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Program Integrity: Preventing Health Care Fraud and Abuse

Headlines regularly call attention to pockets of fraudulent activity in the health care arena – scams that amount to millions and potentially billions of dollars. The stories typically focus on catching the crooks but not so much on efforts to prevent fraud, waste and abuse in health care programs. Both…

Coping with Fragmented Payment in the Real World

The Alliance for Health Reform and The Commonwealth Fund sponsored this briefing which focused on three communities that have reformed and harmonized health care payments across payers to improve care: a New York health center that serves a low income population; a Colorado community that pools money from public and…

50 Million Uninsured: The Faces Behind the Headlines

Almost 50 million Americans lacked health insurance in 2010 — about a million more than in 2009. Who are the uninsured? Why do so many Americans lack coverage? What are the trends in coverage among different segments of the population? What do these trends mean for the health care system…

Integrating Care for Dual Eligibles: What Do Consumers Want?

Many deficit reduction plans have recognized the need to improve care for the 9 million beneficiaries dually eligible for Medicare and Medicaid. How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are Health and Human Services initiatives encouraging innovations to integrate care for dual…

Medicaid Innovations: Can Managed Care Cut Costs and Improve Value?

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…

Managing Costs and Improving Care: Team-based Care of the Chronically Ill

Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs. This briefing, cosponsored by the Alliance for Health Reform and…

Accountable Care Organizations: A New Paradigm for Health Care Delivery?

The health reform law of 2010 authorizes Medicare, beginning next year, to contract with accountable care organizations (ACOs) in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs. But providers have raised red flags, saying the…

Health Care Costs in the U.S.: The Role of Prices and Volume

The Alliance for Health Reform and several cosponsors held the first event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. This briefing and others in the series take an in-depth look at a select few of…

Public Opinion on Health Reform: What Do the Polls Mean?

The Alliance for Health Reform and the Kaiser Family Foundation co-sponsored this briefing to have a panel of experts answer questions about how public support for health reform waxes and wanes depending, not only on what’s being proposed in the reform proposals, but also on who asks the question and…