Jeffrey Kimbell

In Medicaid, Access to Coverage Does not Equal Access to Care

This summer marks the 50th anniversary of President Lyndon B. Johnson signing the Medicaid program into law. Throughout its existence, Medicaid has been widely praised as extending health care insurance to low-income individuals and families who would otherwise be unable to afford coverage. Today, nearly 70 million individuals, including 30 million children, rely on Medicaid and […]

Republicans Must Leverage A Successful Challenge In King Case

With oral arguments now complete in King v. Burwell, focus has shifted to Congressional back-up plans in the event the U.S. Supreme Court invalidates federal subsidies available to eligible consumers in states that use a federally-run exchange. A ruling in favor of the petitioners could mean that 7.5 million consumers in the 34 states that […]

Getting a Head Start in the Quality Game

With the growing interest in quality and value across the health care delivery system, a new process is evolving. Specialty societies are partnering with universities and organizations like the National Quality Forum (NQF) to develop metrics in nearly every area of practice with the goal of finding gaps in care and working to fill them […]

CMS Takes Hard Look at Prescription Drug Benefit for Exchange Plans

As exchange plans enter their second year of operation, stakeholders have raised growing concerns regarding enrollees’ ability to access and afford prescription drugs. This is in part because of the minimal requirements the Centers for Medicare and Medicaid Services (CMS) established when it set up the Essential Health Benefit (EHB) standards for exchange plans. However, […]

Shutting the Door on Blunt Pricing Tools

With an array of breakthrough specialty drugs anticipated to enter the U.S. market in the next few years, the debate around specialty drug pricing and reimbursement is unlikely to die down anytime soon. Experts have thrown around all sorts of solutions – some old and some new – to revamp pricing mechanisms for these drugs. […]

The Cash Trend

Ever since the passage of the Affordable Care Act in March of 2010, the majority of monitoring, analysis, and litigation in Washington healthcare circles has revolved around the law’s ongoing implementation. Simultaneously, a different healthcare trend has begun to emerge: the advent of cash-pay and concierge medicine, particularly in family medicine. There are many reasons […]

Life Sciences: A New Opportunity for Innovation

When most people hear that Congress is working on health care legislation, they immediately assume we are in for another politically charged and polarizing debate.  However, history shows that when it comes to improving the ability of our nation’s pharmaceutical and medical device manufacturers to bring safe and innovative products to patients, Congress can come […]