health policy articles

Making the Case for Addressing Health Disparities: What Drives Providers and Payers?

The creation of the Centers for Medicare & Medicaid Services Office of Minority Health placed increased emphasis on federal efforts to address health disparities. Although the literature establishes a social justice case for addressing health disparities, there is limited evidence of this case being sufficient for businesses to invest in such initiatives. The purpose of this study was to better understand the “business case” behind an organization’s investment in health disparity reduction work.

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Nearly 1 In 5 Hospice Patients Discharged While Still Alive

A study published last month in the journal Health Affairs finds that hospices with the highest rate of so-called live discharges also have the highest profits. The lead author is Rachel Dolin, a David A. Winston fellow researching health policy. Her paper found an association between high live discharge rates and high profit margins, but it didn’t determine the cause….

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Factors Driving Live Discharge From Hospice: Provider Perspectives

The proportion of patients disenrolling from hospice before death has increased over the decade with significant variations across hospice types and regions. Such trends have raised concerns about live disenrollment’s effect on care quality. Live disenrollment may be driven by factors other than patient preference and may create discontinuities in care, disrupting ongoing patient-provider relationships. Researchers have not explored when and how providers make this decision with patients.

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The Dubious Empirical and Legal Foundations of Wellness Programs

Abstract The article offers information on the dubious empirical and legal foundations of workplace wellness programs in the U.S. Topics discussed include enactment of Affordable Care Act for expanding the scope of incentives availas; analysis of financial incentives offered to the employees for encouraging their participation in wellness programs; and targeting incentives specifically toward individuals diagnosed with chronic diseases. Source: Adrianno McIntyre, Nicholas Bagley, Austin Frakt, and Aaron Carroll, The Dubious Empirical and Legal Foundations of Wellness Programs, 27 Health Matrix 59 (2017) Available at:... read more

BOOK REVIEWS: Our Health Care Tug-of-War

Steven Brill makes some keen points about what works—and what doesn’t—in our health care system. He’s not so good on what will fix it. BY ADRIANNA MCINTYRE FROM SUMMER 2015, NO. 37 America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System By Steven Brill • Random House • 2015 • 528 pages • $28 Several weeks after the disastrous October 1, 2013, launch of Healthcare.gov, I had dinner with friends who also happened to be reporters on the health-care beat. “We knew it was going to be bad,” one person at the table remarked grimly. “But did we know it was going to be this bad?” On the first day that the federal insurance exchange was online, just six people were able to register for coverage. The site struggled to work for months. But when open enrollment finally ended in April 2014, after several extensions from the Administration, more than eight million people had found coverage through the state and federal insurance exchanges, surpassing projections from the Congressional Budget Office. In America’s Bitter Pill, Steven Brill deftly chronicles this disaster and recovery with a depth of reporting that day-to-day coverage didn’t provide. With the benefit of hindsight and the space of 455 pages of text, Brill is able to trace the stubborn and complex confluence of pressures, inescapable trade-offs, and fallible actors that brought us the nation’s most sweeping health reform in half a century. But Brill, the celebrated investigative journalist, proves to be fallible, too: Rather than stick to reporting, he chooses to play pundit and issue ill-informed prescriptions for our health-care system. His recommendations demonstrate a... read more