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Issue Briefs

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Adobe Acrobat PDF Public Health Prevention Efforts: Saving Lives, Saving Money?, Public_Health_Prevention_Efforts_Issue_Brief_115.pdf

10/29/2012: This issue brief examines chronic conditions as the biggest driver of health care costs, and the potential help of community intervention. Obesity, for example, is closely associated with several chronic conditions, and diabetes and other chronic conditions can often be prevented or delayed by addressing health-related behaviors such as smoking, physical inactivity and poor diet. The briefs draw from information presented from a recent Alliance congressional briefing: Chronic Disease Prevention: Saving Lives, Saving Money, July 13, 2012. Webcast of the briefing available at: http://www.kff.org/ahr071312.cfm

 

Adobe Acrobat PDF Oral Health and the Affordable Care Act: Only Part Way to the Finish Line, Oral_Health_Issue_Brief_116.pdf

10/29/2012: Oral Health and the Affordable Care Act: Only Part Way to the Finish Line, identifies provisions in the Patient Protection and Affordable Care Act that expanded dental coverage, primarily for kids, and called for education. But some provisions in the law have gone unfunded. Many adults currently lack dental coverage, and minorities and poor people are at the highest risk for disease. Some states are considering legislative proposals to train less expensive mid-level practitioners – somewhere between dentists and hygienists – to be able to do more. The briefs draw from information presented from a recent Alliance congressional briefing: Oral Health: Putting Teeth into the Health Care System, August 17, 2012. Webcast of the briefing available at: http://www.kff.org/ahr081712.cfm

 

Adobe Acrobat PDF Cost Drivers in Health Care, Cost_Drivers_in_Health_Care_109.pdf

4/1/2012: This issue brief catalogues cost drivers in health care. It is not a formal review of the literature, or evaluative in any sense; it simply attempts to capture and catalogue the variety of factors that have been identified without comment on the merits, the interactions, or in some cases, the conflicting views about the factors cited.

 

Adobe Acrobat PDF Preventing Chronic Disease: The New Public Health, Preventing_Chronic_Disease_New_Public_Health_108.pdf

9/1/2011: The U.S. is facing an epidemic of chronic disease at the same time as it's facing tough decisions on where to spend limited public health dollars. This issue brief spotlights community programs shown to help reduce chronic disease. Written by Joanne Silberner, formerly of NPR, and supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Improving Health Care Quality Through Community Collaboratives, Improving_Health_Care_Quality_Through_Community_Collaboratives_107.pdf

8/18/2011: The latest Alliance issue brief reports on how collaboratives are working at the local level to improve care in ways tailored to each community’s needs. Written by Deanna Okrent of the Alliance and supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Health Care Workforce: Future Supply vs. Demand, Health_Care_Workforce_104.pdf

4/19/2011: The physician and nurse shortage is plain to see, especially in certain parts of the country. But experts disagree on how best to fix this problem. Enlarge medical school class size? Create more residency slots? Let nurse practitioners and physicians assistants have more authority? This issue brief explores many options for growing the health care workforce, including those in the Affordable Care Act. Written by Deanna Okrent of the Alliance and supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Implementing Health Reform - Employer & Consumer Issues, Implementing_Health_Reform_Employer_and_Consumer_Issues_101.pdf

12/2/2010: The new health reform law contains a smorgasbord of provisions affecting how employers offer health coverage and how consumers buy coverage. This issue brief offers an overview of both. Written by Andy Miller, editor and CEO of Georgia Health News, and supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Implementing Health Reform - Employer & Consumer Issues - with endnotes, Employer_and_Consumer_Issues_with_endnotes_102.pdf

12/1/2010: This text version of the issue brief includes extensive endnotes.

 

Adobe Acrobat PDF Implementing Health Reform - Federal Rules and State Roles, Implementing_Health_Reform_-_Federal_Rules_and_State_Roles_100.pdf

10/14/2010: Implementing the new health reform law falls in large measure to the federal government. But all 50 states and the District of Columbia have responsibilities under the new law. This issue brief describes how federal and state government efforts will mesh, and some key tasks to be performed by each. Written by Deanna Okrent of the Alliance and supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF The Future of Children's Health Coverage, The_Future_of_Childrens_Health_Coverage_98.pdf

6/8/2010: This issue brief details the children's coverage expansions in the new health reform law and also the law's potential to strain existing coverage programs for children. Written by Lisa Swirsky of the Alliance for Health Reform and supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF How Well Have Lessons Learned from Clinton-Era Health Reform Been Applied to Today's Reform Effort?, Applying_1993-94_Health_Reform_Lessons_Learned_96.pdf

3/17/2010: How well have Obama-era health reformers applied lessons learned from the failure of reform in 1993-94? Experts who were active in health issues on Capitol Hill during the Clinton Administration offer their thoughts.

 

Adobe Acrobat PDF Rural Health and Health Reform, Rural_Health_and_Health_Reform_94.pdf

1/6/2010: Health care delivery poses unique challenges in rural communities. Provider shortages are particularly acute. Unemployment rates are higher and private insurance rates are lower in rural areas than elsewhere. Do the health reform bills in Congress adequately address the needs of rural areas? A new issue brief from the Alliance for Health Reform offers some insights. Written by Deanna Okrent, Alliance senior health policy associate, and supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Access to Care: Beyond an Insurance Card, Access_to_Care_92.pdf

11/5/2009: If tens of millions of American gain health coverage, can the current health system meet the new demand? This issue brief looks at why so many now live in physician shortage areas, and what can be done to help ensure access to care after reform. Written by Deanna Okrent, Alliance senior health policy associate. Supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF The Case for Prevention - Tales from the Field, The_Case_for_Prevention_90.pdf

9/30/2009: This issue brief offers an overview of disease prevention strategies, including examples of federal and state efforts. Includes a box on why the Congressional Budget Office declines to attribute savings to prevention programs. Sponsored by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Health Information Technology: More Than the Money, Health_Information_Technology_More_Than_the_Money_86.pdf

10/21/2008: Some health policy analysts believe that the main importance of health information technology lies in its potential for improving health care quality and reducing disparities. This issue brief explores the quality improvement aspects of health IT, and some barriers to its wider adoption. Supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Comparative Effectiveness: Better Value for the Money?, Comparative_Effectiveness_Better_Value_for_the_Money_84.pdf

8/8/2008: Comparative effectiveness research offers the attractive prospect of cutting costs while improving the quality of health care. What exactly do comparative effectiveness studies compare? What research of this type is already underway in the U.S. and in other countries? What could we do to stimulate more of it? This issue brief, written by Alliance senior health policy associate Lisa Swirsky, addresses these questions and others. Sponsored by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Employer-Sponsored Coverage: Shape It Up? Ship It Out?, Employer-Sponsored_Coverage_83.pdf

4/29/2008: Employer-sponsored coverage rates have been steadily falling, from 68 percent of non-elderly Americans in 2000 to 62 percent in 2006. Experts cite rising premium costs and workforce changes as factors driving the erosion in such coverage. A new Alliance issue brief, funded by the Robert Wood Johnson Foundation, offers perspective on why this trend is happening and how alarmed we should be. Funded by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Lessons Learned: The Health Reform Debate of 1993-94, Health_Reform_Debate_of_1993-94_81.pdf

4/22/2008: No matter who wins the White House and control of Congress in November, health reform legislation will likely be a front-burner issue for both the House and Senate in 2009. The debates about reform and the behind-the-scenes meetings of 1993 and 1994 produced a wealth of knowledge on what should be done differently the next time Congress and the White House take up this issue. This issue brief, funded by the Robert Wood Johnson Foundation, recounts nine lessons learned as recalled by veterans of both sides of the aisle and the administration.

 

Adobe Acrobat PDF Changing the Nursing Home Culture, Changing_the_Nursing_Home_Culture_79.pdf

3/1/2008: About a third of those turning 65 in 2010 will need nursing home care during their lifetimes. Yet so many people dread the thought of spending their last days or years in a nursing home. This is because many people aren’t aware of the creative alternatives being developed for those needing such care – facilities such as “Green Houses” that are resident-centered, less institutional and more home-like. This issue brief addresses the challenges being faced by those trying to change the nursing home culture, and some of their successes. Supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Rebuilding Louisiana's Health Care System, Rebuilding_Louisianas_Health_Care_System_66.pdf

7/26/2007: Though the Katrina flood waters have long since receded, the debate continues over how to restore – or even improve – Louisiana’s devastated health care system. This issue brief covers the health care problems still facing the city and proposed solutions. Supported by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Long-Term Care Partnerships: An Update, Long_Term_Care_Partnerships_53.pdf

3/15/2007: Long-term care partnerships offer states a way to encourage the purchase of private long-term care insurance and, it is hoped, relieve some of the financial pressure on Medicaid. This issue brief reports on the rationale behind the partnership programs, results so far and issues going forward. Funded by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Linking Providers Via Health Information Networks, pub_39.pdf

12/21/2006: As many as 98,000 Americans die each year due to preventable medical mistakes. Health information technology could help reduce mistakes, but adoption by health care providers has been slow. This issue brief describes what's needed to link providers via information networks, and what barriers must be overcome. Funded by the Robert Wood Johnson Foundation.

 

Adobe Acrobat PDF Racial and Ethnic Disparities in Health Care, pub_38.pdf

11/3/2006: Racial disparities are a persistent problem in the U.S. health care system. This four-page issue brief reviews the types of disparities that minority populations face, some programs underway to reduce disparities, and proposals for future action. Also included is a list of expert sources with telephone numbers, and helpful websites. Funded by the Robert Wood Johnson Foundation.

 

Word Document HSA's and High Deductible Health Plans, with endnotes, pub_24.doc

4/1/2006: Microsoft Word text of issue brief, with endnotes and links to most resources cited.

 

Adobe Acrobat PDF Cash & Counseling Moves Into the Mainstream, pub_2.pdf

4/1/2006: "Cash and Counseling" is a way of allowing individuals receiving personal assistance services through Medicaid to have more control over the services they get and who provides them. This issue brief describes how the program works and cites results of a three-state demonstration project.

 

Adobe Acrobat PDF HSAs and High-Deductible Health Plans: A Primer, pub_3.pdf

4/1/2006: Health savings accounts (HSAs) linked to high-deductible health plans form the leading edge of the consumer-directed health care movement. HSAs got a boost when President Bush promoted them in his 2006 State of the Union address. This issue brief covers HSA basics, history, arguments raised for and against them, and a forecast of their impact on health insurance markets and consumer behavior.

 

Adobe Acrobat PDF SCHIP and Medicaid Enrollment: What's Next?, pub_6.pdf

4/1/2006: The State Children's Health Insurance Program (SCHIP) has been quite successful, with a monthly average of 4.2 million children covered by the program in 2005 -- double the figure in 2000. Likewise, the number of children covered by Medicaid has climbed steadily. But the job of signing up all eligible children for these two programs is far from complete. This issue brief documents the successes and challenges of SCHIP and Medicaid as congress gears up to consider the future of SCHIP in 2007. (For a Microsoft Word version with endnotes and links to most sources used in writing this issue brief, go to http://www.allhealth.org/publications/pub_20.doc).

 

Word Document SCHIP and Medicaid Enrollment, with endnotes, pub_20.doc

4/1/2006: Microsoft Word text of issue brief, with endnotes and links to most resources cited.

 

Word Document Cash and Counseling, with endnotes, pub_21.doc

4/1/2006: Microsoft Word text of issue brief, with endnotes and links to most resources cited.

 

Word Document Pay-for-Performance, with endnotes, pub_22.doc

2/1/2006: Microsoft Word text of issue brief, with endnotes and links to most resources cited.

 

Adobe Acrobat PDF Pay-for-Performance: A Promising Start, pub_4.pdf

2/1/2006: "Pay-for-Performance" programs attempt to reward quality health care by setting different payment levels for providers based on how well they meet benchmarks for quality and efficiency. More than 100 pay-for-performance programs were up and running in the U.S. as of September 2005. This issue brief describes how the programs work, why they were established and what challenges need to be addressed going forward.

 

Adobe Acrobat PDF The Uninsured and Rising Health Costs, pub_5.pdf

1/2/2006: Several reports in 2005 documented the increase both in health care costs and the number of uninsured. This issue brief ties together these two issues, focusing on who is losing and who is gaining health coverage, and how employers and governments are responding to rising costs.

 

Word Document The Uninsured and Rising Health Costs, with endnotes, pub_23.doc

1/2/2006: Microsoft Word text of issue brief, with endnotes and links to most resources cited.

 

 


Uwe Reinhardt Questions Bundled Payment Savings Prospects


Video (2:58)

A new Alliance for Health Reform video features Princeton’s Uwe Reinhardt questioning whether bundling payments for medical services might actually lead to higher – not lower – costs.

"The ACO's, the accountable care organizations, could create local monopolies that could dictate to you what that bundled price would be, and some of us fear that bundled prices might be even more than what the fee-for-service for that bundle would be today. … You really should align all the payers and say, 'Let us jointly negotiate with the ACOs what those bundles should be so that they cannot divide and rule and sort of make us on the buy side weak.'"

FULL TRANSCRIPT

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Sister Carol Keehan on Health Law Enrollment Challenges this Year


Video 3:00

A new Alliance for Health Reform video features Sister Carol Keehan of the Catholic Health Association of the United States addressing the challenges of quickly enrolling millions of Americans for health insurance this fall. Open season begins October 1 of this year, yet she says that up to 85 percent of those who will be newly eligible for Medicaid or for subsidies to buy private insurance in state-based exchanges don't know it.  FULL TRANSCRIPT

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Jonathan Blum on CMS Efforts to Keep Medicare Spending Growth Down


Video (2:54)

Jonathan Blum, acting principal deputy administrator and director of the Center for Medicare at the Centers for Medicare and Medicaid Services (CMS), addresses the slower growth of Medicare spending over the last few years, and what his agency is doing to try and continue the trend. “There are promising signs that this strategy to change the payment system, to change the payment models, to focus on waste and abuse, is paying off," he said. "We are taking a whole new approach to addressing fraud in the program. Much more data resources, much more on the ground reaction. We have seen dramatic spending declines in areas of spending, such as home health and durable medical supplies that historically fueled lots of the fraud.”  FULL TRANSCRIPT

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Two Former Medicare Administrators Discuss How to Save the Program


A new Alliance for Health Reform video features two former Medicare administrators -- Gail Wilensky and Bruce Vladeck -- on their ideas about how to save the program.

Ms. Wilensky, who ran Medicare in a Republican administration, argued for increasing the eligibility age of Medicare for future retirees, while still making the program available at age 65 for those who are disabled.

Watch at http://www.youtube.com/watch?v=GQjsfam9-w0

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Douglas Holtz-Eakin: Health Care Spending Lull Only Temporary


Video (3:11)

A new Alliance for Health Reform video features Douglas Holtz-Eakin of the American Action Forum, and a former director of the Congressional Budget Office, arguing that recent slower spending growth in health care won’t continue.

"We also saw a slowdown in the mid-90s, and we all declared victory and it came right back. I think next year we’ll see a noticeable uptick. There will be lots of new people entering the insurance markets because of the exchanges and the subsidies that come along with them, and those subsidies are very generous. … These are an invitation for people to get coverage and to buy more health care. I think that’ll place a lot of pressure on spending."

FULL TRANSCRIPT

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Marketplace Enrollment Helpers Toolkit


Beginning October 1, insurance marketplaces open for enrollment, and millions of people will be eligible to purchase plans. To guide them in the application process, the federal government has invested in programs to train community organizations and hired staff.

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The Employer Mandate of the Patient Protection and Affordable Care Act


The Toolkit, available here, details the ACA’s employer requirements and penalty. It also includes information about the delay in the mandate to 2015, and analysis about its impact on employer-based coverage.

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Toolkit: Training the Workforce for a Changing Health System


A new Alliance for Health Reform toolkit addresses concerns about whether newly-trained physicians are adequately prepared for today's evolving health care delivery system. Does training adequately emphasize care coordination, team-based care, costs of care, health information technology, cultural competence and quality improvement? Does it encourage students to practice in a primary care setting?

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Toolkit: Emergency Preparedness in the U.S.: The Ebola Threat


Is the U.S. prepared for a potential virulent pandemic? This new Alliance toolkit examines public health infrastructure, funding and policy levers that deal with these kinds of health crises in America.

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