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Medicare and Medicaid

The policy landscape is changing, so understanding Medicare and Medicaid reform is essential for Medicare and Medicaid providers. New initiatives such as the Medicare shared savings program promise gains for patients and organizations. How can we make it all work?

Leadership

From the Commonwealth to Obamacare: Reflections on 10+ Years of Expanding Health Insurance Coverage

The former Executive Director of the Commonwealth Health Insurance Connector — a model for the Affordable Care Act and other state marketplaces — reflects on what worked, what didn’t, and what could be done differently in both Massachusetts and at the federal level.

Rating the Raters - Strengths and Weaknesses Assessment of the Four Public Hospital Quality Rating Systems - 2a

Care Redesign

Rating the Raters: An Evaluation of Publicly Reported Hospital Quality Rating Systems

Some promising innovation is taking place among organizations that rate hospital performance, but major systemic change is needed in the field to ensure access to meaningful comparisons through better data and relevant metrics, and to establish integrated oversight through robust audits and peer review.

Screenshot from the NewYork Quality Care Chronic Condition Dashboard

Leadership

Success in a Hospital-Integrated Accountable Care Organization

How NewYork Quality Care achieved shared savings — by strengthening collaboration, enhancing care management with telehealth, and transparently sharing performance data.

Miller03_pullquote social determinants whole-person

Leadership

How a State Advances Whole-Person Health Care

Pennsylvania addresses social determinants of health by bringing together managed care and social services organizations to expand access to vital resources.

30-Day Mortality Rates at Non-Teaching and Major Teaching Hospitals 2013-2014 - value-based care at academic medical centers

New Marketplace

What Value-Based Payment Means for Academic Medical Centers

Academic medical centers must become as dedicated to advancing operational and clinical efficiency as they have been to advancing the science of medicine.

Medicare Compared to Private Spending Cumulative Growth 2009-2019 - traditional Medicare coverage

New Marketplace

Redesigning Medicare to Work for Everyone

A proposal to improve the Medicare benefit package.

Leff06_pullquote home-based medical care for homebound patients

Care Redesign

Using Quality to Shine a Light on Homebound Care

How two thought leaders in the fields of home-based medical care, geriatrics, and palliative medicine advanced a quality-of-care agenda for homebound adults.

Charlotte Yeh head shot - hearing aids hearing loss

Care Redesign

“You’re Old Without Hearing Aids”— Addressing the Silent Epidemic of Hearing Loss

Hearing loss isn’t a normal consequence of aging. But it is associated with a higher risk of dementia, depression, and falls. The Chief Medical Officer for AARP Services talks about combating this huge but silent epidemic that impacts all ages.

Percentage of U.S. Adult Hemodialysis Patients Achieving Dialysis Adequacy, 2013-2016. Data will be released in early 2019.

Care Redesign

Innovation in Dialysis: Continuous Improvement and Implementation

The U.S. dialysis sector has been criticized for its lack of innovation, but this criticism disregards the kidney community’s success in creating — and continuously improving on — dialysis as a safe, globally scaled, quality-oriented outpatient therapy.

Treatment Authorization Increases and Rapid Boost in New Mexico Medicaid Members Treated for Chronic HCV

Care Redesign

A Collaborative Model to Expand Medicaid Treatment Coverage for Chronic Hepatitis C Virus

How managing the benefit coverage expansion for the treatment of HCV in New Mexico was successfully achieved after less than 2 years.

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