Blog: The View from Here

  • Sovaldi Redux – The States Muddle Through

    Oct 16, 2014 | Christopher F. Koller, President

    What kind of coverage decisions are states making about Sovaldi, the new Hepatitis C drug that costs $1,000 a pill or up to $168,000 a treatment? The drug presents new hope for patients, but grave risks to Medicaid and state corrections budgets, both of which must pay for care for a disproportionate number of people with Hepatitis C. Drugs like Sovaldi—and there are more like it on the … Read more

  • Transforming Delivery Systems—It’s All About Alignment

    Sep 1, 2014 | Christopher F. Koller, President

    How does systemic restructuring happen in health care delivery systems? It’s a given among the health policy intelligentsia that to improve the value of health care in the United States, delivery systems need to “restructure”—to change the people, technology, and processes used to provide medical care. The conventional wisdom is that this restructuring is an even bigger policy challenge than … Read more

  • Learning Chinese

    Aug 1, 2014 | Christopher F. Koller, President

    “Physicians at my hospital are retiring. Younger doctors are exploring opportunities in other regions where they can make more money. I can’t recruit new physicians. If my rates from payers don’t improve, I won’t have any providers to see patients.” When I was Health Insurance Commissioner in Rhode Island reviewing proposed rate increases from insurers, I regularly heard complaints like these. … Read more

  • New Hepatitis C Drug, Old Problems

    Jul 1, 2014 | Christopher F. Koller, President

    Every once in a while, an issue comes along that serves up so clearly the conflict between a societal desire to maximize medical care treatment choices and the reality of limited resources that people say, “Maybe this is the one that will provoke the hard conversations.” Enter Sovaldi for the treatment of Hepatitis C. In the US, about 2.7 to 5.2 million people have Hepatitis C, a chronic … Read more

  • Thinking and Doing

    Jun 1, 2014 | Christopher F. Koller, President

    “Knowing is not enough; we must apply. Willing is not enough; we must do.” These words of the German poet Goethe grace each final report of the Institute of Medicine (IOM) of the National Academy of Sciences in Washington, DC—and are meant to inspire or compel readers to link theory and practice, thinking and doing. The IOM exists to “…help those in government and the private sector … Read more

  • The Work of Transforming Primary Care

    May 1, 2014 | Christopher F. Koller, President

    I recently addressed a gathering of about 50 health leaders—providers, payers and state officials—who had come together at a Milbank Memorial Fund-convened meeting as part of their work on implementing local multi-payer primary care enhancement projects. This is just the kind of work the Fund likes to support—improving population health by linking leaders and decision makers with the best … Read more