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.
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.
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.
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.
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.
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.
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.
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.
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.
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.