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The Center for Evidence-based Policy at Oregon Health & Science University is a national leader in evidence-based decision making and policy design.
The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
Oct 31, 2017 | Christopher F. Koller, President
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 socioeconomic factors, and parochial politics could all swamp the well-intentioned efforts of earnest state-level … Read more
Sep 26, 2017 | Christopher F. Koller, President
Sandy Praeger did not seek to be a leader. “Local party officials had to keep asking me,” she said of her first public position as a member of the Lawrence City Council. “The same thing happened when I was asked to run for the Kansas House of Representatives—I thought I was done.” But now public service was in her blood, and she went on to serve as chair of several committees in the … Read more
Aug 29, 2017 | Christopher F. Koller, President
With the Senate Affordable Care Act (ACA) “repeal and replace” effort collapsing into partisan rubble (how did you learn about the dramatic US Senate vote in the early hours of July 28?), attention will turn to whether and how the states will assemble the pieces of a health policy agenda. A new survey of state legislators may give us some clues and shed insights into what bipartisanship in … Read more
Jul 31, 2017 | Christopher F. Koller, President
We all have our obsessions. Many are best not shared, although sometimes airing them is helpful, especially when they are informed by research. One of my persistent professional preoccupations is the US health care system’s stubborn aversion to orient itself to the fundamental importance of primary care. Fortunately, I am not alone in being somewhat haunted by this issue—and a new report by … Read more
Jun 20, 2017 | Christopher F. Koller, President
The game of hot potato ends one of two ways—someone drops the potato as it is being tossed or it finally cools off. But what happens if the potato stays hot? How long can you get everybody to keep playing catch? How do you get it to cool off? We are playing hot potato with health care costs in the United States—shifting them to whomever we can. Some new analyses on health care spending … Read more
May 30, 2017 | Christopher F. Koller, President
Like rising sea levels, Medicaid costs are flooding state and federal budgets. Medicaid reform efforts, such as those in the American Health Care Act (AHCA), promise more flexibility to states to take on these Medicaid cost challenges. They need, however, to be viewed with caution by state policymakers: addressing the problem should not involve leaky sandbags or throwing people into the … Read more
Apr 27, 2017 | Christopher F. Koller, President
We should expect competence as public policies are planned and implemented. Frequently, with state health policies, we get it: heroic responses by public workers reacting to environmental emergencies or outbreaks of infectious diseases; well-executed outreach and enrollment of large populations newly eligible for public programs; well-coordinated and persistently implemented efforts to tackle poor … Read more
Mar 30, 2017 | Christopher F. Koller, President
Finding dissenting opinions in a public health class on policy priorities for the US health system is like looking for stars in the night sky of a city—you know they exist in the bigger world, but they are nowhere to be found in the current setting. Universal health insurance? Heck yes! Centers for Disease Control and Prevention and Agency for Healthcare Research and Quality? Fully funded! … Read more
Feb 27, 2017 | Christopher F. Koller, President
From 1997 to 2005, I ran Neighborhood Health Plan of Rhode Island (NHPRI), the state’s largest Medicaid managed care organization. We worked hard to help coordinate high-value health care and we thought we did pretty well. Recently compiled Medicaid spending data, however, points out that success for states may not mean success for the federal government, and might explain why the state-federal … Read more
Jan 25, 2017 | Christopher F. Koller, President
Dear Members of Congress: As both Houses continue to debate whether and how the Affordable Care Act (ACA) should be repealed and what it would be replaced with, let me suggest three considerations for discussion. 1) Health Insurance Matters. Your primary goal should be to get as many people covered as possible. That coverage should give Americans assurance that if they get sick they will … Read more
by Christopher Koller | President, Milbank Memorial Fund
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