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Consumer assistance offices that help people find and use their health insurance are vital to decreasing barriers to coverage and care. But consumers’ needs extend beyond just-in-time assistance. They also need a powerful representative to report pervasive problems to policymakers and recommend solutions.
Some states have addressed this by establishing offices that not only assist consumers with their immediate needs, but advocate on their behalf to create long-term improvements as well. These offices show great promise in making the healthcare system work better for consumers. This webinar will profile one high-performing consumer advocacy office and will offer best practices for states looking to increase protections and strengthen representation for consumers.
March 16, 2018
Surprisingly, insurance regulators are rarely explicitly empowered to use affordability as a factor in the annual evaluation of proposed health insurance rates, known as “rate review.” Insurers, however—with their teams of actuaries, claims of innovation, unparalleled access to claims data, and knowledge of provider contracted rates—are well positioned to address America’s healthcare affordability crisis. State should consider granting additional authority to their regulators to press insurers to take on cost containment and quality efforts, as well as provide data and reports that could inform policymakers about local cost drivers.
In this webinar we’ll learned about two states’ efforts to push these boundaries.
Feb. 16, 2018
The U.S. healthcare system has long required a transformation – from rewarding volume to incentivizing value-based care. Physicians play a critical role in efforts to deliver better value, making them the primary target of strategies to address poor quality and high costs.
Efforts to modify provider behaviors have primarily relied on new reimbursement methods, with mixed success. But a growing body of evidence suggests that non-financial incentives may be an equally, if not more, effective way to incentivize a value-driven approach to care. This webinar explored non-financial incentives’ ability to deliver better value by increasing use of high-value services, decreasing use of low-value services and decreasing excess prices.
Jan. 19, 2018
High healthcare spending is a top concern policymakers, advocates and consumers alike. But what is driving our ever-increasing spending? New research provides details about the relative importance of various cost drivers (e.g., unit prices, disease prevalence and intensity, obesity, etc.), both overall and within patient diagnoses groups (e.g., diabetes or heart disease). This research identifies the cost drivers that matter most and actionable information we can use to tackle our high healthcare spending trend.
Dec. 15, 2017
It’s hard to imagine robust progress on healthcare value issues without an overarching entity whose role is to look at the big picture. And yet, to date, only a few states have a centralized oversight agency that focuses on reducing healthcare costs, improving quality, bringing spending in line with overall economic growth and implementing new innovations for better value. In this webinar you’ll hear about the key roles these entities play and how they are operating in states today.
Nov. 17, 2017
Like many areas of the country, rural communities suffer from inconsistent healthcare value. But in the national discussion about addressing high healthcare costs and improving quality, rural areas have been largely left behind. Due to distinct differences between rural and non-rural settings, strategies to achieve rural healthcare value should be customized to reflect the unique challenges faced by rural populations and providers. This webinar provided an overview of rural challenges, identified initiatives with limited utility in rural settings and explored promising strategies to improve healthcare value in rural America.
Nov. 6-8, 2017
The Hub's Getting to Healthcare Value: Focusing the Policy Debate on Lower Costs and Better Quality conference featured advocate leaders and national experts with an interest in lowering healthcare costs and increasing quality.
Sept. 15, 2017
Physician-turned-journalist Elisabeth Rosenthal—formerly a reporter for The New York Times, now the editor in chief of the nonprofit Kaiser Health News—is best known for a prizewinning series of articles, “Paying Till It Hurts.” In her new book, An American Sickness, Rosenthal illuminates the dysfunctional medical market and speaks to some of our greatest concerns: ever more powerful hospitals, skyrocketing drug prices and more. In this webinar, she’ll discuss not only why our healthcare markets fail to deliver value but how to begin to fix the problem.
July 14, 2017
This webinar featured AcademyHealth’s Vice President Enrique Martinez Vidal who provided an overview of their Robert Wood Johnson Foundation-sponsored Payment Reform for Population Health (P4PH) initiative. He described the framework for considering the role of the healthcare system’s financing sources in supporting community-wide population health interventions. Specifically, he reviewed the histories and motivating factors that enable health care systems to consider these upstream investments. Participants learned about the challenges and barriers of using alternative payment models to support population health, as well as lessons in how to overcome those barriers.
As a bonus, the webinar featured new Healthcare Value Hub products that can support your efforts to improve community health by addressing both social and medical needs of patients.
May 19, 2017
Some argue that to improve the cost and quality of healthcare, the government should get out of the way and let the free market reign. Yet healthcare is different from other consumer products and services in ways that can make such an approach challenging. This webinar examined the opportunities and limits of a free market approach to healthcare.
The webinar featured a discussion, moderated by the Hub's Lynn Quincy, with Wendell Potter, former insurance executive and New York Times best-selling author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Nation on the Take: How Big Money Corrupts Our Democracy and What We Can Do About It.
April 21, 2017
States have a critical role to play in the provision of good healthcare value for their residents. This role includes increasing system efficiency, reining in high healthcare prices and waste, improving quality and public accountability for making progress towards these goals.
Despite a strong business case for why states should embrace comprehensive, data-driven oversight of healthcare value, few states are ready to fully embrace this role.
March 31, 2017
Across stakeholders (providers, drug manufacturers, insurers) and across political affiliation, health reform is always cast as being about the patient. From consumer-directed healthcare, to shared decision-making, to consumer assistance, what does it mean to really address consumers’ needs and preferences? How can we elevate the voice of the consumer and validate that this voice is one consumers trust to represent their interests?
To bring rigor to today’s healthcare debate, this event introduced an overarching framework for thinking about consumers’ touch points with respect to healthcare, presents evidence on consumers’ wants and needs for each, and discussed how to amplify and support the consumer voice, as well as ensuring this voice is one consumers trust to represent their interests.
Feb. 22, 2017
Treating complex patients, also known as high-cost, high need patients, by addressing unmet social and medical needs can result in lower healthcare costs, improve quality and may reduce disparities. These approaches deserve the sustained attention of advocates, as well as national and local policymakers. Hear from expert speakers about successful models of care.
Jan. 18, 2017
The incoming administration has promised to broaden healthcare access, make healthcare more affordable and improve the quality of the care. But how will we know whether these promises are kept?
While high healthcare costs are a top-of-mind worry for consumers, it turns out we don’t have a universal standard for defining affordability. Instead, we have a diversity of opinions on what constitutes affordability and a patchwork of program standards (Medicaid, CHIP, tax deductibility, etc).
This webinar will feature expert speakers to make sense of what we know and what we don’t know about affordability, tools we have to measure affordability, the key policies up for repeal and replacement that affect affordability and options for stronger consumer protections going forward.
Starting January 20th, our country will have a new administration. Our featured experts will describe what the election results mean for advocates working on healthcare value issues. You'll hear our current understanding of President-elect Trump's healthcare platform, the likely timetable, as well as possible barriers to enactment and implementation. Experts will review the evidence for some of the major policy proposals and as we'll discuss next steps for advocates interested in evidence-based, consumer-friendly solutions.
Nov. 9-11, 2016
The Healthcare Value Hub hosted a national conference of healthcare advocate leaders and national experts with an interest in lowering healthcare costs and increasing quality.
Robust data can provide insights into everything from healthcare cost drivers to health disparities. Innovative states and organizations are already harnessing the power of data to inform practice and policy choices that lower spending and improve quality of care. National data trends often make the news but what resources are easily and readily available for advocates to use at the state level?
Our health system is inefficient and expensive. High costs and uneven quality leads to poor value for the money we spend on healthcare. What can be done to rein in costs and increase the value? This webinar will provide a comprehensive introduction—or refresher—on healthcare costs and quality issues. What are the major drivers of healthcare costs? What interventions are available to address rising costs and increase quality?
Our physical, social, and economic environments play a significant role in determining how healthy we are and how long we live. Thanks in part to a new requirement under the ACA, nonprofit hospitals and health systems are beginning to incorporate programs and policies that address these “upstream” determinants of health in new and innovative ways. Advocates can take a seat at the table as hospitals conduct their community benefit planning process to identify and address local and regional community priorities around upstream issues like housing, education, employment, and environmental health.
As policymakers, academics and other stakeholders focus on ways to bring better value to our healthcare system, it is critical that we acknowledge when and where our knowledge is lacking. A new Hub report finds that there are critical gaps in our knowledge that are preventing us from getting to a system that delivers the right healthcare, at the right time, at the right price.
This first-of-a-kind analysis summarizes interviews with 14 prominent researchers to learn what the gaps exist and which are most important. Our findings may surprise you. We call upon researchers, funders and other stakeholders to start a national conversation around research gaps, honing our understanding of what they are, as well as providing direction and a framework for how we spend our research dollars. Consumers deserve nothing less.
Health plan mergers are being hotly debated right now. In general, such mergers can raise prices for consumers while rarely providing compensatory benefits. Proposed mergers that cause too much consumer harm should be rejected, but when such mergers are allowed to go forward, they provide an opportunity to focus regulator and health plan attention on "remedies" that could address certain consumer harms and otherwise ensure that consumers realize real, enforceable benefits from the merger.
Vermont has a long history of pursuing innovative policies in the name of better value in health care, such as the transformation of primary care as outlined in its Blueprint for Health. While efforts to enact a single-payer system were derailed by cost concerns, the state has continued to push ahead with a variety of proposed reforms including an all-payer financing system and the expansion of the state’s low-cost Dr. Dynasaur health plan to cover all residents up to age 26. As Vermont moves forward, the state’s experience can serve as a valuable example to policymakers and advocates across the country.
Healthcare consumerism has received significant attention in recent years. Employers, policymakers, benefit consultants and researchers have touted "consumer-directed healthcare," such as high-deductible health plans, as a way to reduce costs by giving consumers more "skin in the game." But there's considerable recent evidence to suggest that these approaches don't realize their stated goals and don't benefit consumers. This webinar looked at new evidence around consumer-directed approaches to increasing healthcare value and discuss alternate approaches that are truly consumer-friendly and evidence based.
April 21, 2016
This event focused on the role of consumers in shopping for healthcare value. The expert panel, drawn from a diversity of perspectives, respond to recent evidence on consumer-directed approaches and discussed a new path forward for consumerism in healthcare. The event was conducted with Consumer Reports and sponsored by the Robert Wood Johnson Foundation.
Modifying the cost-sharing incentives facing patients is not a new idea but Value-Based Insurance Design (VBID) takes this idea one step further by using a “clinically nuanced approach” to benefit design. A classic example would be to lower or eliminate the cost of medications to control diabetes or high blood pressure as a way to reduce barriers for patients and reduce the need for future expensive medical procedures. VBID is on the radar of legislators, advocates and health plan designers. Is VBID a silver bullet to increase quality and decrease costs?
After a period of moderation, prescription drug prices are rising and are a leading driver of overall healthcare cost increases. These growing costs have quickly become a high profile healthcare value issue that has garnered significant media attention and can lead to affordability problems for consumers.
This free Hub webinar provided an in-depth discussion on the mechanics of drug pricing, reasons for recent price increases and toolsets available for advocates to address these issues.
Consolidations are increasing the market power of hospitals, physicians and insurers in ways that may ultimately act as a major cost driver in the U.S. healthcare system. The industry claims consolidation leads to better care coordination, health outcomes, innovation and cost savings through efficiencies, but does the research suggest the same?
This free Hub webinar is for consumer advocates and others who want an in-depth discussion on plan and provider consolidation, the impact on consumers and the tool set available to advocates to prevent or mitigate the negative effects of consolidation.
At a time when networks are narrowing and consumers are facing greater out-of-pocket costs, consumers need a basic level of assurance that the plan they are buying has the ability to deliver promised benefits.
The National Association of Insurance Commissioners (NAIC) recently completed work on a comprehensive model law to address health plan network adequacy. This high profile effort could be a jumping off point for legislation and/or regulations on issues including access to in-network providers, surprise medical bills, provider directory improvements, and more in your state. This joint webinar was held to help advocates make the most of this opportunity.
What do hospital-acquired conditions (HACs), serious reportable events (SREs), healthcare associated infections (HAIs) and "never events" have in common? They're all forms of medical harm. Medical harm is far too common, affecting more than 8 million patients every year, causing more than 400,000 deaths and costing our nation more than $75 billion dollars. It's easy to engage consumers and policymakers around patient safety discussions but the lexicon can be very difficult to unravel.
Nov. 8-10, 2015
The Healthcare Value Hub hosted a national conference of healthcare advocate leaders and national experts with an interest in lowering healthcare costs and increasing quality.
High healthcare spending is widely recognized as one of the most pressing challenges facing the U.S. today. Experts have argued that healthcare price transparency could be a powerful tool for reducing prices by leveraging competition to reduce excess prices and allow a better focus on quality.
In practice, providing consumers with this type of information is more difficult than it appears. New research identifies less than 10% of all health spending is both out-of-pocket and “shoppable,” suggesting there are significant limits on the degree to which consumers can influence overall health system spending, even if they had access to thorough, accurate information on price and quality.
Nonetheless, expanding healthcare pricing transparency is an initiative that legislators and regulators around the country are eager to explore. And there’s good reason to do so—transparency has many audiences.
Meaningful health system improvements are hindered when systematic information about prices, quality and utilization levels are not available. All-payer claims databases (APCDs) are an important tool for revealing spending flows within a state and measuring progress over time. To fully realize their value, implementation of an APCD requires broad stakeholder engagement, sufficient funding, participation by consumer representatives, and extensive data access so that the data can be used for a variety of public purposes. APCDs are a necessary step to building healthcare transparency in states.
Oregon is an active state considering many healthcare cost and quality initiatives. This webinar featured a summary of Oregon's busy and productive legislative session on topics including price transparency, network adequacy, hospital rate setting and health insurance rate review.
This webinar will address the serious—and possibly growing—trend of surprise out-of-network medical bills. The webinar will provide a background of what constitutes a surprise bill, a summary of effective state legislative solutions and legislative updates from advocates from several states that have targeted this widespread problem. We will also discuss what states are doing to establish mechanisms for consumer complaints and what actions and materials are available to advocates to take action now.
Accountable Care Organizations, Patient Centered Medical Homes, shared savings, episode-based payment.... How to make sense of it all? And what’s best for consumers?
This webinar discussed the policies and practices that decrease healthcare costs and increase quality—in short, pursuing better value for our healthcare dollars.
It was the first of our series of free monthly webinars on the hot topics related to finding ways to decrease healthcare costs, increase quality—in short, pursuing better value in our healthcare system.
Materials from this webinar can be found here.
Lynn Quincy, Hub Director, provided an overview of the resources offered by the Hub and a tour of the Hub website. Audience members also discussed healthcare cost and quality issues facing the nation and how advocates can make an impact.
This March 27 conference was held in Washington, D.C., to launch the Healthcare Value Hub.
More information, including speaker presentations and videos, can be found here.
From November 10-12 2013, Consumers Union and the Robert Wood Johnson Foundation (RWJF) convened a working meeting in New Orleans for consumer advocates on ways to address rising healthcare costs. This meeting featured expert speakers and new resources including research offering insight into healthcare cost drivers and potential cost containment strategies.