- N Engl J Med 2022; 387:294-297
With policymakers targeting members of sexual and gender minority groups, the health care sector can mitigate resulting harm and advocate for evidence-based policies protecting health and well-being.
- N Engl J Med 2022; 387:99-102
By better aligning its initiatives and policies related to accountable care organizations, CMS hopes to create pathways for payers and providers to advance high-quality, accountable care.
- N Engl J Med 2022; 387:97-99
Recent value-based payment models have often moved dollars away from patients and providers with fewer resources and toward those with more. A new model names promoting equity as a central goal.
- N Engl J Med 2022; 386:2352-2354
Michigan was among the first states to institute premiums for people covered by Medicaid expansion. Amid current uncertainty surrounding the use of premiums, the Michigan experience may provide insights into program design and the effects of premiums on coverage.
- N Engl J Med 2022; 386:2164-2167
The financial burden associated with orally administered anticancer drugs can be overwhelming for Medicare beneficiaries. Policies adding an out-of-pocket spending cap to Part D have been proposed, and Congress could permit price negotiation for anticancer drugs.
- N Engl J Med 2022; 386:e54
Although the Covid pandemic drew renewed attention to problems in U.S. nursing homes, the underlying issues with long-term care are long-standing. Susan Mitchell moderates a Perspective Roundtable about shortcomings and possible solutions.
- N Engl J Med 2022; 386:1869-1871
More than 30 years after the Nursing Home Reform Act, the United States still fails to protect nursing home residents and provide them with high-quality care. The Covid-19 pandemic’s devastating effect on nursing homes reminds us that further reforms are sorely needed.
- N Engl J Med 2022; 386:1775-1777
Randomized, controlled trials remain underutilized within the Medicaid program, even though state Medicaid programs regularly implement new policies that require evaluation. What are the key barriers to implementing RCTs in Medicaid, and how can we increase their use?
- N Engl J Med 2022; 386:1773-1775
The Biden administration has made important incremental progress in expanding access to affordable health insurance. But its struggles to enact a broader reform agenda reflect the daunting political constraints that limit U.S. health policy.
- N Engl J Med 2022; 386:1488-1490
Under the Reentry Act, Medicaid would be able to pay for health care for eligible people who are incarcerated starting up to 30 days before their release from jail or prison. Changes to this bill could bring care in these facilities in line with community standards.
- N Engl J Med 2022; 386:1104-1106
Existing laws could be used to help make many drugs more affordable. One gives the government a royalty-free license to use patented inventions that were discovered using federal funding; the other gives the government immunity from being sued for patent infringement.
- N Engl J Med 2022; 386:1008-1010
The perception that a good death is one that occurs at home is ingrained in our cultural and social history. But palliative care clinicians have begun to question this idea. What is needed is high-quality end-of-life care that aligns with individual goals and needs.
Coverage of Transvenous Pulmonary Embolectomy — Medicare’s Missed Opportunity for Evidence GenerationN Engl J Med 2022; 386:904-906
There is no evidence of clinical benefit associated with catheter-based aspiration thrombectomy for pulmonary embolism. Nevertheless, CMS has ended its national noncoverage policy for the procedure, allowing coverage decisions to be made on a local basis.
- N Engl J Med 2022; 386:408-411
Policies that broaden eligibility for affordable coverage, though necessary, do little to address the administrative burdens involved in securing and maintaining coverage. Automatic insurance policies could remove barriers and make it easier for people to stay insured.
- N Engl J Med 2021; 385:e93
Relief may be in sight for Medicare Part D beneficiaries who currently face high out-of-pocket spending. Redesign of the program is expected to be part of the fiscal year 2022 budget reconciliation currently moving through Congress.
- N Engl J Med 2021; 385:2209-2211
As we enter a new stage of pandemic response and recovery — in which we must address issues of racial health inequities, frontline health care infrastructure, and community preparedness — what constitutes adequate support for the U.S. health care safety net?
Inequitable Access to Hospital Care — Protecting Disadvantaged Populations during Public Health EmergenciesN Engl J Med 2021; 385:2211-2214
Load balancing among hospitals is a critical public health intervention during emergencies: failing to balance patient loads will cause unnecessary loss of life, particularly in historically marginalized racial and ethnic groups and rural or low-income communities.
- N Engl J Med 2021; 385:e80
Traditional Medicare still lacks dental coverage, which has contributed to inequities in pain, edentulism, and unmet need among lower-income people, people of color, and older adults. The federal government is now closer than ever to enacting a Medicare dental benefit.
- N Engl J Med 2021; 385:2017-2019
Aducanumab’s price can inform the drug-pricing policy debate because it responds to key features of the market environment for physician-administered drugs: Medicare’s reimbursement formula, payment to physicians for infused drugs, and cost-sharing requirements.