California Healthline: Road to Reform

If ACA Stands, What California Stands To Gain (or Lose)

Wed, 30 May 2012 08:00:00 GMT

The Supreme Court's ruling on ObamaCare is imminent, and most analysts have focused on what happens if the law gets struck down. Here's a reminder of what comes next if the law is allowed to stand.

Does Health Care's Profit Motive Hurt More Than it Helps?

Wed, 23 May 2012 08:00:00 GMT

The federal health care law has created a whole new set of financial incentives, and some less-appealing implications -- like several marketers pitching hospice care as a "cost-cutter" for hospitals -- are now coming to light.

Four Myths About ObamaCare That Just Won't Die

Wed, 16 May 2012 08:00:00 GMT

Has any piece of major legislation ever engendered as much misinformation? More than two years after the Affordable Care Act passed, both critics and supporters are still telling tall tales -- and coming up with new ones, too.

If Individual Mandate Is Overturned, States Still Have Lots of Options

Wed, 09 May 2012 08:00:00 GMT

As they await a ruling from the Supreme Court on the Affordable Care Act, state officials are weighing their options if the individual mandate is struck down. And there are a number of choices to consider.

'The Passage of Power' and the Passage of Medicare

Wed, 02 May 2012 08:00:00 GMT

A long-awaited biography of Lyndon Johnson goes inside White House strategy in the early 1960s. Does the battle to pass Medicare hold any lessons for today?

Advocates Hope ACA Will Knit Children's Patchwork

Wed, 25 Apr 2012 08:00:00 GMT

Hoping the Affordable Care Act will knit together a patchwork of protections, advocates for children's health coverage await the Supreme Court's ruling with an uncomfortable mixture of worry and optimism.

A Second Opinion on Medicare 'Double Counting'

Wed, 18 Apr 2012 08:00:00 GMT

Myth or fact: There's no such thing as an honest Medicare budget. Why the latest blow-up over health care accounting is symptomatic of a larger problem.

Health IT: The Common Ground in Health Care Reform?

Tue, 10 Apr 2012 08:00:00 GMT

Arguments inside and outside the Supreme Court building last month reaffirmed the nation's sharp divide over the federal health reform law. But one aspect of the law is likely to continue drawing support from both sides of the aisle: health information technology.

'We'll Deal With it Then': The State of Play if ACA is Struck Down

Wed, 04 Apr 2012 08:00:00 GMT

Most states -- even some that have sued the government over the Affordable Care Act -- are preparing contingency plans whether the law is upheld or struck down. But not all states are equally ready to respond.

Does Obama Deserve Blame for Mandate's Troubles?

Wed, 28 Mar 2012 08:00:00 GMT

Candidate Obama opposed health reform's individual mandate; President Obama signed the mandate into law. Why did the president shift his thinking -- and will the decision haunt his signature legislation?

Clues to How the Supreme Court Might Rule on Health Reform

Wed, 21 Mar 2012 08:00:00 GMT

The fate of the Affordable Care Act rests in the hands of the Supreme Court justices, who next week will hear oral arguments over three days. How the court might rule is a hot topic -- and several historic court decisions provide some hints as to which way the case will go.

On the Health Reform Trail: The Good, the Bad and the Ugly

Wed, 14 Mar 2012 08:00:00 GMT

At the two year anniversary of the Affordable Care Act, California has made significant progress in establishing an insurance exchange and undertaking other provisions of the law. However, the road ahead is marked by uncertainty, and California must meet more challenges before the job is done.

Health Care Reform Driving Physicians Together

Wed, 07 Mar 2012 08:00:00 GMT

Hospitals increasingly are employing physicians, while independent doctors are teaming up to jointly contract with health insurers -- driven in large part by the Affordable Care Act. Both trends have led to larger provider networks, though the effect on health care costs is not yet clear.

Are ACOs Casting a Wide Net for Patients?

Wed, 29 Feb 2012 08:00:00 GMT

With the launch of the Pioneer Accountable Care Organization Model in January, health care provider organizations have been working to build their patient bases. Early signs point to a heated competition among Pioneer ACOs to attract a diverse population now in order to reap financial benefits in later years.

Assessing the First Year of CMS' New Innovation Center

Wed, 22 Feb 2012 08:00:00 GMT

In a report released earlier this month -- "One Year of Innovation: Taking Action to Improve Care and Reduce Costs" -- the CMS Innovation Center summarizes what it's been up to in its first year of existence: 16 initiatives involving more than 50,000 health care providers in all 50 states.

Making a Place for Small Businesses in Exchanges

Wed, 15 Feb 2012 08:00:00 GMT

Health insurance exchanges for small businesses are set to go online in 2014, alongside state-based exchanges for the individual market. Recent research shows that the success of the so-called Small-Business Health Options Program will be based on whether it can offer more plan choices and contain costs.

State Choices on Essential Benefits May Become More Complicated

Wed, 08 Feb 2012 08:00:00 GMT

Stakeholders are responding to HHS' recent bulletin giving states a large hand in determining "essential health benefits" to be offered through insurance exchanges in 2014. In California, officials are trying to determine how to handle a growing list of state-mandated benefits within the exchanges.

Why We Can't Get National Malpractice Reform

Wed, 01 Feb 2012 08:00:00 GMT

National medical malpractice reform has been stalled for years, and a newly released White House memo helps underscore why federal efforts have been a non-starter.

State of the Union: Time To Trim the Regulatory Fat in Health Care?

Wed, 25 Jan 2012 08:00:00 GMT

President Obama scarcely mentioned health care in last night's speech -- and perhaps that's more of a metaphor than the president intended. In keeping with the Obama administration's efforts to cut through "red tape," efforts are growing to rein in federal health care regulations.

It May Be Time 'To Take the Pain' on Medicaid

Wed, 18 Jan 2012 08:00:00 GMT

New Kaiser Family Foundation data illustrate the rise in Medicaid enrollment and lawmakers' continuing struggle to control costs. Budget battles in Washington state, not Washington, D.C., may show the future of the program: stark efforts to slow utilization.

Four Resolutions We Hope Lawmakers Will Keep This Year

Wed, 11 Jan 2012 08:00:00 GMT

The Republicans have promised a replacement for the health reform law. The Democrats had planned a payment advisory panel. Both parties want a "doc fix." Will this be the year lawmakers stick to their promises?

New Year, New Deals? Breaking Down Health Plan, Doctor Alliances

Wed, 04 Jan 2012 08:00:00 GMT

Is California driving the next health care earthquake? A striking batch of insurers and physician groups are teaming up -- and shaking up the industry -- with the Golden State at the epicenter.

Five Health Care Issues To Watch in 2012

Wed, 21 Dec 2011 08:00:00 GMT

Mark your calendars: A slew of ACA-related payment reforms, health IT changes and health insurance exchange updates will debut next year -- even as constitutional questions over the law come to an end. (Maybe.)

Politics Have Always Been Part of Policy -- but Have We Hit a New Low?

Wed, 14 Dec 2011 08:00:00 GMT

Berwick's out. Overruling the FDA is in. A flurry of recent headlines recall another moment when politics and health policy collided and set the nation on a new course.

What a Waste: Why We Can't Rein In Extra Health Spending

Wed, 07 Dec 2011 08:00:00 GMT

Don Berwick took a parting shot at the waste in the U.S. health system as he stepped down at CMS, reinvigorating a question as old as Medicare: Why isn't our system more efficient?

For Mentally Ill, Home Is Where the Health Home Pilot Is

Wed, 30 Nov 2011 08:00:00 GMT

Which grant was buried in the week's news? Rhode Island won a big award for its health insurance exchange efforts, but a second CMS announcement -- that the Ocean State was approved for a Health Home Medicaid project -- could have major implications for mental health care.

Dueling Polls Offer Alternative Reform Opinions

Wed, 23 Nov 2011 08:00:00 GMT

Two polls released last week offered conflicting views of public opinion on health care reform. Coming in the same week the Supreme Court announced it would hear reform arguments, the polls also raise a couple of questions: How much influence does public opinion have on the Supreme Court? And vice versa?

Healthy San Francisco's Lessons for National Health Reform

Wed, 16 Nov 2011 08:00:00 GMT

It has an employer mandate. It has improved access to care. It has survived a Supreme Court challenge. So, why aren't national health policy leaders paying more attention to Healthy San Francisco?

Five Key Lines in the Circuit Court Rulings on Reform

Wed, 09 Nov 2011 08:00:00 GMT

Questions about the Affordable Care Act's constitutionality took center stage again this week, as a fourth appeals court rendered its decision and the Supreme Court prepares to conference on whether to take the case.

Follow the Money: How Industry Is Lobbying To Preserve Reform Law

Wed, 02 Nov 2011 08:00:00 GMT

New reports on health sector lobbying reveal that the industry continues to donate generously to President Obama and Democrats, despite public criticism of last year's health reform law.

When a Law Loses Its Teeth, Can the Reform Still Bite?

Wed, 26 Oct 2011 08:00:00 GMT

After months of industry criticism, CMS' accountable care organizations are winning plaudits after the agency made the program less intimidating for participants. Some suggest that will make ACOs less effective tools of reform, too.

As Health Jobs Grow, a Prescription for Smart Growth

Wed, 19 Oct 2011 08:00:00 GMT

Health care is facing a different kind of jobs debate. The sector has added more than one million jobs since the Great Recession began, but analysts warn that the jobs growth masks major concerns about labor productivity.

Why the 'Moneyball' Approach Isn't a Home Run for Health Care

Wed, 12 Oct 2011 08:00:00 GMT

Billy Beane's data-driven strategies made him the talk of baseball, the king of the current box office and a highly visible advocate for evidence-based medicine. But Beane's teams have faded since their "Moneyball" heyday -- and evidence-based medicine might not be the home run that some reformers hope it will be.

The Benefits of Changing Medicare's Drug Benefit

Wed, 05 Oct 2011 08:00:00 GMT

Medicare Part D is Exhibit A in how a health reform can evolve from partisan legislation to beloved protection. Aware of the drug benefit's popularity, but facing real fiscal concerns, lawmakers are broaching delicate changes to the program.

Our Sidneys: The Six Key Studies That Shook Up the Summer

Wed, 28 Sep 2011 08:00:00 GMT

With a nod to David Brooks' annual awards in the New York Times, "Road to Reform" highlights our own Sidney Awards, named for Kaiser Permanente's co-founder. Here are six major health policy studies that changed the course of conversation this summer.

Reform's Unanswered Question: To Trim or Transform Medicare?

Wed, 21 Sep 2011 08:00:00 GMT

More cuts to Medicare are looming, just months after the Affordable Care Act sliced billions in program spending. Whether the new changes will be sweeping or merely substantive remains to be seen.

What Texas Can Teach California About Health Care Reform

Wed, 14 Sep 2011 08:00:00 GMT

Texas' hands-off approach to its health care safety net can offer takeaways for California, either as a hard lesson for the cash-strapped Golden State -- or as an example of what not to do.

FTC Emerges as Another Obstacle to Health Reform Law

Wed, 07 Sep 2011 08:00:00 GMT

The Affordable Care Act pushes new efforts at health care provider integration, like accountable care organizations, that may lead to more market concentration. The Federal Trade Commission is stepping up efforts to stop provider consolidation. Which approach will win out?

Bundled Payments and the Scars of Capitation

Wed, 24 Aug 2011 08:00:00 GMT

Health care organizations are grappling with a new CMS plan to realign payment along episodes of care. California's experience with capitation and other payment models will give state providers a unique vantage point on the initiative.

Did the Democrats Miss Chance To Protect Reform Law?

Wed, 17 Aug 2011 08:00:00 GMT

The 11th Circuit Court's decision to strike down the Affordable Care Act's individual mandate raises questions for the law's future, but also its past. Could the White House have better constructed its sweeping health law to avoid constitutional challenges?

Fixing U.S. Workforce May Be a Job for ... Health Reform

Wed, 10 Aug 2011 08:00:00 GMT

Health care remains the standout amid the nation's flagging jobs numbers. Do the sector's latest employment figures put to rest the "job-killing ObamaCare" argument once and for all?

Remember the Co-Ops? Overlooked Plan Raises Questions

Wed, 03 Aug 2011 08:00:00 GMT

Two years after lawmakers and activists battled over the fate of the public option, its erstwhile replacement -- a plan to create health cooperatives -- was finally unveiled last month.

Ranking the Reforms at Risk in a Deficit Deal

Wed, 27 Jul 2011 08:00:00 GMT

As the nation's leaders lurch toward a deal to cut the deficit, lawmakers have floated a range of possible health care cuts. Here's a list of potential programs and reform initiatives that are most at risk in the current negotiations.

The Afterlife of 'Death Panels' Still Haunts Health Reform

Wed, 20 Jul 2011 08:00:00 GMT

False accusations that the health reform law would spawn "death panels" continue to cause political problems. A renewed push to strike down the Independent Payment Advisory Board relies on similar claims of government rationing.

Will 'Most Important Study in Decades' Matter for Reform?

Wed, 13 Jul 2011 08:00:00 GMT

Although Medicaid is set to be the backbone of the Affordable Care Act's health coverage expansion, the program is beset by criticism from conservatives. Health policy experts hope that a once-in-a-generation study will strengthen the case for preserving the program.

Four Rules and Regs Health Policy Experts Can't Wait To Read

Wed, 06 Jul 2011 08:00:00 GMT

Health policy experts list the upcoming rules and regulations that have the potential to shape the industry, such as proposals to implement health reform provisions like state health insurance exchanges and accountable care organizations.

Unsolved Mystery: Could Secret Shoppers Have Helped Reform Law?

Wed, 29 Jun 2011 08:00:00 GMT

The Obama administration's plan to use mystery shoppers to gauge physician wait times was abruptly killed on Tuesday. Health policy experts sleuth out why the program met its sudden end and whether it will hurt health reform implementation.

Accounting for the ACO Backlash by Recounting DRG Fight

Wed, 22 Jun 2011 08:00:00 GMT

All kinds of health care stakeholders seem to agree: CMS' proposed ACOs are profoundly disagreeable. But is this criticism truly new or just providers' traditional resistance to federal efforts to overhaul health care payment?

Are Legal Challenges to Reform Actually Making it Stronger?

Wed, 15 Jun 2011 08:00:00 GMT

Opponents of health reform rushed to challenge the law in court -- but the flurry of anti-overhaul cases may have helped the government build its own case to defend it. Lawyers explain the Obama administration’s rare approach to the unprecedented legal battle.

Insurers Flip the Script: Making Sense of Givebacks

Wed, 08 Jun 2011 08:00:00 GMT

Blue Shield of California pledged to cap its income. Aetna requested to cut its premiums in Connecticut. The moves aren't unprecedented. But will they set a precedent?

Next Political Battle Brewing on Medicaid Messaging

Wed, 01 Jun 2011 08:00:00 GMT

Democrats have seized on Republicans' planned reforms to Medicare, using the issue to frame their deficit reduction talks and as a starting point for political campaigns. While the GOP's Medicaid proposal has drawn less scrutiny, advocates are expected to focus on threats to the program's funding in the coming weeks.

The Other Republican Health Reformer

Wed, 25 May 2011 08:00:00 GMT

As governor, one GOP presidential candidate oversaw dramatic health reforms in his state. His name? Tim Pawlenty.

Why Nursing Homes Want To Waive Goodbye to Reform Law

Wed, 18 May 2011 08:00:00 GMT

Should health care workers get adequate health care -- or should nursing homes be exempt from the health reform law? Long-term care providers test the boundaries.

Sequels to ObamaCare: ScottCare, ShumlinCare and More Take Stage

Wed, 11 May 2011 08:00:00 GMT

As states implement the federal health care law, three new governors are carrying out bold health reforms of their own -- and possibly setting a template for similar decisions across the nation.

Don Berwick Wants You To Judge the Quality, Not Quantity, of His Service

Wed, 04 May 2011 08:00:00 GMT

Much of the news coverage -- and political debate -- on the federal health care overhaul has focused on long-term changes to health coverage. Although CMS head Don Berwick's full quality agenda has received less of the spotlight, his plans are intended to immediately affect millions while saving billions.

Medicare's Old Age Problem Is New Again

Wed, 27 Apr 2011 08:00:00 GMT

Is 67 the new 65? Republicans have again proposed hiking Medicare's eligibility age as a gambit to extend program solvency. Some have championed the plan, but many policy analysts -- and much of the public -- are resisting the idea.

Insurance Agents Try To Broker Deal on MLR

Wed, 20 Apr 2011 08:00:00 GMT

Few stakeholders have been as quickly affected by the health reform law as insurance brokers -- and few have pushed back against the law as speedily. Brokers' battle to change medical-loss ratio rules is a microcosm of the broader fight to shape the overhaul's implementation.

Taking Stock of Three Major Health Reform Laws on Their Birthdays

Wed, 13 Apr 2011 08:00:00 GMT

Last year's federal health overhaul, the Massachusetts health reform law and the groundbreaking EMTALA all marked significant anniversaries in recent weeks. "Road to Reform" looks back on how the laws affected the nation's health policy -- and each other.

Paul Ryan's Radical Plan To Reform Medicare not so Radical

Wed, 06 Apr 2011 08:00:00 GMT

While Republicans' plan to transform Medicare into a voucher program is being hailed as groundbreaking, the model has been floated for decades. Here's a look back at the history of Medicare vouchers -- and what makes Ryan's plan different.

How March Madness Can Help Explain Health Reform

Wed, 30 Mar 2011 08:00:00 GMT

The constitutional battle over health reform shares unusual parallels with the nation's college basketball tournament. Here's a scouting report as the legal fight moves to the next round of courts.

Overlooked but Not Forgotten: Three Lesser-Known Reforms

Wed, 23 Mar 2011 08:00:00 GMT

The first anniversary of the federal health care law is drawing attention to its major changes. Here are three under-the-radar reforms that also will shape health care practice.

California's Hospital Systems Try To Be Accountable

Wed, 16 Mar 2011 08:00:00 GMT

Three major California health systems are embarking on transformative changes ahead of the federal health law's major payment reforms. Sutter Health, Sharp HealthCare and Scripps Health all are eyeing a range of new opportunities -- and challenges -- that lie ahead.

Do Health Insurers Deserve the Latest Public Hit?

Wed, 09 Mar 2011 08:00:00 GMT

As California health insurers announce a slew of rate hikes, a new report criticizes insurers' profits and suggests that the federal health reform law remains imperative to tamping down rising premiums.

President's First Major Reform to Reform Law May Be DOA

Wed, 02 Mar 2011 08:00:00 GMT

President Obama now backs an effort to let states opt out of significant elements of the health reform law sooner than currently allowed. However, the president's decision to concede an aspect of his overhaul may not be much of a concession, as the legislation is unlikely to pass.

Altered States: Paths to Reform Increasingly Diverge

Wed, 23 Feb 2011 08:00:00 GMT

Governors in Wisconsin, Alaska and Massachusetts are forging unique paths to custom fit health reform around their budget pressures and existing overhauls. The three states may serve as templates -- or outliers -- as the rubber starts to hit the road to reform.

What Does Obama's Budget Hold for Health Reform?

Wed, 16 Feb 2011 08:00:00 GMT

President Obama's proposed budget would ramp up federal spending on the health reform law in an effort to help carry out its provisions. The proposal has renewed GOP criticism that the White House is overextending the government's role in health care and is pushing off hard choices on health costs.

One Small Judicial Step, One Giant Leap for Mandate?

Wed, 09 Feb 2011 08:00:00 GMT

Concerns about the health reform law's legality have coalesced around the controversial individual mandate. A Florida judge's decision to void the entire law based on the mandate may accelerate plans to find a replacement provision.

When Health Repeal Was 'Catastrophic'

Wed, 02 Feb 2011 08:00:00 GMT

Talk of rolling back the Patient Protection and Affordable Care Act is dominating the news, but this isn't the first time that Congress has weighed suddenly overturning a major health law. Does the battle over the 1988 Medicare Catastrophic Coverage Act -- and its repeal 17 months later -- hold any lessons for today?

And the State of Our Health Reform Is ...

Wed, 26 Jan 2011 08:00:00 GMT

Did the State of the Union hold any surprises for health reform? The health care law was more than a bit player in President Obama's address, but what unfolded on Tuesday night's national stage paled next to what's transpiring in Congress this week.

Who Wins if Republicans Repeal Health Reform Law?

Wed, 19 Jan 2011 08:00:00 GMT

The debate over the nation's health care overhaul has reached its highest pitch in months, but most industry stakeholders are sitting out of Republicans' fight to repeal the law. The industry's silence illustrates an emerging consensus: with the exception of a few groups, even former opponents of the overhaul now want the law to stay.

New Year, but Same Old Budget Challenges

Wed, 12 Jan 2011 08:00:00 GMT

From coast to coast, governors and state legislators are assuming or returning to office with a common cry: We need to cut Medicaid. Are there new solutions to this old problem?

What You Missed While on Holiday Break

Wed, 05 Jan 2011 08:00:00 GMT

Washington, D.C., often goes quiet during the winter holiday season, but officials continued to pave the road to reform even as Congress was on break. Several agencies issued key guidance on implementing the federal health overhaul, and a number of new patient protections took effect last week.

Looking Back, Heading Forward: A Checkpoint on the Road to Reform

Wed, 15 Dec 2010 08:00:00 GMT

A year that began with unprecedented health reforms also featured unpredictable political twists and still unanswered questions over policy. As 2010 draws to a close, experts look back on the path to implementing the federal health law and what's been tabled for next year.

Rationalizing Rationing in Arizona's Medicaid Program

Wed, 08 Dec 2010 08:00:00 GMT

Both parties have debated whether the federal health reform law would lead to rationing. After Arizona's unprecedented cuts to its Medicaid program, new questions have emerged about the difficult trade-offs around health care spending.

Myth-Busting the Reform Law: Sea Change or Scapegoat?

Wed, 01 Dec 2010 08:00:00 GMT

A number of organizations have painted the health reform law as a catalyst for changes in their industries. Yet some groups may be invoking the law as a scapegoat for transformations that would have happened anyway, or using it as a convenient platform on which to advance their interests.

Golden State Looks On as Others Threaten To Cut Medicaid

Wed, 17 Nov 2010 08:00:00 GMT

Can states pull out of the Medicaid program -- and will they? The questions have taken on sudden importance, as some state officials suggest that health reform's costs are too high and the federal program too restrictive.

Policy, Not Punditry: Update on Three Key Provisions

Wed, 10 Nov 2010 08:00:00 GMT

Speculation over the midterm elections' effect on health reform has threatened to overshadow recent regulatory developments. Work to date on high-risk insurance pools, medical-loss ratios and accountable care organizations shows there are roadblocks beyond politics that could hamper reform.

What's on Tap for Reform Before Next Congress Takes Over

Wed, 03 Nov 2010 08:00:00 GMT

As Congress enters a lame-duck session, lawmakers face several pieces of health reform-related legislation. Some Democrats may also weigh using the final days of their House majority to enact their own fixes to health reform.

How the Midterm Elections Could Shape Reform

Wed, 27 Oct 2010 08:00:00 GMT

The debate over health reform was heavily framed by the midterm elections. While Democrats had hoped the law's passage would boost their prospects, Republicans appear likely to make significant gains and could further shape the overhaul's implementation.

Reform Rollout May Waver if More Seek Exemptions

Wed, 20 Oct 2010 08:00:00 GMT

HHS' recent decision to grant waivers for health plans that would not meet a key provision of health reform exposes how stakeholders can weaken implementation by simply resisting its measures.

Has Reform Improved Health Care Yet?

Wed, 13 Oct 2010 08:00:00 GMT

The bulk of the federal health reform law's provisions are slated to launch in 2014, but several incremental changes have already taken effect. An early look at those provisions shows mixed results for insurance access, services utilization and system improvements.

Does Medicaid Need a Checkup?

Wed, 06 Oct 2010 08:00:00 GMT

Since the start of the reform debate, questions have swirled about Medicaid's role and sustainability. New reports raise further concerns about the program's long-term prognosis.

Spotting a Unicorn: ACOs Inch Closer to Reality

Wed, 29 Sep 2010 08:00:00 GMT

More health care providers are entering into arrangements to create "accountable care organizations," but these emerging alliances face legal questions because regulators have yet to define ACOs. Potential answers, and several milestones, lie ahead for the model.

A Tale of Two Campaigns: Repeal vs. Reinforce

Wed, 22 Sep 2010 08:00:00 GMT

Republican efforts to do away with health reform have coalesced around a strategy to defund the law. Meanwhile, Democrats will mount a spirited defense of the overhaul timed to its six-month anniversary and the rollout of new provisions.

Exchanging Challenges in Health Plan Marketplace

Wed, 15 Sep 2010 08:00:00 GMT

While California is poised to emerge as a health reform leader with a new health insurance exchange, the state -- like many -- still faces numerous challenges over the exchange's operation.

Employer System a Shaky Base for Health Reform

Wed, 08 Sep 2010 08:00:00 GMT

The health care overhaul built on the nation's unique employer-based health insurance system, instead of revamping the model. However, a number of recent shocks to the system are creating new challenges for consumers and raising concerns ahead of coverage expansions in 2014.

Politics of Economy May Affect Health Care Policy

Wed, 25 Aug 2010 08:00:00 GMT

Financial concerns from Sacramento to Washington, D.C., are overshadowing the health reform overhaul and could shape implementation efforts moving forward.

Some Fear IPAB Will Be Error of Commission

Wed, 18 Aug 2010 08:00:00 GMT

Proponents of the Independent Payment Advisory Board -- which is slated to launch in 2014 -- hail IPAB as a transformative effort to ensure needed cost controls, but critics warn that the board will weaken Medicare and harm patient care. Both sides note that IPAB may undergo a makeover before its ultimate debut.

Will ACOs Be A-OK? Model Stirs Hopes, Questions

Wed, 11 Aug 2010 08:00:00 GMT

Accountable care organizations, or ACOs, are the most-discussed acronym-cum-health care payment model since HMOs. As providers across the nation rush to adopt the concept, is California poised to be a leader?

State of Contention as Officials Wrestle Over Reform Law

Wed, 04 Aug 2010 08:00:00 GMT

The health reform law has presented a significant challenge for many of the nation's governors, who are struggling with scarce funding, election-year politics and new federal policies. In some states, officials are moving forward to comply with certain portions of the law as they also fight the overhaul in court.

How Reform Could Affect Four Key Populations

Wed, 28 Jul 2010 08:00:00 GMT

A health policy expert explores how the national health reform would affect four groups of U.S. residents. While younger workers are poised to benefit, Medicare beneficiaries may feel cuts.

Berwick Takes Reins at CMS, But Reign Might Be Short

Wed, 21 Jul 2010 08:00:00 GMT

Donald Berwick's selection to run CMS is among President Obama's most influential policy decisions. However, the White House's move to install Berwick via recess appointment has been criticized and may complicate his role in the reform law's implementation.

Fiscal Issues Could Put Medicaid Expansion in Jeopardy

Wed, 14 Jul 2010 08:00:00 GMT

The health care overhaul relies on a significant expansion of Medicaid to reduce the uninsured population. Budgetary pressures that have forced many states to implement cuts to Medicaid ahead of the expansion and uncertainty about federal funding have raised questions about the plan's viability.

New Data From Mass. Revive Old Concerns

Wed, 07 Jul 2010 08:00:00 GMT

Massachusetts has served as the proverbial canary in the health reform coal mine, and new findings about rising health costs and access concerns in the Bay State underscore the risks of the nation's health care overhaul.

Insurer Response Remains Key Story To Watch

Wed, 30 Jun 2010 08:00:00 GMT

The health industry's focus is on HHS this week, as the department sprints to launch insurance portals and pools by key implementation deadlines. However, tensions between policymakers and private payers remain the long-term narrative to watch.

Despite Best Intentions, New Ratios Creating Problems

Wed, 23 Jun 2010 08:00:00 GMT

Requiring insurers to spend a certain amount on patient care was a widely acclaimed element of the health care overhaul. However, early efforts to set standards for medical-loss ratios are delayed, and resistance is growing. While some say industrywide MLR standards remain achievable, others are warning that it's a "fool's errand."

Calls To Repeal Reform Win Now, But What's Next?

Wed, 16 Jun 2010 08:00:00 GMT

Many Republican candidates who favor a repeal of the health reform law won their primaries last week, including California governor and Senate hopefuls Meg Whitman and Carly Fiorina. However, the primary results might not be a meaningful barometer for this fall's midterm elections.

Why Small Businesses Aren't Embracing Reform

Wed, 09 Jun 2010 08:00:00 GMT

The health reform law was supposed to help small businesses. So why have some turned against it?

High-Risk Pools May Need Lower Expectations

Wed, 02 Jun 2010 08:00:00 GMT

With days to go before uninsured residents can begin applying to new high-risk insurance pools, issues ahead of the program's launch have emerged as a microcosm of the past year's health debate.

What Will Happen to HSAs Under Reform?

Wed, 26 May 2010 08:00:00 GMT

More than one million Californians now are covered by health savings account-eligible health plans. However, the six-year-old HSA model may be threatened by the health care overhaul.