Editor’s Note: This column previously appeared in Bridge Magazine. In recent months, a conversation has burgeoned in health and public policy forums about the slowdown in the growth of health care spending. We are all asking the same questions: Is this slowdown real? Are some of the past cost containment efforts and recent provisions in the ACA beginning to take …

Editor’s Note: This column previously appeared in Bridge Magazine. On February 6, 2013, Governor Snyder announced his support for expanding Medicaid as envisioned in the Affordable Care Act. In his announcement, he talked about how the expansion would help hundreds of thousands of people in Michigan (our own estimates at the Center for Healthcare Research & Transformation put the numbers …

Newspaper headlines about small employers’ fears of the Affordable Care Act (ACA) make it seem like there will be a major cataclysm in the small employer health insurance market come January 1, 2014. What most of these stories miss, however, is that a cataclysm has already occurred in employment-based coverage and the likely impacts of the ACA on the small …

Editor’s Note: This column previously appeared in Bridge Magazine. Recent reports about a Medicaid experiment in Oregon reveal a major disconnect we have in the health care world: we make a historic —and unwarranted— distinction between “physical health” and “mental health.” Worse, that distinction actually interferes with both our investment in mental health treatment and patients’ willingness to seek treatment. …

Of the Affordable Care Act’s (ACA’s) many provisions aimed at improving health care access, quality, and efficiency, one has been the subject of considerable recent debate: the hospital readmission reduction program. The program’s approach has some merit, but in the end, doesn’t do enough to address the systemic issues underlying the problems it aims to fix. This policy needs adjustments …

Great news! The latest and greatest approaches to reducing health care spending are here: paying primary care doctors more, bundling payments for doctors and hospitals; sharing savings and investing more in systems that integrate care. Hooray! New answers to the cost curve dilemma! The question is: will any of these approaches actually work? As it turns out, we’ve been down …

Lisa Rosenbaum wrote a terrific piece in the March 7 issue of the New England Journal of Medicine. Her article is a powerful reminder that views of medical appropriateness—what is “right” in health care—can be very different for physicians, patients, and analysts. She highlights the challenges inherent in a system of incentives that reward “value” without taking into account these …

Steven Brill’s article on health care costs in the March 4 issue of Time magazine is the talk of the town in health care. While journalists have generally praised the piece, reactions from those in health care have been mixed. The American Hospital Association critiqued a number of Brill’s major points in a fact sheet, Setting the Record Straight on …

On February 5, 2013, Congressional Budget Office (CBO) director Douglas Elmendorf testified before Congress on the CBO’s budget outlook for 2013-2023. As reported in the New York Times and elsewhere, the health care outlook was remarkable: projected Medicare and Medicaid spending for 2020 was down 15 percent over projections made three years ago. Specifically, the CBO noted “net outlays for …

Why does health care cost so much more in America than in any other country in the world? One major reason is that our system is really a non-system. That is, in America we have many different payers, financing mechanisms, benefit designs, and structures. Every health plan has its own ways of doing things, and every health purchaser wants a …