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• Medicare’s Bundling Pilot: Including Post-Acute Care Services [Internet].
  Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for […]
• Trading Places: Real Choice Systems Change Grants and the Movement to Community-Based Long-Term Care Supports [Internet].
  The Real Choice Systems Change grant program was created to help states transform their long-term care service systems from ones that rely on institutions to ones that are more community-based. The grants are intended to help states develop the infrastructure needed for seniors and individuals with disabilities to live in integrated community settings. This issue […]
• Medicare’s Post-Acute Care Payment: A Review of the Issues and Policy Proposals [Internet].
  Medicare spending on post-acute care provided by skilled nursing facility providers, home health providers, inpatient rehabilitation facility providers, and long-term care hospitals has grown rapidly in the past several years. The Medicare Payment Advisory Commission and others have noted several long-standing problems with the payment systems for post-acute care and have suggested refinements to Medicare’s […]
• CMS’s Proposed Rule Implementing the ACA-Mandated Medicaid DSH Reductions [Internet].
  State Medicaid programs make Medicaid disproportionate share hospital (DSH) payments to hospitals to help offset costs of uncompensated care for Medicaid and uninsured patients. Unlike most Medicaid spending, annual DSH allotments for each state are capped. Under the Patient Protection and Affordable Care Act of 2010 (ACA), DSH payments will decrease starting in fiscal year […]
• Medicare’s Post-Acute Care Payment: An Updated Review of the Issues and Policy Proposals [Internet].
  Medicare spending on post-acute care provided by home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals accounted for about 10 percent of total program outlays in 2013. The Medicare Payment Advisory Commission and others have noted several long-standing problems with the payment systems for post-acute care and have suggested refinements to […]
• Oral Health Checkup: Progress in Tough Fiscal Times? [Internet].
  Almost ten years after the surgeon general’s report designating dental disease as the “silent epidemic,” the nation continues to struggle with adequate access to and utilization of dental services. This is particularly true for low-income individuals, who experience more than twice the amount of untreated dental disease as their higher-income peers. This issue brief reviews […]
• A Health Insurance Exchange: Prototypes and Design Issues [Internet].
  Many reform proposals call for the creation of one or more health insurance exchanges, intermediaries that can help individuals or small employers navigate the insurance market. An exchange might be public or private, national or local. It might serve simply as a clearinghouse for plan information or could play an active role in setting benefit […]
• Updating the WIC Food Packages: It’s About Time [Internet].
  This issue brief reviews key revisions to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program proposed by the USDA, which are based substantially on recommendations by the Institute of Medicine. Should the changes become regulation, they will be the most significant revision of the WIC food packages in over 25 years. […]
• Primary Care Physician Supply, Physician Compensation, and Medicare Fees: What Is the Connection? [Internet].
  Primary care, a cornerstone of several health reform efforts, is believed by many to be in a crisis because of inadequate supply to meet future demand. This belief has focused attention on the adequacy of primary care physician supply and ways to boost access to primary care. One suggested approach is to raise Medicare fees […]
• Deprescribing for Older Veterans: A Systematic Review [Internet].
  More than 40% of people in the United States age ≥65 years take 5 or more prescription medications on a regular basis to control and/or prevent disease symptoms and complications. Exposure to multiple medications, known as polypharmacy, is associated with increased risk of negative outcomes, such as falls, cognitive impairment and other geriatric syndromes, hospitalizations, […]