New Ideas to Help the Aquino Administration Achieve its Health Agenda

One of the inaugural commitments made by the Philippines` new administration is the provision of quality and affordable health care for each and every Filipino. To achieve this, a strategic health agenda is needed. This Policy Note offers a few new ideas that may help the administration achieve its health agenda.health sector, health care, health insurance, hospitals, health care financing, Philippines, health

The Role of ERISA Preemption in Health Reform: Opportunities and Limits

The Employee Retirement Income Security Act (ERISA) is a federal law regulating the administration of private employer-sponsored benefits including health benefits (i.e., health insurance offered by an employer). In general, since the federal government has exercised its authority to preempt state regulation of the administration of private employer-sponsored health plans, states are blocked from enforcing laws interfering with ERISA. As many states pursue health care reform experiments, ERISA preemption becomes relevant as a potential limit on the scope and type of reforms states are able to enact. The dominant trend in ERISA litigation has been to preempt state legislation and litigation interfering with the administration of private employer sponsored health plans, making large-scale state health care reform initiatives difficult. The purpose of this paper is to examine the trajectory of judicial interpretation of ERISA and to discuss what opportunities exist to facilitate health care initiatives given the constraints of ERISA preemption

Department of Veterans Affairs FY2016 Appropriations: In Brief

[Excerpt] The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans who meet certain eligibility rules; these benefits include medical care, disability compensation and pensions, education, vocational rehabilitation and employment services, assistance to homeless veterans, home loan guarantees, administration of life insurance as well as traumatic injury protection insurance for servicemembers, and death benefits that cover burial expenses. The VA carries out its programs nationwide through three administrations and the Board of Veterans Appeals (BVA). The Veterans Benefits Administration (VBA) is responsible for, among other things, providing compensation, pensions, and education assistance. The National Cemetery Administration (NCA) is responsible for maintaining national veterans’ cemeteries; providing grants to states for establishing, expanding, or improving state veterans’ cemeteries; and providing headstones and markers for the graves of eligible persons, among other things. The Veterans Health Administration (VHA) is responsible for health care services and medical and prosthetic research programs. The VHA is primarily a direct service provider of primary care, specialized care, and related medical and social support services to veterans through the nation’s largest integrated health care system. Inpatient and outpatient care are also provided in the private sector to eligible dependents of veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Health Care for Dependents and Survivors of Veterans

[Excerpt] The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) was established by the Veterans Health Care Expansion Act of 1973 (P.L. 93 82). CHAMPVA is primarily a health insurance program where certain eligible dependents and survivors of veterans receive care from private sector health care providers. The program is administered by the Veterans Health Administration (VHA), Office of Community Care, located in Denver, CO

Department of Veterans Affairs FY2017 Appropriations

[Excerpt] The Department of Veterans Affairs (VA) provides a range of benefits and services to veterans and eligible dependents who meet certain criteria as authorized by law. These benefits include medical care, disability compensation and pensions, education, vocational rehabilitation and employment services, assistance to homeless veterans, home loan guarantees, administration of life insurance as well as traumatic injury protection insurance for servicemembers, and death benefits that cover burial expenses. The VA carries out its programs nationwide through three administrations and the Board of Veterans Appeals (BVA). The Veterans Benefits Administration (VBA) is responsible for, among other things, providing compensation, pensions, education assistance, and vocational rehabilitation and employment services. The National Cemetery Administration (NCA) is responsible for maintaining national veterans’ cemeteries; providing grants to states for establishing, expanding, or improving state veterans’ cemeteries; and providing headstones and markers for the graves of eligible persons, among other things. The Veterans Health Administration (VHA) is responsible for health care services and medical and prosthetic research programs. The VHA is primarily a direct service provider of primary care, specialized care, and related medical and social support services to veterans through the nation’s largest integrated health care system. Inpatient and outpatient care are also provided in the private sector to eligible dependents of veterans under the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Pedagogy: How to best teach population health to future healthcare leaders

Our healthcare system is moving from a fee-for-service reimbursement model to one that provides payment for improvements in three areas related to care: quality, coordination, and cost. Healthcare organizations must use a population health approach when delivering care under this new paradigm. Health administration programs play a critical role in training future leaders of healthcare organizations to be adaptable and effective in this dynamic environment. The purpose of this research was to: (1) engage health administration educators in a dialogue about population health and its relevance to healthcare administration education; (2) describe pedagogical methods appropriate for teaching population health skills and abilities needed for successful careers in our healthcare environment; and (3) identify current student learning outcomes that participants can tailor to utilize in their undergraduate and graduate health management courses. Authors conducted focus groups of participants attending this educational session at the 2018 annual AUPHA meeting. Qualitative analysis of the focus group discussions identified themes by a consensus process. Study findings provide validated recommendations for population health in the health administration curriculum. The identification of pedagogical approaches serves to inform educators as they prepare future health administrators to practice in this new era of healthcare delivery

Do No Harm

The mission of Congress and the Obama administration should be the same as a doctor treating a patient: do no harm.Bob Corker, health care reform, healthcare reform, healthcare, health care, SGR, Medicare, Oliver Wyman, Tennessee, insurance

The Rhetoric and the Reality of Health Care Reform Legislation. 6th Annual Herbert Lourie Memorial Lecture on Health Policy

A plethora of political autopsies have been performed on the Clinton Administration's failed health care reform of 1994--it was too much; it was too late; there was too much pandering; there was too little pandering. Such critiques of this complex undertaking are at least partially correct. It was probably hubris to believe that such a comprehensive health care reform package could be proposed and passed in a single year. But much of the instant analysis of its failure has repeated the rhetoric of the debate rather than stepping back and placing the events of 1994 in perspective. Here I focus on five areas where rhetoric confused the debate, and compare them with the underlying realities of health care reform: (1) Financing. Proponents of the Administration proposal argued that universal coverage could be achieved primarily by redirecting existing revenue flows. It offered almost no new revenue sources--aside from a "sin tax" on tobacco. The reality is that to achieve universal coverage, we all have to pay for it, either directly or indirectly. And indirect payments can cause serious problems. (2) Controlling Costs. In an attempt to make cost containment efforts seem less onerous on individuals, the rhetoric offered two somewhat contradictory strategies of imposing *price controls* on health care providers and introducing market reforms, called *managed competition*. Presumably, managed competition would also automatically eliminate fraud, waste, and abuse, and in some unspecified way painlessly discipline the market for health care. The reality is tht people must face difficult choices if we are to control the costs of health care. Cost containment is a much more controversial issue than the Administration admitted. Many persons are nervous about the impacts of such controls. (3) Choice. The Administration went out of its way to promise choice, often in ways that complicated the plan. Opponents countered that the Administration's plan would actually limit choice. But what did they mean by choice? If they meant choice of doctors and hospitals, or choice of insurance plans, the Administration's plan stacked up very well. But the right to choose any kind of health care at any time would have been restricted under the Clinton proposal. Moreover, choice has long been eroding for most Americans as employers and insurance companies have imposed more control on insurance. In this case, the rhetoric of the opponents won out over the reality of what is already happening in our health care system. (4) Incremental Reform. Opponents of the Administration's proposal claimed that successful health care reform could be achieved by "tinkering around the edges," keeping what was right about the health care system and getting rid of what was wrong. The reality is that changes in one area of health care provision affect other areas, in ways that are not always understood or anticipated, and there is little consensus on what should be kept and what should be changed under an incremental approach. (5) Nostalgia. Many of those who opposed health care reform altogether expressed a longing to return to a health care system that they remember and think still exists, but that probably hasn't been in place for the last decade. Their warning that we should not surrender what we have for something less was given more credence than the Administration and other reformers realized. The reality is that health care has already changed rapidly and will continue to change with or without health care reform legislation. The Clinton Administration assumed that Americans understood the current status of national health care, including its flaws, and assumed this meant they had a mandate for change.

Health Care for Veterans: Answers to Frequently Asked Questions

The Veterans Health Administration (VHA), within the Department of Veterans Affairs (VA), operates the nation’s largest integrated direct health care delivery system, provides care to approximately 6.6 million unique veteran patients, and employs more than 287,000 full-time equivalent employees. While Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) are also publicly funded programs, most health care services under these programs are delivered by private providers in private facilities. In contrast, the VA health care system could be categorized as a veteran-specific national health care system, in the sense that the federal government owns the medical facilities, employs the health care providers, and directly provides the majority of health care services to veterans. It should be noted that VA health care is not a health insurance plan similar to what many individuals or employers purchase in the private health insurance market and does not have the same health insurance plan characteristics, such as coinsurances, deductibles, and premiums. This report provides responses to frequently asked questions about health care provided to veterans through the VHA. It is intended to serve as a quick reference to provide easy access to information. Where applicable, it provides the legislative background pertaining to the question