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Health Reform: Reinventing the Wheel, Health Affairs Blog, October 12th, 2006, and Comment

Excerpt: The American health care systems perform impressively, producing what they are designed to deliver: cost inflation, inefficiency, and inequity. [Alan Maynard writes on Porter and Teisberg's reinvention of the health care system wheel.]

Regarding the Recent Article on Massachusetts Health Reform: What Were They Thinking at Health Affairs?

Based on telephone surveys, the authors declare that RomneyCare 'continued to fare well in 2010.' This is an important finding, as the authors consider RomneyCare 'the template for the federal Affordable Care Act of 2010.' Unfortunately, in several cases the authors fail to inform readers that their results are contradicted by other, possibly more reliable, sources of information. They also neglect to put some of their results in proper context.

Testimony of IRS Commissioner Koskinen Before the Senate Homeland Security and Governmental Affairs Committee on Implementation of the ACA

"While the operation of these Marketplaces is overseen by the Department of Health and Human Services (HHS), the IRS has the limited role of providing Marketplaces with data and computational services for use in their determinations about eligibility for financial assistance.... The IRS, through this computational service, provides the Marketplace with a single figure: the maximum advance premium tax credit for which the applicant may be eligible based on those data inputs.... During the 2015 open enrollment period, the IRS processed more than 25 million requests for federal tax return data and more than 17 million computational requests, with an average IRS response time of less than five seconds."

Department of Veterans Affairs Leads in Changing the Telehealth Landscape

"As a general rule, most telehealth practitioners are required to comply with various and state-specific licensing, registration, and certification requirements in order to render health care services via telehealth ... [T]he VA is exercising its authority as a federal agency to preempt conflicting state laws relating to the practice of medicine or other health care services via telehealth."

Bloomberg Agrees to Buy Bureau of National Affairs for About $990 Million

BNA, which publishes the Daily Labor Report and U.S. Law Week, will 'significantly grow Bloomberg's presence in Washington' and its research will contribute to coverage and analysis of employment, health care, labor, accounting, intellectual property and telecommunications, Bloomberg said.

Leading ACA Columnist Passes Baton to New Author

"[Timothy Jost, in the Health Affairs Blog, chronicled] the development and eventual passage of the ACA. Then, he began doing [hundreds of] posts on the seemingly endless stream of rules, guidances, and other documents necessary to put the new law into action.... Tim will continue to write the monthly 'Eye on Health Reform' [column in] Health Affairs.... Katie Keith will [take over for Jost on the ACA column]."

Defined Contribution Health Insurance Products: Development and Prospects

From the Jan./Feb. 2002 issue of Health Affairs. Excerpt: In this paper we contrast several [Defined Contribution Plans, or DCPs] with respect to their characteristics and development processes ... The DCPs generally agree with this assessment and believe that they need to diffuse rapidly over the next three to five years, or they will be preempted by look-alike products offered by existing health plans. They have several factors in their favor.

The BPC Health Care Reform Plan: A Response to Coulam, Feldman and Dowd

"We commend Robert Coulam, Roger Feldman, and Bryan Dowd for bringing attention to competitive bidding in Medicare ... However, we believe the authors missed the mark in their recent Health Affairs Blog analysis of the Bipartisan Policy Center's (BPC) proposal. Most notably, they failed to consider the political realities surrounding competitive bidding.... We believe the BPC approach provides a stronger means to achieve key goals of premium support -- increased competition and promoting the creation of more integrated systems of care -- by not focusing exclusively on competitive bidding and including other significant reforms."

Implementing Health Reform: Data Hub Security and Other Issues

"The hub will verify data provided by applicants against information in existing and secure federal and state databases, such as those of the [IRS], [SSA], the Department of Veterans Affairs, Medicare, and others. It will provide one highly secure connection to these databases rather than requiring each exchange to set up its own connections. The hub has several levels of protection to mitigate security risks. It employs a continuous monitoring model to rapidly identify and take action against irregular behavior and unauthorized system changes that could indicate a potential incident."

Solving The Challenges Of Employee Health Benefits: The North Carolina State Health Plan Story

"Covering a little more than 750,000 lives, the [North Carolina State Health Plan (SHP)] spends between plan costs and employee contributions nearly $4.5 billion annually ... [The SHP] faces an estimated deficit of greater than $500 million for Calendar Year (CY) 2026 and a total projected deficit of $949 million by the end of CY2027. In this article, [the authors] review the challenges that drove the fiscal instability of the North Carolina SHP.... [They] then describe the dynamic, market-driven tools that we are applying to efficiently and effectively control costs with sensitivity to the varied needs of more than 750,000 SHP members."