Posts by Gail Wilensky, Ph.D.

The second term of the Bush presidency is under way, a new secretary for HHS has been chosen, and many are now wondering what will be in store for HHS in the next four years. The short answer is: HHS will be even busier than usual, but there won’t be a lot of new legislation…

A lot has been written about the adequacy of the drug benefit in the new Medicare Prescription Drug, Improvement, and Modernization Act (MMA) and the political arm-twisting needed to get the legislation through Congress. More recently, considerable attention has also been focused on the $134 billion discrepancy in the 10-year cost estimates of the legislation…

Between the president’s focus on Social Security and the release of the latest Medicare Trustees report this spring, most of the media’s attention has been focused on these two federal programs. But it is Medicaid that is presenting the more immediate challenge for both the current federal budget and the states. The federal-state Medicaid program…

Consumer-directed health plans—high-deductible health insurance plans combined with tax-advantaged savings accounts that can be used to cover unreimbursed healthcare expenditures—have generated both a lot of attention and a lot of controversy. For some, these plans represent the most significant promise for moderating healthcare spending to have emerged over the past several decades. For others, they…

Pay for performance is one of Washington’s most popular healthcare buzzwords. Although the term has raised the ire of some physicians, who seem to think it suggests being paid something “more” for what they are or should already be doing, most have embraced the concept as representing an important payment reform. Two other terms, rewarding…

It’s one thing to conceive of a pay-for-performance system in health care; it’s quite another thing to set up the system so it will work. In a previous Eye on Washington column, I described the current interest in pay for performance as a way of rewarding practitioners and institutions that “do it well, do it…

In August, during a stop in Minnesota, President Bush “went public” about transparency—urging that better information be made available to the public about the costs and quality of health care. In August, during a stop in Minnesota, President Bush “went public” about transparency—urging that better information be made available to the public about the costs…

The dilemma for Medicare is to devise a physician payment strategy that promotes the delivery of the appropriate volume and mix of services, provides good access to physician services for seniors, and moderates or controls physician spending. With the new emphasis in Medicare and elsewhere in health care on rewarding “good performers”—that is, those who…

Pay for performance as a payment strategy in health care has continued to gain substantial momentum over this past year. Pay for performance as a payment strategy in health care has continued to gain substantial momentum over this past year. The recent push toward pay for performance has been spurred on by the rapid rates…

In his State of the Union address, President Bush proposed major changes in the tax treatment of health insurance coverage. These changes, which are included in the president’s FY08 budget, would eliminate the current employee tax exclusion for employer-sponsored health insurance and replace it with a new deduction for all individuals who purchase health insurance.…