patient Protection and Affordable Care Act (ACA) address cost and quality of health care issues for this population? What is the office of duals? What federal initiatives are helping to improve quality, integrate care and align financing? How are the states involved in serving dual eligibles? In improving their care and coping with the high cost of care? What do the demos hope to show? Read More

The patient-centered medical home (PCMH), also referred to as the primary care medical home, is a model that aims to transform the organization and delivery of primary care. Why are we investing in testing the patient-centered medical home model? What does current evidence say about the impact of PCMH models? Can these models generate savings for the health care system down the road? Do primary care practices have the capacity and time to develop these models? What resources are necessary to ensure a functioning PCMH? What is the status of the demonstration projects run under CMMI? What are some successes and challenges that active PCMHs have encountered? How else does the ACA provide support for patient-centered medical homes? A distinguished panel of experts addressed these and related questions.  Read More

States and the federal government must be ready to begin enrolling millions of people in insurance marketplaces in October of this year. By January 1, most Americans will have to have health coverage or pay a penalty. Most states are also expected to draw new federal money to significantly expand their Medicaid programs. Insurers, meanwhile, face new rules, and doctors, hospitals and other medical providers will experiment with payment models intended to encourage quality instead of volume when it comes to care. This briefing will be especially helpful to congressional staff members and others with limited knowledge of the Patient Protection and Affordable Care Act (ACA), but it will also be a useful review for anyone dealing with the complex issues leading up to major changes scheduled to take effect in 2014.  Read More

The Patient Protection and Affordable Care Act (ACA) calls for increased consumer involvement in health care decision-making. Transparency in price and quality as a tool for consumer engagement is a critical component of that process. One does not buy food, clothing or housing without comparison shopping. Yet in health care, equally important and typically a large part of the family budget, consumers have not had the tools to compare prices and quality of the product they are buying. The data are spotty and the little data that are available are not consumer friendly. What tools are needed to compare price? Quality? What does the ACA require with regard to transparency? Will consumers have the information they need to compare products on state-based insurance exchanges? Are the data available? In a consumer friendly format? What kinds of information in addition to price do consumers need to make choices between various treatment options or to choose a care provider?  Read More

The Patient Protection and Affordable Care Act (ACA) has the potential to greatly increase the number of insured people and change how health care services are delivered. What the additional coverage will mean regarding access to providers, who those providers will be and what services they will deliver are issues that affect all segments of the health care workforce.  Read More