October 26, 2023
Consumer surveys from multiple states have revealed that people with insurance still go without
critical services due to cost.1 Most frequently reported is dental care, with respondents across
insurance types foregoing dentures, root canals, extractions, and many other dental services. Looking
to Medicaid as an example, this webinar will explore the impacts of going without dental care on the
whole body and other high-cost medical conditions, and some causes behind it such as limited
coverage for dental care and a lack of providers accepting certain insurance types. It will also
capture policy solutions and strategies for state administrators and advocates for low- and middle-income communities to expand access to affordable care.
August 24, 2023
Prior authorization was originally developed to curtail expensive tests or care that was not needed in
order for care to be more cost-effective. However, over time, insurers began requiring prior authorization for many common medical services. Now, the system creates administrative burdens, delays needed care, and increases patients’ cost burdens. Many patients do not have the time, willpower, or resources to fight denied claims—they give up and either go without the care or pay for it themselves out-of-pocket.
Reports have revealed that insurers flag expensive claims for special review and use computer programs
to review, and often, deny, claims. While data is limited, it shows that insurers deny between 10-20% of
claims. Among Marketplace plans, 0.2% of denials were appealed, and of those, 41% were overturned;
among Medicare Advantage plans, 11% of denied claims were appealed, 82% were overturned.
A few states have taken action to improve the process, including regulating the amount of time insurers
are required to respond to prior authorization requests and requiring insurers to annually report data on
the number of requests denied and appealed.
This webinar will explore the relationship between prior authorization and access to affordable health
care for consumers, along with action states can take to improve the process.
May 19, 2023
The end of the Public Health Emergency (PHE) is anticipated to impact coverage and care for millions of people with Medicaid nationwide. In addition to the end of the Medicaid continuous coverage requirement, the PHE unwinding will also impact the many temporary provisions and flexibilities introduced throughout the coronavirus pandemic. Although several states have codified some of these changes, and the federal government has extended certain provisions, many others are going to expire once the federal public health emergency declaration is lifted on May 11, 2023.
In this webinar, experts working at the intersection of policy and service provision will discuss the redetermination and renewal process, provide a survey of changes to the many flexibilities introduced during the pandemic, and confer practical strategies to avoid disruptions in care among individuals eligible for both Medicaid and Medicare, ending with a spotlight on the potential impact to dual eligible individuals and their caregivers.
July 13, 2022
Blurb: Healthcare affordability burdens are all too familiar within the American healthcare system, but they do not affect all groups equally. In addition to facing greater health disparities, non-white communities and low-income earners experience greater affordability burdens—two things that are closely linked. Due to systemic inequities, people of color have significantly worse health outcomes and are overrepresented in the group of low-income earners targeted by affordability policies. Offering more affordable healthcare options to this group of individuals allows states to advance health equity by addressing the needs of the most disadvantaged. Incorporating equity components in such policies allows states to further ensure they address affordability, access, and health disparities challenges for those who struggle the most.
In this webinar, we will look at how states can incorporate health equity considerations into policies across four healthcare affordability domains: curbing excess prices; reducing low-value care; expanding coverage options; and lowering out-of-pocket costs. We will be joined by experts and state leaders working at the intersection of healthcare affordability and equity who will share their knowledge with those looking to enact similar measures in their own states.
April 28, 2022
Between 2009 and 2020, unpaid medical bills became the largest source of debt that Americans owe collections agencies. Medical debt is an increasing problem for consumers and disproportionately impacts Black and Hispanic families, uninsuredhouseholds and households with little or no wealth. In addition, hospitals are increasingly taking consumers to court and garnishing wages over unpaid medical bills, though many of these institutions are non-profits required to provide care at a reduced or no cost. The confluence of rising healthcare costs, increased cost-sharing and lax charity care provisions works to saddle consumers with more and more medical debt.
In this webinar, we will be joined by advocates from three states that have recently enacted medical debt protections. The speakers will discuss the potential impact of these new laws, as well as their experiences advocating for such measures. In discussing the strategies they used to pass medical debt protections, the speakers will create a knowledge sharing space for advocates and policymakers looking to enact similar medical debt protections for their own states.
March 30, 2021
Provider scope of practice laws define the range of services that various types of clinicians are authorized to provide. Some states have eased restrictions on professional practice for certain providers, namely for nurse practitioners and physician assistants, allowing clinicians to evaluate patients, diagnose, order and interpret diagnostic tests and initiate and manage treatments, including prescribing medications and controlled substances. By allowing non-physician providers to provide a broader array of health services, states hope to expand access to care and lower costs for consumers who may not always need a doctor’s expertise for every interaction with the health system. This trend has been hastened by the COVID-19 crisis, for which the HHS Secretary recommended that states waive certain restrictions on scope of practice to ensure that providers can meet patient needs during the public health emergency.
In this webinar, speakers will explain the policy changes that states have made to their scope of practice laws prior to and during the COVID pandemic and discuss the potential for these changes to stay in place after the crisis ebbs. They will also discuss how scope of practice changes could impact healthcare cost and value, as well as equity in access to care for people who have been marginalized.
Dec. 11 and 15, 2020
The COVID-19 pandemic has changed many aspects of healthcare, notably the rapid rise of telehealth demand and usage by patients, telehealth provision by providers, and temporary and permanent reimbursement changes. However, the quick switch to telehealth usage has brought up questions on how it will impact the larger healthcare system. Are telehealth appointments always appropriate, and if not, when should they be used? How do we incentivize high-value care in telehealth and reduce low-value care? How can we ensure equity in telehealth services?
In this two-part webinar, experts will discuss what we’ve learned from the recent telehealth boon and what we can expect at the state and federal levels, as well as a discussion on ensuring value in telehealth payment and equity in access. The two sessions will be broken down to focus on Equity and Value, respectively.
Oct. 16, 2020
Healthcare services and procedures that cause patients bodily harm are major drivers of excess spending, waste and patient suffering. Medical harm—injury resulting from largely preventable events caused by human error in healthcare facilities—is suspected to be the third-leading cause of death in the U.S., despite ongoing work to address patient safety concerns.
In this webinar, speakers will brainstorm the creation of a National Patient Safety Authority (NPSA)—a centralized authority that will spearhead the effort to prevent medical harm events. These experts will highlight the importance of establishing a NPSA and describe what this entity could look like. They will also discuss the prevalence of medical harm and its impact on patients and families as well as offer actionable suggestions for consumers that wish to advocate for a national patient safety entity.
May 8, 2020
COVID-19 is an unprecedented crisis that has redirected our policy and healthcare bandwidth to unanticipated activities and profoundly engaged the public. The crisis has also caused us to question our policy priorities and our preparedness. But as past crisis have taught us, this new policy openness could have potentially lasting effects, reinforcing the necessity of getting our COVID-19 policy response right.
This webinar featured a wide ranging set of experts that discussed the issues of emergency preparedness, the disparate effects on vulnerable populations, our new appreciation for coverage and the role of cost-sharing and ensuring that our new policy openness has a lasting, positive impact on Americans.
March 20, 2020
Healthcare costs are a major concern for people in the US, with over 137 million people struggling to pay medical bills and 79 million people burdened with medical debt. Healthcare provider bills are often viewed as vague and arbitrary, with exorbitant markups – as much as 200 times the cost to provide the service. Numerous media reports have brought the issue of aggressive medical debt collection to light.
In this webinar, our speakers will discuss the pathway by which healthcare bills transform into unmanageable medical debt and explore what a better system would look like – one that ensures providers operate efficiently and revenues cover costs, yet patient cost-sharing is tailored to their ability to pay. We will highlight state strategies that can protect consumers at each step along the pathway.
Feb. 28, 2020
There is a strong consensus that the primary driver of high and rising healthcare spending in the United States is unit prices—the individual prices associated with any product or service like a medication or a medical procedure. Moreover, research shows that prices may not reflect the underlying cost to provide healthcare services, particularly prices paid by commercial health insurance which covers almost 60 percent of the U.S. population. There are many approaches to address excessive prices but all rest on establishing what a fair price would look like, sometimes known as a “benchmark price” or “reference price.” The prices paid by the Centers for Medicare and Medicaid Services (CMS) for Medicare beneficiaries is one of the most common standards, not only in use today but a key component of many universal coverage proposals.
This event will explore whether or not Medicare’s approach to setting prices for services like hospitals and specialists, or products like drugs, can be used by other payers to address our high unit price problem and any unintended consequences we might want to be aware of.
Feb. 12, 2020
For years, polling data has shown that healthcare affordability is the number one issue that Americans, on both sides of the political aisle, want elected officials to address. Until recently, however, state policymakers lacked a clearly defined menu of policy options to inform legislative change. Efforts to make healthcare “affordable” are further complicated by a lack of agreement about how healthcare affordability should be measured. But that is starting to change.
This event focused on policy recommendations to make healthcare more affordable and current state efforts to craft a “healthcare affordability standard” to measure progress.
Oct. 25, 2019
Addressing healthcare provider consolidation has been at the forefront of state-level policy conversations for years. Georgetown’s Center for Health Insurance Reforms (CHIR) recently completed six case studies of healthcare markets that have experienced recent provider consolidation. To no one's surprise, these case studies show provider consolidation and its resulting market power has a profound effect on healthcare prices.
In this webinar, our speakers took a deep dive into the six case studies and explored state-based public and private effort to address provider consolidation.
Oct. 4, 2019
The Mental Health Center of Denver constructed the Dahlia Campus for Health and Well-Being through a partnership with the Northeast Park Hill community in Denver, Colorado, recognizing that community members are experts of both the community’s needs and the best approaches to improve their health and well-being. The design of the Dahlia Campus is a case study of how community members can affect change.
Dr. Carl Clark, the President and CEO of the Mental Health Center of Denver, will discuss the community’s role in the creation of the Dahlia Campus and the Center’s continued efforts to meet the community’s needs. The Dahlia Campus serves as a model for involving the community in the design and implementation of healthcare services and facilities, bolstering the strength of a health service to efficiently address a community’s health and well-being.
Aug. 29, 2019
According to poll after poll, consumers’ top concern is healthcare--specifically, consumers want policymakers to address the affordability of healthcare. A particular patient grievance is the bizarre range of prices – all of them unaffordable.
This webinar featured two investigative journalists–a regional reporter and a podcaster--who have reported on the murky healthcare prices that befuddle patients and policymakers alike. Our panelists described their stories that exposed and explained how healthcare prices are set. The panelthen discussed the role of media coverage in addressing our dysfunctional healthcare system.
June 14, 2019
A community health needs assessment (CHNA) is a report that identifies the healthcare and health-related (food, housing, etc.) needs of a community’s residents. The goal of a CHNA is to systematically assess a community’s unmet needs in order to develop strategies to address them.
CHNAs can be a powerful tool to create healthier communities if reporting entities are supplied strong guidance, sufficient resources and solicit input from a diversity of stakeholders. Some communities have exceeded expectations by conducting coordinated, city-or county-wide community health needs assessments produced by collaboratives of community stakeholders to comprehensively assess residents’ needs.
This webinar highlighted three examples of communities (in LA, OR and NC) that are taking CHNA requirements to the next level.
May 16, 2019
The U.S. healthcare system has long been criticized for its complex design, high prices, inequitable coverage and uneven outcomes. Our fragmented payment system, in particular, has been cited as a reason for high healthcare spending and excessive administrative spending. One proposal to address these concerns is the concept of a “single-payer” healthcare system.
In this webinar, we will review this concept and explore the features that must be included to truly “bend the healthcare cost curve,” while maintaining or improving quality for patients. This webinar will showcase speakers with a variety of perspectives to explore how single payer might, or might not, curb healthcare spending and improve quality.
April 19, 2019
Consumer facing price and quality tools are one strategy that states and other stakeholders are looking at to keep consumers safe in the healthcare marketplace, with some proponents hoping these tools will drive value in the system. Several efforts have been made to score these tools, including efforts by Altarum.
A study by Altarum used a scoring exercise that emulates the consumer’s real-world experience of trying to schedule needed healthcare. Using 6 pre-determined medical scenarios and 6 transparency tools that received high scores in prior scoring efforts, we observed real consumers to see how well the selected transparency tools performed. The results may surprise you.
March 22, 2019
The U.S. healthcare system is transforming in response to many types of pressures. To ensure these changes benefit the people the system is intended to serve, policymakers, funders, advocates, and others need actionable information from which to guide improvement efforts. Moreover, it is imperative that we are systematic and evidence-based in our approach.
This webinar focused on an overarching policy compendium, or roadmap, designed to serve that purpose. The roadmap is the result of extensive literature reviews and key informant interviews with a wide range of experts. The information is designed to be highly actionable, with a tool kit designed to help a wide range of stakeholders use the information. Moreover, thought leaders discussed novel ideas for how to enact these policies.
Feb. 22, 2019
Medical devices—ranging from tongue depressors to implants to robotic surgery machines—have revolutionized medical care. While the associated healthcare spending is only 4 to 6 percent of total healthcare spending in the U.S, the rate of spending growth is alarming. Like drugs, pricing information for medical devices is opaque. Additionally, a majority of the devices available on the market today have not undergone clinical trials. Advocates have long had safety concerns about devices, calling for reforms to the FDA’s regulatory process.
This webinar focused on the pricing and marketing parallels between drugs and medical devices, as well as the key issues surrounding medical device safety.
Jan. 11, 2019
This webinar featured Beth Bortz, the President and CEO of the Virginia Center for Health Innovation, who described the Center’s unique public/private partnership gives them the ability to leverage state-wide data to make evidence-based, value driven policy. She described the Center’s new dashboard tool which aims to use data to reduce low-value care, increase high-value care and improve the state’s infrastructure for value based care. Advocates can use this model to learn best practices for implementing a strong data collection and analytic system to improve healthcare value in their own states.
Dec. 7, 2018
Healthcare price and quality transparency are important tools being considered by states. This webinar describes a first-of-its kind, comprehensive database of 230 transparency tools in four categories: hospital, Rx, doctor, and health plan. The database is easily searchable by state and is accompanied by a report that summarizes key findings from the inventory and offers best practices and recommendations for states to consider.
This webinar featured study authors and an advocate from New York to discuss how advocates and others can use this information to promote best practices in transparency tools.
Nov. 14-16, 2018
The Hub's High-Value, Patient-Centered Care: Where's the Greatest Return on Investment? conference was held at the Hotel Monteleone in New Orleans on Nov. 14-16, 2018, and featured advocate leaders and national experts with an interest in working to achieve a high-value health system that is equitable, patient-centered, allocates resources wisely and delivers uniformly positive health outcomes.
Oct. 27, 2018
Have you heard of SIPPRA? Passed in 2018, the Social Impact Partnerships to Pay for Results Act (SIPPRA) provides $100 million to support the launch of state and local Pay for Success initiatives — an innovative contracting approach that ties payments to the achievement of measurable outcomes. This new program is a new funding opportunity for states and local governments that incorporates performance measures into the provision of human and social services.
This webinar resources below provide an overview of Pay for Success, detail how the tool has been used to advance policy initiatives, explain how it fits into the larger set of options for coordinating social and health spending, and explore how advocates, and state and local governments can leverage SIPPRA funding to improve health outcomes.
Aug. 28, 2018
This webinar provided an overview of Healthcare Value Hub’s free products and services. How many of our infographics are you familiar with? Did you know that you can repurpose these graphics with your own logo? Or that we have presentation slides that you can use to help make your points on key issues? This webinar is tailored for advocates (and others!) who want to learn how the Hub can assist your efforts toward a healthcare system that delivers uniformly high health outcomes and patient satisfaction for the lowest level of spending through coordinated and evidence-based treatment decisions and a focus on personal and social determinants of health.
This webinar is ideal for advocates who are new to the Hub’s resources, however—given the large number of products that we’ve recently released—all will benefit from attending. The webinar was fast-paced, interactive and entertaining, with plenty of time for questions. Additionally, we provided a robust guide to the resources available to you after the webinar.
May 11, 2018
Community-based approaches to organizing health services seek to integrate care, improve population health, and occasionally control costs.
Variously known as Accountable Communities of Health (ACHs), Accountable Care Communities (ACCs), and Accountable Health Communities (AHCs), these place-based approaches utilize a backbone organization to coordinate healthcare (including behavioral health), public health, social services, and community-based supports to meet medical and social needs of all individuals living in a specific place. This webinar explored the pros and cons of these models and provided a taxonomy to help you make sense of the myriad terms used to refer to these collective action approaches.
April 20, 2018
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.