Current Topics

	Medicare Spending and Physician Reimbursement With Congress again under pressure to pass a short-term “Doc Fix” to avert cuts to physician reimbursements in Medicare, there is renewed interest in broader reforms to overhaul the way Medicare pays providers and controls spending. A RWJF/Health Affairs brief examines various proposals for revamping the Medicare payment system and their possible effects on federal spending and on health care providers. An Urban Institute brief provides a status report on the Center for Medicare and Medicaid Innovation, established by the ACA primarily to test new payment and delivery models. An RWJF/Health Affairs brief explores the Independent Payment Advisory Board (IPAB), a new executive-branch entity created by the ACA that will have significant authority to curb rising Medicare spending.
	Easier Interaction Between Medicaid and the Exchanges As policymakers wrestle with integrating new health insurance exchanges, Medicaid, and the ongoing challenge of offering access to seamless coverage, RWJF highlights the following resources on these topics: A policy brief from RWJF and the California Endowment recommends the best ways to provide uninterrupted health coverage. An RWJF two-page brief and a report from the National Academy of Social Insurance explore how to integrate exchanges and Medicaid. A report from RWJF's Maximizing Enrollment program offers a road map on exchanges for state policymakers. Authors of these reports discuss these issues in a recent webinar.
	New Nutrition Standards for School Meals The USDA finalized new nutrition standards for school meals January 25, the first big upgrades to school menus in 15 years. These changes will add more fruits, veggies, whole grains and low-fat milk while placing stricter limits on fat and calories. A statement from RWJF CEO Risa Lavizzo-Mourey on the new standards. A statement from the Kids' Safe & Healthful Foods Project. Research has shown that only one-fifth of public elementary school students have access to salad bars and whole grains most of the week, while nearly 60 percent of high schoolers had access to snacks such as candy, cookies and ice cream. Read more in Bridging the Gap's elementary and secondary school surveys.
	The Future of the Individual Mandate The individual mandate is an integral but controversial part of the Affordable Care Act. A variety of reports examine the mandate and the role its future could play on health insurance coverage and health care costs. A new report from the Urban Institute examines the effect that eliminating the individual mandate would have on health insurance coverage, spending, premiums and uncompensated care. An RWJF two-page brief provides an overview of the individual mandate and explores its effects. A Health Affairs brief explores the past, present, and future of the individual mandate.
	Investments in Prevention Save Lives and Money Research shows that strategic investments in proven, community-based prevention programs can reduce the burden of disease and result in significant U.S. health care cost savings and overall economic cost savings. An RWJF brief summarizes key recent research findings on the return on investment in public health and prevention. A report from the Urban Institute explores how investments in prevention could curb the alarming growth of U.S. health care costs. A set of six case studies from Minnesota, Texas, Tennessee, Indiana, California and Mississippi shows how improving the health of a community spurs economic development.
	States Slash Tobacco Prevention and Cessation Budgets Tobacco use is the leading cause of preventable death in the United States. States collect billions of dollars in tobacco revenue from the 1998 tobacco settlement and tobacco taxes—with less than two cents of every dollar going to fight tobacco use. A new report, funded by RWJF, and Q&A on NewPublicHealth.org examine states' allocation of tobacco settlement dollars. An RWJF two-page brief explores prevention strategies to stop young people from smoking, help smokers quit and protect against secondhand smoke. Fast Fact: Counting both state funds and federal grants, only Alaska and North Dakota currently fund tobacco prevention programs at CDC-recommended levels. Read more Fast Facts.
	The Future of Accountable Care Organizations The final rule for Accountable Care Organizations (ACOs) received positive reactions, but what’s next? These resources from RWJF and its grantees take a look at the final rule and consider where ACOs go from here. A report from the Urban Institute examines whether the ACO model will spread, whether it will save money and whether anti-trust concerns will materialize. Consumer and employer groups say the real measure of success will be whether ACOs are soon widespread, providing better-coordinated, patient-centered, high-value care. Read a statement from the Consumer-Purchaser Disclosure Project. An implementation brief from HealthReformGPS.org looks at whether the final rule will advance national goals to better integrate and reform health care delivery.
	HHS Releases Final Standards To Measure Disparities The Department of Health and Human Services has released final standards to measure health care disparities based on race, ethnicity, sex, primary language, and disability status, as required by health reform. An RWJF two-page brief explores the link between collecting data and eliminating disparities An implementation brief from HealthReformGPS.org examines how the Affordable Care Act handles disparities. Fast Fact: The 25 percent of hospitals that are the most crowded care for nearly 90 percent of elderly African-Americans. Read more Fast Facts on Disparities.
	Uninsured Residents Affect Insured Neighbors In areas with high rates of uninsured people, even residents with insurance suffer. Insured, working-age adults report worse access to care and less satisfaction with care. A report from the University of California, Los Angeles, and the RAND Corporation looks at the spillover effects of community uninsurance. A 2009 report from the Institute of Medicine reviews the research evidence on how high rates of uninsurance affect both the insured and the uninsured. A brief from the Urban Institute looks at the specifics of how the Affordable Care Act (ACA) will expand health insurance coverage. Fast Fact: An estimated 32 million uninsured Americans will gain coverage under the ACA. View more Fast Facts on health insurance coverage.
	Physical Activity Improves Academic Performance As policymakers work to reauthorize the Elementary and Secondary Education Act, these materials from RWJF summarize the most up-to-date research on the impact of physical education and physical activity on academic performance. An RWJF two-page brief examines how active kids do better in school. A research brief from Active Living Research offers a more in-depth look at research on physical activity and academics. A policy brief from Leadership for Health Communities outlines steps policymakers can take to ensure that children get the physical activity they need to succeed in the classroom. Surveys of secondary schools and elementary schools show lapses in physical education in schools.
	Controlling Health Care Costs A variety of recent reports examine proposals to reduce health care costs -- from limiting Medigap policies to improving care for dual eligibles to promoting consumer action. A Health Affairs/RWJF brief examines whether limits on Medigap policies would lower Medicare spending. A September Urban Institute brief looks at how Medicare could improve quality and reduce costs for dual eligibles. A Dartmouth Atlas report finds hospitals have wide room for improvement in readmissions. Avoidable readmissions cost an estimated $17 billion annually. A new study shows that consumers drive cost reductions in consumer-directed health plans.
	Marketing Food to Children The Interagency Working Group on Food Marketed to Children made recommendations this summer for how companies could improve the nutritional quality of foods they market to children. RWJF two-page brief: How does food and beverage marketing influence children's food choices? A new report from the Hudson Institute shows marketing healthier foods can drive profits for major food and beverage companies. View video of the release of the report. Read about how fast food and cereals are marketed to children in two reports from the Rudd Center for Food Policy & Obesity, Fast Food FACTS and Cereal FACTS.
	50 Million Americans Lack Health Insurance New estimates from the U.S. Census Bureau show the number of uninsured continues to climb and fewer workers are able to obtain insurance through employers. "The ability to afford health insurance has become even more tenuous." Read RWJF's statement on the new numbers. Experts from the Census Bureau and the State Health Access Data Assistance Center (SHADAC) held a webinar on the estimates September 23. Read SHADAC's policy brief on how to interpret the four government surveys that track the uninsured. Read RWJF's two-page brief on the link between having health insurance and enjoying the best health outcomes.
	Scrutinizing Competitive Foods Competitive foods are the high-calorie, low-nutrition snacks sold in school vending machines, school stores and elsewhere in schools. They are largely exempt from federal nutrition requirements and are a contributor to childhood obesity. Briefs from Healthy Eating Research here and here summarize current research on the availability, nutritional content and impact of competitive foods. An RWJF policy brief reviews key research findings on competitive foods and school meals and makes policy recommendations. A study in the Archives of Pediatrics and Adolescent Medicine shows high-calorie drinks are widely available in elementary schools.
	Releasing Medicare Claims Data The Centers for Medicare & Medicaid Services (CMS) will soon begin releasing claims data from Medicare. If done well, this release of data can help patients assess the performance of physicians and hospitals. RWJF offers comments to CMS on Medicare data release. The Consumer-Purchaser Disclosure Project a group representing employers and patients offers comments to CMS. An RWJF brief examines the impact of local efforts to publicly disclose data on physician performance. Data in Action: The Wisconsin Collaborative for Healthcare Quality uses claims data from private sources to compile online reports that allow patients to compare doctors.
	Prevention Leads To Better Health and Lower Costs Research shows that funding prevention can reduce the burden of preventable illnesses while also lowering health care costs. RWJF two-page brief: How does an investment in prevention improve the public's health? Health Affairs study: More public health spending leads to declines in preventable illnesses. Health Affairs study: Preventive care aimed at diabetes and cardiovascular disease could save Medicare $7 billion. State-by-state listings of programs funded by the federal Prevention Fund and what each state spends on public health, from the Trust for America's Health.

Medicare Spending and Physician Reimbursement
With Congress again under pressure to pass a short-term “Doc Fix” to avert cuts to physician reimbursements in Medicare, there is renewed interest in broader reforms to overhaul the way Medicare pays providers and controls spending.

A RWJF/Health Affairs brief examines various proposals for revamping the Medicare payment system and their possible effects on federal spending and on health care providers.
An Urban Institute brief provides a status report on the Center for Medicare and Medicaid Innovation, established by the ACA primarily to test new payment and delivery models.
An RWJF/Health Affairs brief explores the Independent Payment Advisory Board (IPAB), a new executive-branch entity created by the ACA that will have significant authority to curb rising Medicare spending.

Easier Interaction Between Medicaid and the Exchanges
As policymakers wrestle with integrating new health insurance exchanges, Medicaid, and the ongoing challenge of offering access to seamless coverage, RWJF highlights the following resources on these topics:

A policy brief from RWJF and the California Endowment recommends the best ways to provide uninterrupted health coverage.
An RWJF two-page brief and a report from the National Academy of Social Insurance explore how to integrate exchanges and Medicaid.
A report from RWJF's Maximizing Enrollment program offers a road map on exchanges for state policymakers.
Authors of these reports discuss these issues in a recent webinar.

New Nutrition Standards for School Meals
The USDA finalized new nutrition standards for school meals January 25, the first big upgrades to school menus in 15 years. These changes will add more fruits, veggies, whole grains and low-fat milk while placing stricter limits on fat and calories.

A statement from RWJF CEO Risa Lavizzo-Mourey on the new standards.
A statement from the Kids' Safe & Healthful Foods Project.
Research has shown that only one-fifth of public elementary school students have access to salad bars and whole grains most of the week, while nearly 60 percent of high schoolers had access to snacks such as candy, cookies and ice cream. Read more in Bridging the Gap's elementary and secondary school surveys.

The Future of the Individual Mandate
The individual mandate is an integral but controversial part of the Affordable Care Act. A variety of reports examine the mandate and the role its future could play on health insurance coverage and health care costs.

A new report from the Urban Institute examines the effect that eliminating the individual mandate would have on health insurance coverage, spending, premiums and uncompensated care.
An RWJF two-page brief provides an overview of the individual mandate and explores its effects.
A Health Affairs brief explores the past, present, and future of the individual mandate.

Investments in Prevention Save Lives and Money
Research shows that strategic investments in proven, community-based prevention programs can reduce the burden of disease and result in significant U.S. health care cost savings and overall economic cost savings.

An RWJF brief summarizes key recent research findings on the return on investment in public health and prevention.
A report from the Urban Institute explores how investments in prevention could curb the alarming growth of U.S. health care costs.
A set of six case studies from Minnesota, Texas, Tennessee, Indiana, California and Mississippi shows how improving the health of a community spurs economic development.

States Slash Tobacco Prevention and Cessation Budgets
Tobacco use is the leading cause of preventable death in the United States. States collect billions of dollars in tobacco revenue from the 1998 tobacco settlement and tobacco taxes—with less than two cents of every dollar going to fight tobacco use.

A new report, funded by RWJF, and Q&A on NewPublicHealth.org examine states' allocation of tobacco settlement dollars.
An RWJF two-page brief explores prevention strategies to stop young people from smoking, help smokers quit and protect against secondhand smoke.
Fast Fact: Counting both state funds and federal grants, only Alaska and North Dakota currently fund tobacco prevention programs at CDC-recommended levels. Read more Fast Facts.

The Future of Accountable Care Organizations
The final rule for Accountable Care Organizations (ACOs) received positive reactions, but what’s next? These resources from RWJF and its grantees take a look at the final rule and consider where ACOs go from here.

A report from the Urban Institute examines whether the ACO model will spread, whether it will save money and whether anti-trust concerns will materialize.
Consumer and employer groups say the real measure of success will be whether ACOs are soon widespread, providing better-coordinated, patient-centered, high-value care. Read a statement from the Consumer-Purchaser Disclosure Project.
An implementation brief from HealthReformGPS.org looks at whether the final rule will advance national goals to better integrate and reform health care delivery.

HHS Releases Final Standards To Measure Disparities
The Department of Health and Human Services has released final standards to measure health care disparities based on race, ethnicity, sex, primary language, and disability status, as required by health reform.

An RWJF two-page brief explores the link between collecting data and eliminating disparities
An implementation brief from HealthReformGPS.org examines how the Affordable Care Act handles disparities.
Fast Fact: The 25 percent of hospitals that are the most crowded care for nearly 90 percent of elderly African-Americans. Read more Fast Facts on Disparities.

Uninsured Residents Affect Insured Neighbors
In areas with high rates of uninsured people, even residents with insurance suffer. Insured, working-age adults report worse access to care and less satisfaction with care.

A report from the University of California, Los Angeles, and the RAND Corporation looks at the spillover effects of community uninsurance.
A 2009 report from the Institute of Medicine reviews the research evidence on how high rates of uninsurance affect both the insured and the uninsured.
A brief from the Urban Institute looks at the specifics of how the Affordable Care Act (ACA) will expand health insurance coverage.
Fast Fact: An estimated 32 million uninsured Americans will gain coverage under the ACA. View more Fast Facts on health insurance coverage.

Physical Activity Improves Academic Performance
As policymakers work to reauthorize the Elementary and Secondary Education Act, these materials from RWJF summarize the most up-to-date research on the impact of physical education and physical activity on academic performance.

An RWJF two-page brief examines how active kids do better in school.
A research brief from Active Living Research offers a more in-depth look at research on physical activity and academics.
A policy brief from Leadership for Health Communities outlines steps policymakers can take to ensure that children get the physical activity they need to succeed in the classroom.
Surveys of secondary schools and elementary schools show lapses in physical education in schools.

Controlling Health Care Costs
A variety of recent reports examine proposals to reduce health care costs -- from limiting Medigap policies to improving care for dual eligibles to promoting consumer action.

A Health Affairs/RWJF brief examines whether limits on Medigap policies would lower Medicare spending.
A September Urban Institute brief looks at how Medicare could improve quality and reduce costs for dual eligibles.
A Dartmouth Atlas report finds hospitals have wide room for improvement in readmissions. Avoidable readmissions cost an estimated $17 billion annually.
A new study shows that consumers drive cost reductions in consumer-directed health plans.

Marketing Food to Children
The Interagency Working Group on Food Marketed to Children made recommendations this summer for how companies could improve the nutritional quality of foods they market to children.

RWJF two-page brief: How does food and beverage marketing influence children's food choices?
A new report from the Hudson Institute shows marketing healthier foods can drive profits for major food and beverage companies. View video of the release of the report.
Read about how fast food and cereals are marketed to children in two reports from the Rudd Center for Food Policy & Obesity, Fast Food FACTS and Cereal FACTS.

50 Million Americans Lack Health Insurance
New estimates from the U.S. Census Bureau show the number of uninsured continues to climb and fewer workers are able to obtain insurance through employers.

"The ability to afford health insurance has become even more tenuous." Read RWJF's statement on the new numbers.
Experts from the Census Bureau and the State Health Access Data Assistance Center (SHADAC) held a webinar on the estimates September 23.
Read SHADAC's policy brief on how to interpret the four government surveys that track the uninsured.
Read RWJF's two-page brief on the link between having health insurance and enjoying the best health outcomes.

Scrutinizing Competitive Foods
Competitive foods are the high-calorie, low-nutrition snacks sold in school vending machines, school stores and elsewhere in schools. They are largely exempt from federal nutrition requirements and are a contributor to childhood obesity.

Briefs from Healthy Eating Research here and here summarize current research on the availability, nutritional content and impact of competitive foods.
An RWJF policy brief reviews key research findings on competitive foods and school meals and makes policy recommendations.
A study in the Archives of Pediatrics and Adolescent Medicine shows high-calorie drinks are widely available in elementary schools.

Releasing Medicare Claims Data
The Centers for Medicare & Medicaid Services (CMS) will soon begin releasing claims data from Medicare. If done well, this release of data can help patients assess the performance of physicians and hospitals.

RWJF offers comments to CMS on Medicare data release.
The Consumer-Purchaser Disclosure Project a group representing employers and patients offers comments to CMS.
An RWJF brief examines the impact of local efforts to publicly disclose data on physician performance.
Data in Action: The Wisconsin Collaborative for Healthcare Quality uses claims data from private sources to compile online reports that allow patients to compare doctors.

Prevention Leads To Better Health and Lower Costs
Research shows that funding prevention can reduce the burden of preventable illnesses while also lowering health care costs.

RWJF two-page brief: How does an investment in prevention improve the public's health?
Health Affairs study: More public health spending leads to declines in preventable illnesses.
Health Affairs study: Preventive care aimed at diabetes and cardiovascular disease could save Medicare $7 billion.
State-by-state listings of programs funded by the federal Prevention Fund and what each state spends on public health, from the Trust for America's Health.

Health Policy Connection

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