New Directions in Health Care

Annual Medicare spending is expected to double over the next 10 years, as baby boomers age and people live longer on average. And Medicaid will also see greater demand given that it provides coverage to more than 4.6 million low-income seniors. Experts are already concerned about funding these programs — and the tax law passed in late 2017, which is expected to add about $1.5 trillion to the federal deficit, poses new challenges. Federal responses to a ballooning deficit could put the health and financial security of future seniors at stake.      

In this edition of our New Directions podcast, we look at why prices for prescription drugs are so high in the United States.      

A new Commonwealth Fund podcast explores what repeal of the Affordable Care Act might mean for individuals and for the nation. Leighton Ku of the Center for Health Policy Research at George Washington University discusses his study, which found that 2.6 million jobs would be lost by 2019. And while the insurance industry waits for a possible repeal-and-replace the law, Sabrina Corlette of Georgetown University says uncertainty in the insurance market could lead to fewer plan choices and higher premiums.      

India is home to Narayana Health, a chain of specialty care hospitals that delivers state-of-the-art medical services at a fraction of the cost charged here in the U.S. Sandy Hausman interviews Dr. Krishna Udayakumar of Duke University’s Global Health Institute, as well as Chandy Abraham, M.D., CEO of Health City, which offers high-tech, low-cost care in Grand Cayman.      

More than 60 percent of Brazil’s 200 million people are served by a model of primary care with community health workers at its center.      

Basic Needs is a mental health program that is establishing self-help groups and changing public attitudes in Kenya and 12 other African and Asian nations. Producer Sandy Hausman interviews its founder as part of our new series on frugal innovations with global implications.      

MediCallHome is a subscription-based medical hotline that offers 24/7 to a doctor to resolve your minor medical issues. It's the model for a Spanish-language phone service for employers and consumers north of the border, too.      

As the nation debates whether to replace or amend the Affordable Care Act, we’ll look at trends in health insurance provided by employers. Fifty-seven percent of adults under the age of 65 get coverage through their job—a benefit companies have kept since the passage of the ACA.      

Prescription drug spending, a significant driver of overall health care costs, has been rising rapidly over the last few years. This episode explores the reasons for higher drug prices, including the introduction of new high-value medications, potentially inefficient research and development, and a lack of price regulation.      

As more and more health insurers and providers merge, it’s important to look at the potential impact on the cost and quality of health care.      

What's behind the drop in cost hospital readmissions?      

Greater use of medical technology and pharmaceutical drugs, as well as high prices, all contribute to high U.S. health spending, according to The Commonwealth Fund's latest cross-national spending brief. But Americans do not see better health outcomes relative to other wealthy nations as a result.      

This episode offers an update on Medicaid—how the program has changed under the Affordable Care Act and what reforms we may see in the months and years to come. The Commonwealth Fund's Sara Collins discusses Medicaid enrollees’ satisfaction with their coverage and access to care, while George Washington University's Sara Rosenbaum examines how some states have taken different approaches to expanding eligibility for Medicaid. Transcript available.      

A new podcast examines what the lack of insurance coverage has meant for racial and ethnic minority groups in this country and how the Affordable Care Act might change that. It also looks at resources designed to educate patients about their health and their coverage. Producer Sandy Hausman interviews Pamela Riley, M.D., assistant vice president for Delivery System Reform at The Commonwealth Fund, and Cara James, director of the Office of Minority Health at the Centers for Medicare and Medicaid Services.      

The Affordable Care Act creates new opportunities to integrate behavioral health and primary care. This episode looks at the challenges and benefits of coordinating physical and mental health care through interviews with The University of Washington's Jurgen Unutzer, M.D., The Commonwealth Fund's Pamela Riley, M.D., and Deborah Bachrach, a partner with Manatt, Phelps and Phillips.      

To improve decision-making at the health care provider level, policies that blend financial and non-financial incentives are being developed and tested. A new initiative called Incentives 2.0 is exploring this new type of payment reform. Hear from Anne-Marie Audet, M.D., and Mark Zezza, Ph.D., of the Commonwealth Fund and Kevin Volpp, M.D., Ph.D., of The University of Pennsylvania.      

Learn how health IT can dramatically change health care delivery by improving communication and saving time—and can even save lives by providing key information at the right time.      

Navigators are hired to help the public sign up for and choose a health insurance policy through online exchanges, or marketplaces, established by the Affordable Care Act. But some states have laws or regulations that are making it hard for navigators to perform this important role.      

As the nation moves to provide high-quality care for more people at lower cost, the pressure is on to provide real value. A new Commonwealth Fund program on breakthrough opportunities in health care intends to zoom in on new and unconventional ways of delivering care.      

About one-quarter of American workers are employed by companies with fewer than 50 people on the payroll, and until now, insurers have charged these employers more for health insurance. In this episode, The Commonwealth Fund's Sara Collins and grantee Jon Gabel explain how the Affordable Care Act has ended that practice, and given employers the ability to offer their workers a choice of affordable plans.