Gail R Wilensky, PhD

About the Author

Gail R Wilensky, PhD

Latest Work

Medicare’s Move Toward Site-Neutral Payment

A payment change in the OPPS final rule that aims to align payments made for services delivered in off-campus hospital outpatient departments with those made for services delivered in physician offices has raised considerable controversy.

Gail R Wilensky, PhD December 26, 2018

The 2019 ACA Enrollment Period Begins

Rising premiums and reduced choice among insurance options are two challenges facing health insurance purchasers under the Affordable Care Act in 2019; nonetheless, public support for the act continues to be strong enough to block efforts to repeal the act.

Gail R Wilensky, PhD October 29, 2018

Yet One More Legal Attack by Republicans on the ACA

Arguing that the removal of the insurance mandate means Affordable Care Act is no longer a tax, the DOJ has now challenged its constitutionality in court. The author also discusses some of the likely outcomes, depending on the court’s decision.

Gail R Wilensky, PhD June 26, 2018

MA Ruling May Signal Industry Readiness to Integrate SDH into Traditional Medical Care

In addressing social determinants of health and social services, a recent Medicare Advantage ruling by CMS may have taken the first steps toward providing more integrated and comprehensive care to the nation’s aging population.

Gail R Wilensky, PhD April 25, 2018

The “Disruptors” Move Into Health Care

Healthcare joint ventures involving U.S. corporations, such as one announced by Amazon, Berkshire Hathaway, JPMorgan Chase, could significantly disrupt the nation's healthcare system.

Gail R Wilensky, PhD March 1, 2018

The Continued Move to Greater Integration and Consolidation

The nation’s hospitals face a potential threat of being excluded from the healthcare delivery system based on recent merger and acquisition activity in the industry.

Gail R Wilensky, PhD December 20, 2017

Calling Into Question the Nation’s Commitment to Value-Based Health Care

There is widespread agreement that the goal of transitioning the nation’s healthcare system to value-based payment is important, but there remain many impediments to accomplishing such a transition.

Gail R Wilensky, PhD October 27, 2017

The Challenges of “Repeal and Replace”

Despite the success of the “repeal and replace” platform during election season, politics and numbers are getting in the way of Republican efforts to get rid of the Affordable Care Act.

Gail R Wilensky, PhD August 23, 2017

Part B Drugs Revisited—Yet Again

Payment and pricing for Medicare Part B drugs are subjects of much discussion again following the decision by CMS to withdraw its planned pilot projects for these drugs.

Gail R Wilensky, PhD June 20, 2017

From Multiple Health Plans Back to “No Plan”

Healthcare reform may have been temporarily sidelined, but the need to reform, repair, or replace the Affordable Care Act remains.

Gail R Wilensky, PhD April 28, 2017