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Is AI Better for patients? What is changing on the ground? Chip talks with Dr. Patrick Conway, Chief Executive Officer of Optum, a health services and technology business under parent company, UnitedHealth Group. They discuss how to ensure the health care industry’s use of AI serves patients first, particularly when the same company bears financial risk and builds the AI that decides who gets care. They also discuss whether use of AI can make value-based…
State Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system…
How do we know if AI use in health care actually makes patients better? Chip talks with Dr. David Bates — a veteran physician leader at Mass General Brigham and the Brigham and Women's Hospital and Co-director of the Center for Artificial Intelligence and Bioinformatics Learning Systems — about measuring patient outcomes reliably and in real time to create a strong foundation for everything else in health care administration — clinical deployment, payment reform, consumer…
This Issue Brief describes the Medicare Hospital Readmission Reduction Program (HRRP), which penalizes hospitals that have relatively higher readmission rates, analyzes the impact of this program on Medicare patients and hospitals, and discusses several issues that have been raised regarding its implementation.
A number of states have expressed interest in expanding managed care approaches within their Medicaid programs. While managed care may present an opportunity for better delivery of care, it presents challenges within certain populations and geographic areas. How many states are planning Medicaid managed care expansions? What impact would these changes have on beneficiaries, providers and health plans? What have we learned from past efforts to expand managed care? This briefing, cosponsored by the Alliance…
Both the private and public sectors are testing various care delivery transformation models to improve quality, reduce morbidity and mortality, and contain the costs of treatment. The Alliance for Health Reform and WellPoint, Inc. hosted a September 10 briefing to discuss delivery system innovations, Medicare care coordination, and low-spending health care practices. For more information, please visit the Alliance's event page. Full version: Video Speakers for this session: Ed Howard of the Alliance and…
This brief provides an overview of the status of the health care systems and Medicaid programs in Puerto Rico and the U.S. Virgin Islands (USVI) about one and a half years after Hurricanes Irma and Maria struck the islands in September 2017. The hurricanes exacerbated the territories’ existing economic and health care challenges by accelerating outmigration of residents and health care providers and destroying homes, schools, health care facilities, and other infrastructure. After the storms,…
Este resumen ofrece una descripción general del estado de los sistemas de atención médica y los programas de Medicaid en Puerto Rico y las Islas Vírgenes de los EE.UU. (USVI) aproximadamente un año y medio después que los huracanes Irma y María azotaran las islas, en septiembre de 2017. Después de las tormentas, los programas de Medicaid de los territorios han servido como recursos importantes para atender las necesidades de atención médica de los residentes,…
This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically have been for institutional, rather than home and community-based, services. Over the past two decades, major efforts have been undertaken by states and the Centers…
This brief presents findings from the 2017 Kaiser Women’s Health Survey, a nationally representative survey of women ages 18 to 64 on their health status, relationships to regular providers and sites of care, and the frequency at which they receive routine preventive care. The Kaiser Family Foundation has conducted surveys on women’s health care in 2001, 2004, 2008, and 2013. This brief focuses on findings from the newest 2017 survey and presents some findings compared…
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