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Brookings Institution Comments to HHS on Consolidation in Health Care Markets (PDF)

"[The authors] recommend that the agencies collect and make available systematic, high-quality data on the ownership structures of health care entities, with a particular focus on improving the data available on physician practices.... [CMS] should collect systematic data on physician practice ownership as part of the Medicare enrollment process, as it does for institutional providers.... CMS should take steps to improve the quality of entity-reported data."

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Brookings Institution Comment Letter to CMS on Federal Independent Dispute Resolution Operations (PDF)

"While reducing the cost of IDR is desirable ... changes like this may also encourage greater use of IDR, at least partially offsetting any savings from reducing the costs incurred per disputed service. The Departments' proposed changes may also disproportionately reduce the costs that providers bear in IDR, which may give providers more leverage in negotiations with insurers and raise negotiated prices."

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Brookings Institution Comments to CMS on the 2023 Notice of Benefit and Payment Parameters

"[The] letter urges CMS not to implement network adequacy standards related to emergency physicians because doing so would increase patient out-of-pocket costs and premiums without improving patient access."

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Testimony of the Brookings Institution at Senate Committee Hearing: 'How Prepared Are Americans for Retirement?'

"My testimony is in three parts. I first discuss the problem of low retirement savings and, secondly, I summarize relevant theories of saving that help to illustrate areas for improvement. In the final portion, I offer some specific policy recommendations based on my own work and that of my colleagues. In offering these recommendations, I seek to enhance the financial security of Americans in retirement."  MORE >>

Brookings Institution Recommends Shifting Retirement Tax Incentives to Lower-Income Households

"Federal tax subsidies for retirement savings should be redirected to get more people saving for retirement and other purposes, according to the Brookings Institution's Karen Dynan, vice president and co-director of economic studies.... Ms. Dynan also calls for providing more tax incentives for employers to offer retirement savings plans, including a bigger credit for startup costs, and an automatic individual retirement account program for employees."  MORE >>

An Interview with Brooks Hamilton Touching on ERISA and Pre-emption

Excerpt: BrightScope: Why do you think judges are 'ERISA novices' as you have indicated in your writings? Brooks Hamilton: Judges 'appear' to be ERISA novices at their very best, or so it seems to me. Some may indeed even have a heartfelt bias, or perhaps an honest predisposition regarding fundamental ERISA issues, which in the altogether render them fundamentally indifferent, if not viscerally opposed, to the fiduciary standards imposed by ERISA. It must be remembered that 'Trust law' as a descendant of the Common Law was not a basic part of federalism in the first place.  MORE >>

Urban-Brookings Tax Policy Center Says Health Care Tax Benefits Give High-Income Households a Boost

"About 85 percent of people in the top 20 percent of income get a tax cut because of health care-related tax spending ... Only about 12 percent of taxpayers in the bottom quintile have any income tax liability ... And because the income tax is progressive, the exemption is more valuable for taxpayers with higher incomes, because their tax rate is also higher[.]"

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Brookings Proposes Double Tax on 401(k) Contributions

"Because the tax incentive for retirement savings is a deferral, not a permanent exclusion, the proposal would more accurately be described as double taxation of contributions to retirement savings plans for anyone with a marginal tax rate of over 28%. You won't expand coverage by penalizing small business owners for offering a 401(k) plan."

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Brookings Institution Testimony Submitted to Hearing on Tax Reform Options: Promoting Retirement Security (PDF)

"My testimony discusses a proposal that would reform public policies toward retirement saving by replacing the current deduction for contributions to retirement saving accounts with a flat-rate refundable credit that would be deposited directly into the saver's account."  MORE >>

Transcript of Frontline Interview with Brooks Hamilton on Retirement Plans

Excerpt: Put in a 401(k) plan. ... The company's contribution generally was structured to be a match based on whatever the employee put in. They might say, 'You put in a dollar, we'll put in 50 cents.' Well, suddenly the company had a great deal to gain if not 100 percent of the people joined the 401(k) plan. They probably were only putting in 2 or 3 percent of payroll because not everybody was in the plan. ...  MORE >>

A New Take on Premium Trends Gets Pushback from ACA Critics

"Loren Adler and Paul Ginsberg of the Brookings Institution argue ... that premiums would have risen faster without the ACA -- and that the benefits are much more robust than in the old individual market. And that doesn't even take into account subsidies for premiums and, for many, cost sharing.... [C]ritics of the law ... point out that even if the Brookings numbers are right -- that this insurance is cheaper than such a policy would have cost pre-2014 -- it misses the point that a lot of people don't want this insurance."

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Proposed Pension Relief Legislation for Charities

"U.S. Reps. Susan Brooks (R-IN) and Ron Kind (D- WI) introduced bipartisan legislation to provide relief to non-profits such as local Girl Scout councils, which now have higher pension funding rules than taxable, for-profit companies.... The Charitable Pension Flexibility Act applies to charity pension plans with multiple entities that are exempt from normal pension funding rules until 2017. This straightforward bill would permit such plans to elect into the normal rules in 2014. A technical correction that previously passed the Senate would have permitted this same option."  MORE >>

Is It Time to Reform Executive Compensation and Stock Option Grants?

[Video.] "Governance Studies at Brookings hosted a forum on executive compensation practices and the links to economic vitality. A panel of experts discussed the changes in corporate pay since 1980 and how they have affected companies' long-term viability, as well as possible solutions that would encourage executives to focus on long-term business goals and growth."  MORE >>

How Mobile Devices Are Transforming Health Care

"[Mobile] technology is poised to alter how health care is delivered, the quality of the patient experience, and the cost of health care. Mobile technology is helping with chronic disease management, empowering the elderly and expectant mothers, reminding people to take medication at the proper time, extending service to underserved areas, and improving health outcomes and medical system efficiency. In this report, ... [Darrell M. West of the Brookings Institution] review adoption of innovative examples of m-health, its impact on service delivery and medical treatment, and how mobile devices are saving money in the health care system."  MORE >>

President's Budget Proposal Could Help Up to 78 Million More Workers to Save for Retirement

The new budget ... contains the Automatic IRA, which was developed by Brookings' Retirement Security Project in conjunction with The Heritage Foundation. This year's version includes an important change that will also encourage more employers to offer a 401(k) account to their workers.  MORE >>

Your Fiduciary Legacy (PDF)

4 pages. Excerpt: In this latest piece, [Brooks Hamilton] admonishes plan fiduciaries to consider the legacy that they will leave, and provides some excellent suggestions for radiating 'caring conduct and honorable stewardship'.  MORE >>

No Surprises Act Arbitration Databook

"This webpage provides data on how the IDR process is working, including estimates of the average prices emerging from IDR, qualifying payment amounts (QPAs) calculated by health plans, and comparisons of plan and provider offers, all expressed as percentages of Medicare’s payment rates for the same services. It also includes information on the characteristics of the providers and firms using the IDR process."  MORE >>

HIPAA Security Rule Cybersecurity Changes

"If the provisions of the Final Rule are substantially similar to those in the Proposed Rule, it would raise the bar for demonstrating compliance with the HIPAA Security Rule. Under the proposed framework, incomplete documentation or informal practices will be harder to defend, particularly where an entity cannot show consistent, enterprise-wide governance. Organizations with mature, well-documented security programs will be better positioned to adapt, while others may need to reassess foundational compliance structures."  MORE >>

FMLA and ADA Compliance Keys for Employers

"[1] FMLA and ADA overlap but serve different purposes ... [2] Why the ADA interactive process is required for accommodation requests ... [3] Rigid leave policies can create ADA liability ... [4] Why documentation is critical for FMLA and ADA compliance ... [5] When to err on the side of caution under FMLA and ADA."  MORE >>

Has the United States Bent the Health Care Cost Curve?

"The growth of health care spending in the United States seems to have permanently slowed thanks in part to technological advances making medical treatments cheaper and more effective ... The United States spent more than $5 trillion on medical care in 2024, or 18% of its gross domestic product (GDP). That's up a bit from 17.2% of GDP in 2010, but far below the 21.2% share of GDP -- nearly $1 trillion less -- forecast by government actuaries in 2010."  MORE >>