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  • What AI Can Do — And What It Can’t 

    Podcast

    The data is good enough, the technology is getting better, the computing is becoming more available, and the use cases are getting clearer—but is AI truly a revolutionary technological advancement yet for health care? With a 30-year perspective on what digital technology has done and failed to do in health care, Dr. John Halamka, President of the Mayo Clinic Platform, joins Chip in discussing whether AI is actually disruptive or another wave of incremental change.

  • When Minutes Matter, What Is AI’s Role? 

    Podcast

    When minutes matter for a patient’s care, what is AI’s role in clinical practice? Elad Walach, co-founder and CEO of Aidoc — a company with a comprehensive AI health care platform that analyzes real-time images and flags time-sensitive findings — shares his perspective on AI’s transformative power in dodging diagnostic error, improving access to care, and ensuring care quality in busy clinical settings.

  • An Overview of Delivery System Reform Incentive Payment (DSRIP) Waivers

    Issue Brief

    This brief will examine similarities and difference across key elements of DSRIP waivers. The states included in this analysis are: California, Texas, Kansas, New Jersey, Massachusetts, and New York. The key elements of DSRIP initiatives that will be explored in this analysis include: the goals and objectives of the DSRIP initiative; eligible providers; projects and organization; allocation of funds; data collection and evaluation/reporting; and financing of DSRIP waivers.

  • Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018

    Report

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report examines the reforms, policy changes, and initiatives that occurred in FY 2017 and…

  • Medicaid Managed Care Plans and Access to Care: Results from the Kaiser Family Foundation 2017 Survey of Medicaid Managed Care Plans

    Report

    Managed care organizations (MCOs) cover nearly two-thirds of all Medicaid beneficiaries nationwide, making managed care the nation’s dominant delivery system for Medicaid enrollees. As the entities responsible for providing comprehensive Medicaid benefits to enrollees by contracting with providers, managed care plans play a critical role in shaping access to care for Medicaid enrollees. Many plan actions are dictated by state policy or contracting requirements; however, plans also have some flexibility to design payment and delivery…

  • Health Care Costs in the U.S.: The Role of Prices and Volume

    Event Date:
    Event

    The Alliance for Health Reform and several cosponsors held the first event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. This briefing and others in the series take an in-depth look at a select few of the most often cited health care cost drivers. This briefing focuses on the extent to which health care prices, and the volume of services delivered,…

  • States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019

    Report

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia. This report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019 (which began for most states on July 1, 2018). Key areas covered include changes in…

  • AI: As Much Peril As Promise?

    Podcast

    What does AI mean for patients in bed and doctors at the bedside? Host Chip Kahn and guest Dr. Robert Wachter, Chair of the Department of Medicine at the University of California, San Francisco, discuss whether AI will produce a different kind of doctor in the future — a “clinician curator rather than a clinician-diagnostician.” The answer could define the future of medicine and the doctor-patient relationship.

  • Awaiting New Medicaid Managed Care Rules: Key Issues to Watch

    Issue Brief

    More than half of all Medicaid beneficiaries now receive their services in risk-based managed care plans, and states’ use of managed care is expanding. States operate their own Medicaid managed care programs within federal rules and requirements. The federal regulations were last updated in 2002 and a new proposed rule is expected in Spring 2015. This brief identifies key issues in the regulation and discusses how CMS might address them.

  • CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions

    Issue Brief

    On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.