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Health Affairs @Health_Affairs
Joined June 2008
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The finding that Medicaid work requirements could reduce poverty by 1.6 to 2.9 million people, rather than representing their likely impact, stems from an unwarranted assumption: If millions of beneficiaries newly obtain work, poverty would decline by a corresponding amount. | Forefront Richard G. Frank and Sherry Glied | @BrookingsInst, @NYUWagner healthaffairs.org/content/fo…

ASPE’s Analysis Of Medicaid Work Requirements: Argument By Assumption | Health Affairs Forefront

The finding that Medicaid work requirements could reduce poverty by 1.6 to 2.9 million people, rather than representing their likely impact, stems from an unwarranted assumption: If millions of...

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The new rule implementing HR 1’s Medicaid community engagement provision diverges from state expectations. No last-minute change is likely more harmful than the administration’s final approach to “medical frailty,” which ignores statutory guardrails. | Forefront Sara Rosenbaum, et al. | @GWpublichealth, @UMassBoston healthaffairs.org/content/fo…

Medical Frailty Rule Contravenes HR 1, Burdens The Health Care System, And Threatens Public Health...

The new rule implementing HR 1’s Medicaid community engagement provision diverges from state expectations. No last-minute change is likely more harmful than the administration’s final approach to...

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If any institution can bend the curve on preventable stillbirth, it is the American College of Obstetricians and Gynecologists (ACOG). Yet, despite clear evidence and successful state initiatives, the ACOG has been frustratingly slow to revise its clinical guidelines. | Forefront Ann O’Neill, et al. | Measure the Placenta healthaffairs.org/do/10.1377…

Will The ACOG Finally Address The Stillbirth Crisis—Or Continue To Stand On The Sidelines? | Health...

If any institution can bend the curve on preventable stillbirth, it is the American College of Obstetricians and Gynecologists (ACOG). Yet, despite clear evidence and successful state initiatives,...

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Concluding a series of five articles on the final HHS 2027 payment rule, this article covers a new lawsuit seeking to void several parts of the new rule. | Forefront @Katie_Keith | @oneillinstitute healthaffairs.org/content/fo…

HHS Finalizes Sweeping Marketplace Changes (Part 5): Exchange Requirements, Agents And Brokers, And...

This article concludes a series of five articles on the final 2027 payment rule. It also covers a new lawsuit seeking to void several parts of the new rule.

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Policymakers should preserve the achievements of the Transcatheter Aortic Valve Replacement registry while recognizing that ongoing evidence generation does not require a permanent mandate. | Forefront Pei-Jung Lin, et al. | @TuftsMedSchool healthaffairs.org/do/10.1377…

Lessons From TAVR For Medicare’s ‘Coverage With Evidence Development’ Program | Health Affairs...

Policymakers should preserve the achievements of the Transcatheter Aortic Valve Replacement registry while recognizing that ongoing evidence generation does not require a permanent mandate.

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Ageism can lead to undertreatment and overtreatment for older adults, costing $63 billion in excess health spending each year. Our new health policy brief covers interventions for countering ageism in health care settings. ➡️ healthaffairs.org/content/br…
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The classic cost-disease cure is to “productize” what used to be a service by substituting scalable goods. But in health care, the opportunity lies not in replacing services with goods but in raising productivity across labor-intensive workflows. | Forefront @SoleilShahMD, et al. | @BrighamMedRes healthaffairs.org/do/10.1377…

Why New Drugs And AI Chatbots Won’t Cure Health Care’s Cost Disease | Health Affairs Forefront

The classic cost-disease cure is to “productize” what used to be a service by substituting scalable goods. But in health care, the opportunity lies not in replacing services with goods but in raising...

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Geoffrey Hoffman of @UMichNursing and Jun Li of @SyracuseU examine exceptions to the hospital wage index, used by CMS to adjust Medicare payment to align with geographic labor costs. They find that exceptions increased by nearly 60% from 2016–24. healthaffairs.org/doi/10.137…
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AI will not determine whether American health care becomes more or less affordable. The payment system will determine that, as it always has. What AI changes is the speed and scale at which the payment system’s incentives express themselves. | Forefront David Brailer | Health Evolution healthaffairs.org/do/10.1377…

Why AI Will Accelerate Health Care Inflation | Health Affairs Forefront

AI will not determine whether American health care becomes more or less affordable. The payment system will determine that, as it always has. What AI changes is the speed and scale at which the...

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AI is increasingly moving from experimental settings into health care delivery. Improvements in AI have created growing interest in the use of “agentic” systems that can carry out multi-step processes with limited human oversight. | Forefront @DhruvKhullar, et al. | @WeillCornell healthaffairs.org/do/10.1377…

Experts Skeptical About AI Medical Licensure, Readiness To Independently Prescribe | Health Affairs...

AI is increasingly moving from experimental settings into health care delivery. Improvements in AI have created growing interest in the use of “agentic” systems that can carry out multi-step proces...

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Hospitals that received poor grades did not respond with a pledge to improve quality; instead, they sued the messenger. They also invoked a consumer protection statute to silence a consumer advocate. That inversion should give policymakers pause. | Forefront @BarakRichman and Robert M. Kaplan | @DukeU, @StanfordCERC healthaffairs.org/do/10.1377…

Suing The Scorecard Won’t Improve Hospital Safety | Health Affairs Forefront

Hospitals that received poor grades did not respond with a pledge to improve quality; instead, they sued the messenger. They also invoked a consumer protection statute to silence a consumer advocate....

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With the rise of third-party “conveners” recruiting clinicians and accountable care organizations (ACOs) into the Medicare Shared Savings Program, Adam Markovitz of @umichmedicine and coauthors look at the effects of conveners on these ACOs from 2012–21. healthaffairs.org/doi/10.137…
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We should keep grading hospitals. We must also imagine measurement structures as intelligent as the systems they evaluate. | Forefront Eric Leroux | @EisenhowerHeal healthaffairs.org/do/10.1377…

Hospital Safety Grades Aren’t Keeping Up With Technology. Here’s What They Need To Measure Next |...

We should keep grading hospitals. We must also imagine measurement structures as intelligent as the systems they evaluate.

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The DoJ intervened in the whistleblower lawsuit, alleging that the MA Organizations paid the broker defendants hundreds of millions of dollars in purported “marketing” funds. In reality, these payments were kickbacks tied to enrollment numbers. | Forefront Andrew Twinamatsiko, et al. | @oneillinstitute, @Georgetown healthaffairs.org/content/fo…

Medicare Advantage Insurers And Brokers Fail To Toss Whistleblower Lawsuit | Health Affairs...

The DoJ intervened in the whistleblower lawsuit, alleging that the MA Organizations paid the broker defendants hundreds of millions of dollars in purported “marketing” funds. In reality, these...

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Sharon Fernandez of @VanderbiltU & coauthors examine state and federal Medicaid spending on Medicare premiums. Although the number of beneficiaries enrolled in both programs rose 27% during 2013–24, Medicaid spending on Medicare premiums nearly doubled. healthaffairs.org/doi/10.137…
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Offering proposals to improve the FDA’s draft guidance to implement a new approval framework for individualized genetic therapies based on a “plausible mechanism” of action. | Forefront @HollyLynchez, et al. | @PennMEHP healthaffairs.org/do/10.1377…

Refining FDA’s Plausible Mechanism Framework, Part 2: Manufacturing Challenges, Product Scope, And...

This is part two of a two-part article offering proposals to improve the FDA’s draft guidance to implement a new approval framework for individualized genetic therapies based on a “plausible mechan...

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Ultra-rare diseases often lack patient populations large enough to support randomized controlled trials. The question is not whether to abandon rigorous standards, but how to apply them when the denominator collapses. | Forefront @PeterPitts | @drugwonks healthaffairs.org/do/10.1377…

Why FDA’s Plausible Mechanism Framework Matters For Ultra-Rare Disease Policy | Health Affairs...

Ultra-rare diseases often lack patient populations large enough to support randomized controlled trials. The question is not whether to abandon rigorous standards, but how to apply them when the...

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Between 2019–21, six states expanded Medicaid via ballot initiatives. @urbaninstitute's Fredric Blavin & coauthors examine these expansions & find that they substantially increased Medicaid enrollment & reduced the number of uninsured nonelderly adults. healthaffairs.org/doi/10.137…
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How do price reductions for physician-administered biologics affect hospital revenue? James Robinson @UCBerkeley & coauthors explore what price reductions could mean for broader health care systems ➡️ academic.oup.com/healthaffai…

Impact on hospitals of price reductions for physician-administered biologics

Abstract. The prices of physician-administered drugs and biologics are coming under downward pressures from Medicare price negotiations, Most Favored Natio

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Offering proposals to improve the FDA’s guidance to implement a new approval framework for individualized genetic therapies based on a “plausible mechanism” of action. | Forefront @HollyLynchez, et al. | @PennMEHP healthaffairs.org/do/10.1377…

Refining FDA’s Plausible Mechanism Framework, Part 1: Understanding The Draft Guidance And Clarif...

This is part one of a two-part article offering proposals to improve the FDA’s guidance to implement a new approval framework for individualized genetic therapies based on a “plausible mechanism” of...

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