As 2016 winds down, we've compiled our most-read blog posts from the past year. For policy makers in health and health care as well as those who track and study their efforts, the last 12 months have been a whirlwind: premium increases, provider and insurer consolidation, final rules on MACRA, insurers leaving the marketplaces, co-ops going out of business, and most recently the stunning outcome of a national election that has the potential to dramatically change the trajectory of US health policy.
1. Day One And Beyond: What Trump's Election Means For The ACA
Timothy Jost
Just hours after the 2016 presidential election upended most people's assumptions about the future of health policy, Tim Jost provided an in-depth analysis of the implications of the Republican electoral victory for the Affordable Care Act and the potential mechanisms for change.
2. Six Big Trends To Watch In Health Care For 2016
Susan DeVore
In her annual forward-looking post, Susan DeVore highlighted with great prescience some of the most urgent and complex issues policy makers would face in 2016.
3. Breaking Down The MACRA Proposed Rule
Billy Wynne, Katie Pahner, and Devin Zatorski
Earlier this year, CMS released a proposed rule on the implementation of MACRA, Medicare's new physician payment program.
4. Texas Judge Refuses To Dismiss Health Insurance Provider Fees Case
Timothy Jost
The Supreme Court's 2015 ruling on the ACA didn't put an end to legal wrangling around the law. Many cases continued to wend their way through the courts in 2016.
5. Obamacare Premiums Are Lower Than You Think
Loren Adler and Paul B. Ginsburg
While stories about large premium increases dominated news media, Loren Adler and Paul Ginsburg found that premiums are lower than they would be without the ACA.
6. About That Cadillac Tax
Jeff Lemieux and Chad Moutray
The Cadillac Tax has been delayed by Congress until 2020. While economists support the provision as a way to help reduce health care costs, it remains unpopular and its future is uncertain.
7. MACRA Final Rule: CMS Strikes A Balance; Will Docs Hang On?
Billy Wynne
In a follow-up to his earlier post, Billy Wynne analyzed the final MACRA rule, which included some important compromises.
8. Mega Health Insurance Mergers: Is Bigger Really Better?
Paul von Ebers
Three large mergers were announced over the past year — Aetna/Humana, Anthem/Cigna, and Centene/HealthNet. In this post, von Ebers took a critical look at the arguments insurers are making to justify their acquisitions.
9. Why We Stopped Participating In US News' Medical School Rankings
Arthur Kellermann and Charles Rice
The Hébert School of Medicine at the Uniformed Services University (USU) opted out of these annual rankings. The school's leadership explained why in this post.
10. How Would Government Negotiation Of Medicare Part D Drug Prices Work?
Chuck Shih, Jordan Schwartz, and Allan Coukell
High drug prices—from insulin to EpiPen—were a top health care news story. Outrage over steep price increases led to calls for Medicare to negotiate drug prices in an effort to tamp down costs. The authors sketched out how this proposed policy could actually work.
11. Accountable Care Organizations In 2016: Private And Public-Sector Growth And Dispersion
David Muhlestein and Mark McClellan
As ACOs have continued to grow, and ACO payment policies evolve, providers, by and large, have begun to think about population-level payments as an eventuality as opposed to just a possibility.
12. Healthy Indiana 2.0 Is Challenging Medicaid Norms
Seema Verma and Brian Neale
President-Elect Trump selected Seema Verma as his CMS administrator designate. In this post, Verma, the architect behind the Healthy Indiana Medicaid expansion, explained how Indiana's program may provide a model for Medicaid in a new administration.
13. The Tangled Hospital-Physician Relationship
Jeff Goldsmith, Nathan Kaufman, and Lawton Burns
Actuaries make the hospital (nearly $1 trillion) and physician practice (nearly $600 billion) sectors appear to be independent and non-overlapping. This is an optical illusion. Hospitals and physicians are, in day-to-day practice, hopelessly intertwined.
14. HHS Issues Health Equity Final Rule
Timothy Jost
Jost offered an overview of some of the most important or controversial provisions of the final rule implementing section 1557 of the Affordable Care Act. The regulation is sweeping in its coverage and scope.
15. What Risk Adjustment Does — The Perspective Of A Health Insurance Actuary Who Relies On It
John Bertko
With premium increases, insurer liquidations and the risk corridor lawsuit, risk adjustment was in the news more than ever. John Bertko, the actuary for Covered California, provided a primer on the issue.
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