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The Massachusetts Health Care Landscape

This fact sheet summarizes the Massachusetts health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

Emerging Medicaid Accountable Care Organizations: The Role of Managed Care

This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs. An ACO is a provider-run organization in which participating providers are collectively responsible for the care of an enrolled population, and may share in any savings associated with improvements in…

Health Care Costs: A Primer

This primer on health care spending in the United States reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers. The share of the economy devoted to health care increased from 7.2 percent in 1970 to 17.9 percent in 2009…

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…

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…

Federal Funding Under the Affordable Care Act

This fact sheet provides highlights from an analysis tracking the flow of federal Affordable Care Act funds to states as reporter in the Department of Health and Human Services grant database as well as periodic reports from HHS and the Internal Revenue Service. The analysis distinguishes between funds awarded to…

Patient Cost-Sharing Under the Affordable Care Act

Under the Affordable Care Act (ACA), four tiers of health insurance will be offered in the health insurance exchanges and throughout the individual and small group markets beginning in 2014. Under the minimum coverage plan, the “Bronze” plan, the insurance plan will pay for 60 percent of the costs of…

Insurer Rebates under the Medical Loss Ratio: 2012 Estimates

Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…

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…