2---the counterplan doesn’t attract national attention
Hwang et al ’15 (Ann Hwang – MD @ the University of California, San Francisco, former Director of Health Care Policy and Strategy for the Commonwealth of Massachusetts Executive Office of Health and Human Services, where she played a leading role in the implementation of the state’s major health care initiatives, including the Affordable Care Act, payment and delivery system reform and the Commonwealth's State Innovation Model grant, Visiting Fellow in the Department of Health Care Policy at Harvard Medical School. Ann has also served as a Senior Health Policy Advisor to the Massachusetts Health Connector, advised states on ACA implementation as a Senior Consultant with the Wakely Consulting Group and worked on HIV and global health issues as a legislative aide to U.S. Senator Richard J. Durbin. Joshua M. Sharfstein. Christopher F. Koller, “State Leadership in Health Care Transformation Red and Blue,” 28 July 2015, https://jamanetwork.com/journals/jama/article-abstract/2411296)
Despite substantial differences in the local politics of coverage expansion, states across the country are leading major changes in health care payment and delivery. For example, Arkansas and Tennessee are avidly pursuing bundled payments, Maryland has largely eliminated fee-for-service payment to hospitals, Massachusetts has established statewide cost growth targets, and Idaho is creating a statewide network of multipayer medical homes.
These efforts and many others, while largely under the radar of national attention, may have a profound effect on the health care system’s ability to provide better care at lower cost. Understanding why and how states of all political hues are engaged in such efforts and recognizing the limitations of state-led reform are critical to appreciating the opportunities and challenges of this unique moment in US health care.