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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]."

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."

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."

Combining Premium Tax Credits and Health Reimbursement Accounts for Small Businesses

"[The authors] propose a way to connect premium tax credits with health reimbursement arrangements for small businesses that have long struggled to offer health benefits. It would blend the competing health tax proposals -- tax-preferred accounts and credits -- through changes to qualified small employer health reimbursement arrangements (QSEHRAs).... This proposal would harmonize premium tax credits and tax-preferred accounts while maximizing small business workers' tax benefits and choices."

Reducing Spending and Enhancing Value in U.S. Health Care: Reflections on the GAO Report

"[A recent GAO report's] recommendations were structured around five pre-identified areas of potential reform: strengthening primary care; expanding the health care workforce; reforming pricing to better align with high value care; revising Medicare physician payments; and mitigating anticompetitive actions and practices.... [The authors] the areas []they] believe are most critical for policymakers to consider and offer new insights that have gained salience given shifts in the policy landscape since the forum was conducted."

Transparency Reveals Health Care Prices -- and a Billing and Payments System in Need of Overhaul

"To anyone who has peered into the machine-readable files (MRFs) mandated by price transparency rules or simply been on the receiving end of multiple bills and inexplicable explanation-of-benefits statements, it's clear that the health care industry does not strive for the relatively efficient, consumer friendly approach to pricing and payments practices found, for example, in the airline and cell phone industries.... To tackle this complexity, price transparency policies should be closely followed by additional 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."

National Health Expenditure Projections, 2024-33: Despite Insurance Coverage Declines, Health to Grow as Share of GDP

"National health expenditures are projected to have grown 8.2 percent in 2024 and to increase 7.1 percent in 2025 ... During the period 2026-27, health spending growth is expected to average 5.6 percent ... Each year for the full 2024-33 projection period, national health care expenditure growth (averaging 5.8 percent) is expected to outpace that for the gross domestic product (GDP; averaging 4.3 percent) and to result in a health share of GDP that reaches 20.3 percent by 2033 (up from 17.6 percent in 2023)."

The Journey Toward Mental Health Parity: Persistent Challenges and New Roadblocks

"Over the last several decades, Congress has, on a bipartisan basis, sought to given federal officials the authority and the tools to ensure mental health parity, which requires health plans that cover mental health and substance use care benefits do so at the same level as physical health care benefits.... [R]ecently the Trump Administration has taken specific steps that will most certainly undermine mental health parity. This should be troubling for anyone who has a family member or friend with mental illness -- an illness that occurs in more than 1 in 5 U.S. adults."

To Promote Health Through Wearables, Embed Them in New Payment Models

"Historical experience within and beyond health care teaches that to maximize potential benefits, technological advancements must go beyond point solutions -- that is, tools meant to solve specific, narrow problems -- and occur within systems-level change.... This insight -- that point solutions are likely to underperform their potential without complementary systems redesign -- underscores the need to not only encourage adoption of wearable devices but also reform the systems surrounding their use."