The Milbank Blog

  • State Health Policy Leadership: More Perspiration than Innovation

    Oct 11, 2019 | Judith Zimmer

    A couple of years ago, a graduate school professor with deep and senior health policy experience at the state and federal levels looked at me with  raised eyebrows and asked, “Does state health policy even matter?” He was being provocative, implying that federal policies, large socio-economic factors, and parochial politics could all swamp the well-intentioned efforts of earnest … Read more

  • The Path to Multipayer Primary Care Transformation: How Far Have We Come?

    Oct 2, 2019 | Evan Saulino

    Evan Saulino, MD, has implemented quality improvement efforts on the frontline and contributed to policy development at the state and national level. In a new Milbank blog post, Saulino assesses the progress made over the last 20 years, and some of the communication and other gaps that continue to exist between health care payers and providers. Read more

  • Rhode Island: A Most-Improved State in Health Performance

    Sep 11, 2019 | Michelle Alletto, Marie Ganim

    Rhode Island improved on more health system performance indicators tracked over time than any other state in the latest Commonwealth Fund State Scorecard on Health System Performance Scorecard. In a new post copublished today by the Milbank Memorial Fund and the Commonwealth Fund, Milbank Memorial Fund Program Officer Michelle Alletto and Rhode Island Health Insurance Commissioner Marie Ganim examine how Rhode Island made such strides. Read more

  • Public Health Can Help Older Americans Live Healthy and Independent Lives

    Aug 22, 2019 | John Auerbach, Terry Fulmer

    John Auerbach, president and CEO of Trust for America’s Health, and Terry Fulmer, president of The John A. Hartford Foundation on their “Framework for Creating Age-Friendly Public Health Systems,” which describes five key roles for public health departments across the country. Read more

  • States Put Hospital Community-Benefits Requirements to Work for Population Health Improvement

    Jul 25, 2019 | Amy Clary

    In exchange for billions of dollars each year in tax exemptions, nonprofit hospitals are required to invest in the health of their communities. However, the federal government confers this status with little oversight over whether and how hospitals make these investments. As a result, states are increasingly using policy levers to hold hospitals accountable for their community benefits spending … Read more

  • How Well Does State Supervision of Hospital Mergers Work?

    Jul 8, 2019 | Erin C. Fuse Brown

    In a new Milbank blog post, Erin C. Fuse Brown, associate professor of law at Georgia State University College of Law, reports that the research presented at the workshop gave a mixed picture of COPA’s impact on price and quality. The experiences of states highlighted the importance and difficulty of sustaining COPA supervision over the long-term. Nevertheless, COPAs may be an appropriate policy tool in some circumstances, such in rural or semi-rural areas with little competition. Read more

  • A Better Way to Contain Medicaid Costs

    Jun 13, 2019 | Governor John Kitzhaber, Bruce Goldberg

    As the cost of health care continues to rise faster than state revenue, states’ Medicaid commitments undermine their ability to invest in education and other important priorities.1 In response, some states have embraced Medicaid block grants, in which they would receive a fixed annual sum from the federal government, as a way to avoid increasing program costs. The Tennessee legislature, for … Read more

  • How New Data on Hospital Prices Paid by Employers Can Help States

    May 29, 2019 | Rachel Block

    New research published by the RAND Corporation earlier this month compares hospital prices paid by private health plans with Medicare prices in 25 states. These new data shed light on hospital prices and point to some actions that states could take to help manage costs. Read more

  • Comprehensive Primary Care in Ohio and Kentucky – Positive Findings

    Jan 30, 2019 | Lisa Dulsky Watkins

    As a former pediatrician in rural Vermont and a career-long believer in the centrality of primary care, I have been frustrated and dismayed to witness the lack of definitive evidence demonstrating what is considered to be conventional wisdom—that a high-performing health system must have primary care at its core. For a decade, I have been in the position of counseling patience, insisting that … Read more

  • What Local Government Can Do for Aging Populations: Insights from San Diego County

    Nov 28, 2018 | Nick Macchione, Joanne Lynn

    State and local leaders who aim to improve population health must help older Americans live well with the challenges associated with aging. Given the rapidly rising number of elders, local governments have remarkable opportunities to facilitate improvements in health and quality of life for elderly people living with disabilities and serious illnesses. In March 2016, the county of San Diego joined … Read more