In a push to encourage “personal responsibility,” the Centers for Medicare and Medicaid Services (CMS) has approved work requirements as a condition for receiving Medicaid benefits in four states - Kentucky, Indiana, Arkansas, and most recently New Hampshire, with applications from other states pending. In a new JAMA Viewpoint, Harald Schmidt and Allison Hoffman review the implications and ethics of Medicaid work requirements and other personal responsibility policies. They propose safeguards CMS should consider to minimize risk and protect beneficiaries’ health.
The concern that value-based payments will worsen health disparities is not new. Much ink has been spilled about the best way to avoid punishing hospitals that care for disproportionately poor populations, without rewarding poor performance. Two new perspective pieces take a fresh look at the issue, highlighting the potential for value-based payments to reduce disparities rather than to exacerbate them.
The Trump administration recently agreed to let states get tough on Medicaid recipients who don’t work. Kentucky was the first to win approval of a plan to kick those who can work but don’t off the roles, and at least ten other states would like to do the same. However, work requirements will do little to improve the Medicaid program while posing the risk that many people who are fully entitled to benefits would suffer real harm.
At a recent LDI seminar, Nico Pronk, PhD, President of HealthPartners Institute, and Chief Science Officer of HealthPartners, Inc., called for a paradigm shift in how we think about health care in the U.S. “We pay a ton of money for medical care, [but] we don't get a lot of value for that investment. Do we need more medical care, or do we actually need a shift towards more health and well-being?” he asked.
In a post that originally appeared on the Health Affairs Blog, Amol Navathe and colleagues look at the Centers for Medicare and Medicaid Services' (CMS) latest bundled payment model, and compare it to earlier models introduced by CMS during the previous Administration.
At Penn’s fourth annual Martin Luther King, Jr., Health Equity Symposium, keynote speaker Howard Koh, MD, MPH, former Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS) called for building nontraditional partnerships to reduce health disparities and move the social-determinants-of-health approach forward. “Health is too important to be left to health professionals alone,” he said.
There have been concerns about the long-term health of retired National Football League (NFL) players. But evaluating these long-run consequences is challenging, because professional football players tend to be at the extremes of physical fitness. Finding an appropriate comparison group to such a highly select population is hard. So we reached back into NFL history and found the “replacement players” - generally men with some prior football experience (college, semi-pro, sometimes other pro leagues) who played during the three weeks of the NFL player strike in 1987 to use as a comparison group. Here's what we found.
Two Senior Fellow articles make Health Affairs' Top 10 most shared list in 2017. Articles on the effects of the ACA on payday borrowing and the prevalence of completed advance directives captured the public's attention.
In response to Pennsylvania declaring a state of emergency for the heroin and opioid epidemic, we asked our Senior Fellows, physicians on the front lines of the epidemic, to share their thoughts on what the declaration means for their current approaches to identifying and treating substance use disorder patients.
In a New England Journal of Medicine Perspective on the proposed Right to Try Act, LDI Senior Fellows Steven Joffe and Holly Fernandez Lynch argue that the benefits of the proposal are more symbolic than real, while the potential long-term harms to the FDA’s public health mission are great.
In a recently published Health Working Paper for the Organisation for Economic Co-operation and Development (OECD), Claudia Maier and LDI Senior Fellow Linda Aiken analyze the changing role of nurses in response to health care workforce demands in 37 OECD and European Union countries.
Community Health Workers (CHWs) work with people to detect and address the root causes of chronic illness, and to improve aspects of their lives that are contributing to poor health. This isn’t a new idea, but it seems like one whose time has come. Does the evidence support the use of CHWs as an effective and sustainable solution to addressing the evolving face of disease in America? The short answer is, it depends.