Thought Leadership

Our wide array of published insights drive the debate in Washington.

Creating Medicare Advantage Premium Support For All, Part 5: Which Proposal Is Actually Medicare?

With the burgeoning debate around single payer, primarily oriented around "Medicare for All," CEO Billy Wynne takes a look under the hood of Sen. Bernie Sanders' "M4All" proposal and discovers it is not actually based on Medicare. He also continues his inquiry into what bona fide Medicare for All would actually look like, in this case by explaining the basics of the Medicare Advantage program, which covers 33% of Medicare enrollees this year....
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What Might Happen in Federal Health Policy Before the Midterm Elections

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An in-depth guide to the key health policy issues that will dominate DC through the midterm elections....
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Here’s What the House Passed to Tackle the Opioid Crisis

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A breakdown of all of the key provisions in the House-passed opioid package. From the intro: "After months of debate, the US House of Representatives passed a package of bills on June 22 addressing the opioid epidemic by a vote of 396 to 14. H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT), incorporates dozens of House bills. ...
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Medicare’s Hospital Outpatient Prospective Payment System Proposed Rule: Big Changes For 2019

CEO Billy Wynne's breakdown of the key policy changes described in the CY19 Medicare Hospital Outpatient Prospective Payment System proposed rule....
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Creating Medicare Advantage Premium Support For All, Part 4: Financing

In this fourth installment of his Medicare Advantage Premium Support for All series, CEO Billy Wynne demonstrate that this universal coverage approach can be fully funded with current spending (i.e., no new taxes would be necessary). ...
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With Great Power Comes Great Responsibility: Medicare Advantage’s Newfound Supplemental Benefit Flexibility

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The Centers for Medicare and Medicaid Services (CMS) recently made a series of interrelated policy changes to give Medicare Advantage (MA) plans more flexibility than ever to offer additional services outside of traditional Medicare. Known as supplemental benefits, these services have historically included items like dental, vision, and hearing. By allowing plans to offer an even wider and more tailored array of services, CMS expects that plans will be better positioned to attract members and meet beneficiary needs. ...
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“Public Charge” Rule Would Disrupt Safety-Net Access for Some Immigrants

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The Trump administration has signaled its plans to significantly alter the rule on eligibility of applicants for permanent residency and applicants intending to immigrate to the US by redefining “public charge” determinations related to the use of public benefits. This would make it harder to enter the country and reduce access to a broad range of health and human service safety-net programs for immigrants already living here, including US citizen children. ...
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The Consumerization Of Health Care To Improve Value: Secretary Alex Azar’s “Radical” Vision

HHS Secretary Alex Azar recently laid out a four-part strategy to achieve a "radical" vision of reforming health care: giving consumers greater control over health information, encouraging price transparency, using experimental models in Medicare and Medicaid to drive value, and removing government burdens. While certain elements of the secretary’s strategy reflect important reforms, his recommendations raise questions about the desirability of a shift toward consumerization of health care and whether these changes are actually in the best interest of consumers....
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Creating Medicare Advantage Premium Support For All, Part 3: Provider Considerations

"In the first post of this series, I hypothesized that a Medicare-for-all approach that puts market-based principles at its core will have the most success not only in winning sturdy, bipartisan support but in actualizing high-quality universal coverage at lower cost. In Part 2, I explored modest benefit enhancements that would be needed to maintain the quality of coverage various populations have under existing programs, some of which were reiterated in the CAP proposal. "In this post, I will examine what a Medicare Advantage (MA)-based universal coverage regime would mean for providers, who will continue to be the heart of our system and whose decisions affect the cost and quality of our care more than anyone else’s."...
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What Does Alex Azar’s Plan for Value-Based Care Really Mean?

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New HHS Secretary Azar has articulated a four-point plan for value-based transformation of our health care system, but so far concrete details regarding the initiatives he will pursue are scarce. In this post, we break down the components of his plan and their potential implications for various health care stakeholders....
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State Waivers As A National Policy Lever: The Trump Administration, Work Requirements, And Other Potential Reforms In Medicaid

As states line up to avail themselves of new flexibilities in the section 1115 Medicaid wavier process, we thought it important to examine exactly what was approved in Kentucky and Indiana, and to survey the current landscape of pending proposals in search of what other reforms may be on the horizon....
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The Arduous Road to Renewal of CHIP Funding

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After months of uncertainty, on January 22, 2018, Congress passed legislation renewing long-term federal funding for the Children’s Health Insurance Program (CHIP). Nearly nine million children and 370,000 pregnant women nationwide rely on the program for health coverage. This post examines the pathway renewal of the program took through considerable delays and political controversies....
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