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Filling the Gaps: Dental Care, Coverage and Access

While the Affordable Care Act is expected to expand public and private coverage for children when it takes effect in 2014, significant gaps will remain, especially for low-income adults age 21 and older. This June 19, 2012, a public forum at the Foundation’s Washington, D.C. offices examined the gaps and…

A Primer on Dually Eligible Beneficiaries

The nine million dually eligible beneficiaries are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of Medicare and Medicaid spending. Because they often have complex medical and long-term care needs, and must navigate both Medicaid and…

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…

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…

The Alphabet Soup of Care Delivery Transformation

Both the private and public sectors are testing various care delivery transformation models to improve quality, reduce morbidity and mortality, and contain the costs of treatment. The Alliance for Health Reform and WellPoint, Inc. hosted a September 10 briefing to discuss delivery system innovations, Medicare care coordination, and low-spending health…

A Dose of Reality in the Virtual World of Health IT

The Alliance for Health Reform hosted a September 28 briefing to discuss electronic health records (EHRs), and the progress of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Speakers explored such questions as: How does health information technology fit in the strategy for health care delivery transformation?…

The Health Workforce Dream Team: Who Will Provide the Care?

Many providers and policymakers envision team-based care as an important way to improve quality and maximize resources. The “dream team” includes nurses and many other non-physician providers. But how will we ensure enough health care workers for a growing, aging population with ever-increasing chronic care needs? This December 2 briefing,…

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…

Pathways to Payment Innovation in a Post-Health Reform Era

The new health reform law contains a number of changes in the way health care is paid for, particularly in public programs such as Medicare and Medicaid. The Alliance for Health Reform and The Commonwealth Fund sponsored a May 10 briefing which explored topics such as how some health care…

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…