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  • Medicare Part D 2010 Data Spotlight: Coverage of Top Brand-Name and Specialty Drugs

    Issue Brief

    This Part D Data Spotlight documents the wide variations across the private stand-alone drug plans with respect to coverage of drugs, what enrollees pay for those drugs, and restrictions and limitations placed on their use. These variations have potentially significant implications for beneficiaries’ access to medications and out-of-pocket costs. The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. The…

  • Pulling It Together: Bono, Jon Stewart and the HIV/AIDS Message

    Perspective

    One of the most interesting conversations on a health topic happened recently on The Daily Show between Bono and Jon Stewart. Bono told Stewart that we were "at the beginning of the end of the AIDS epidemic," promising an announcement the next day that would explain how a combination of early treatment, treatment for pregnant women, and circumcision, would turn the epidemic around if the American people would continue to put money into the cause.…

  • Explaining Health Care Reform: Key Changes to the Medicare Part D Drug Benefit Coverage Gap

    Issue Brief

    On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. The health reform law, as modified by the Health Care and Education Reconciliation Act of 2010 which passed the House of Representatives on March 21, 2010 and is under consideration in the Senate, makes several key changes to the Medicare Part D drug benefit to reduce Part D enrollees’ out-of-pocket liability when they reach the coverage gap, known as…

  • AI: Show Me the Outcomes

    Podcast

    Chip talks with Dr. Toyin Ajayi, co-founder and CEO of Cityblock Health, which delivers value-based care to more than 100,000 Medicaid and dual-eligible members across ten states, many of them people of color managing chronic conditions. Ajayi makes a pointed case: Roughly 60 percent of health care AI investment goes to billing, coding, and risk adjustment — making sure someone gets paid — while only a fraction goes to delivering care. If we continue to…

  • The AI Arms Race in Administrative Health Care

    Podcast

    Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI) and the Peterson Center on Healthcare, joins Chip to discuss who really benefits as AI moves into health care's back office. A quiet arms race is underway — providers deploying AI to code, bill, and capture revenue and insurers deploying it right back to review, deny, and hold the line. The open question is whether any of this lowers what the country actually spends…

  • Health Care’s AI Disruption, Ready or Not 

    Podcast

    The AI revolution is already here — but what does it mean for patients, clinicians, and health care industry leaders? Eric Larsen, veteran health care strategist and longtime advisor to CEOs across the industry, joins host Chip Kahn for a discussion about why the U.S. health care industry is uniquely exposed to AI-driven disruption and the implications for patients, clinicians, and the health care workforce. Listen to Larsen's take on "the most consequential technology humanity’s…

  • 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.

  • Challenges in the U.S. Territories: COVID-19 and the Medicaid Financing Cliff

    Issue Brief

    More than a year into the public health emergency, the COVID-19 pandemic continues to impact the lives of Americans including those living in the U.S. territories. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. While additional federal funds have been provided over the statutory caps, these funds are set to expire at the end of September 2021. Without additional Congressional…

  • Medicaid: What to Watch in 2022

    Issue Brief

    As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.

  • Medicaid Financing and the U.S. Territories: Implications of The Build Back Better Act

    Policy Watch

    The U.S territories have faced an array of longstanding fiscal and health challenges that were exacerbated by recent natural disasters and the COVID-19 pandemic. This policy watch examines how Medicaid funding for the territories works, the current allotments, and how the Build Back Better Act (BBA) would change Medicaid funding for the territories going forward. While a version of BBBA has passed the house, its fate in the Senate remains uncertain.