In the May 18 issue of the New England Journal of Medicine, Rashi Fein and Arnold Milstein tackled the question of why evidence-based care diffuses so slowly. The article is compelling because of its fundamental conclusion: institutionalized interest group pressure against change in health care and consumer misunderstanding of health care financing make it hard to envision how health care …

Sixty-five quality indicators? Retrospectively attributed patient populations? Risk after the fact? Significant management and financial investment required with uncertain payback? This may not sound like a strategy to win the hearts and minds of providers who are on the fence about whether or not to participate in CMS’ new approach to care: accountable care organizations (ACOs). So, what is going …

Today we are releasing our Cover Michigan Survey, 2011. Like last year’s survey, this report looks at what Michigan residents say about their access to health care. Different from last year, this survey was designed to look more in-depth at access, along with health status. Our findings confirm last year’s major finding: Having health insurance coverage is important but not …

Michigan Governor Rick Snyder deserves special notice and acknowledgement for the courage and focus he displayed in his decision not to sign on to the letter signed by all other Republican governors, asking for changes to the Medicaid program and advocating for the repeal of the Affordable Care Act. I am sure Governor Snyder disagrees with some provisions of the …

In the New England Journal of Medicine on May 26, 2011, Thomas Smith and Bruce Hillner describe a series of strategies to reduce the cost of spending on cancer care in the United States. The article is compelling, and highlights the reasons health care spending is so difficult to talk about—much less do something about: all five strategies involve changes to …

I get asked to speak about health reform on a fairly frequent basis. It is actually quite fun, because health reform is so topical and there is always something new going on. I also enjoy the subject because there is always a range of viewpoints in any given audience: from those who strongly advocate for a single payer system to …

With the announcement of  Rep. Ryan’s proposal to convert Medicare into a voucher program and Medicaid into a block grant, contrasting visions of health care reform became very clear. The Ryan/Republican House approach embraces a market strategy and would effectively cap federal government payments for health care. A Medicare voucher program would leave seniors to purchase health insurance with government …

Mayor Bloomberg of New York made headlines when he decided to take on the soda industry (ok, I know, my New York roots are showing – pop for those of you from the Midwest!). Specifically, Mr. Bloomberg is seeking a federal waiver in the food stamp program (now called SNAP – supplemental nutrition assistance program) to ban the purchase of …

For years, many in the health policy world have talked about the emphasis that pharmaceutical manufacturers were putting on “me too” drugs – drugs that are structurally similar to existing drugs with only subtle differences. And for a long time, I have been reading articles about the lack of new drugs in the drug development pipeline – especially blockbuster drugs …

The April 13 issue of the New England Journal of Medicine includes an important article on how comparative effectiveness research can pay for itself.  In it, the authors describe two procedures to treat osteoporotic vertebral fractures (compression fractures caused by osteoporosis): one in which cement is injected into the vertebral body to support the fractured bone; and one in which …