Income-Related Inequality In Affordability And Access To Primary Care In Eleven High-Income Countries.

A high-performing health care system strives to achieve universal access, affordability, high-quality care, and equity, aiming to reduce inequality in outcomes and access. Using data from the 2020 Commonwealth Fund International Health Policy Survey, we report on health status, socioeconomic risk factors, affordability, and access to primary care among US adults compared with ten other high-income countries. We highlight health experiences among lower-income adults and compare income-related disparities between lower- and higher-income adults across countries. Results indicate that among adults with lower incomes, those in the US fare relatively worse on affordability and access to primary care than those in other countries, and income-related disparities across domains are relatively greater throughout. The presence of these disparities should strengthen the resolve to find solutions to eliminate income-related inequality in affordability and primary care access.

Federal initiatives to support rapid learning about new technologies.

Health policy and financing reforms place increasing emphasis on the ability of doctors and patients to make informed, cost-conscious care decisions. The federal government is supporting new initiatives in Medicare to increase the supply of reliable information on the benefits and risks of health care technologies. Medicare also is working with the Agency for Healthcare Research and Quality (AHRQ) to evaluate the comparative effectiveness of prescription drugs and other items or services. The value of these efforts will depend on coordination among individuals and institutions in the public and private sectors; clarity about focus, purpose, and priorities; and adequate and reliable long-term funding.

Medicare's coverage of colorectal cancer drugs: a case study in evidence development and policy.

Payers point to the lack of unbiased evidence for making coverage decisions for new and often costly technologies. This paper provides a case study of a new approach to developing information to meet the needs of a payer: Medicare's coverage with evidence development (CED) policy. Medicare's decision to condition coverage of cancer therapies on clinical trial participation is an early application of CED and signals Medicare's interest in developing evidence on new technologies for beneficiaries. This paper reviews the rationale and challenges Medicare faces in applying its CED policy and discusses the implications of payers' using and generating evidence.

Restructuring Medicare: a synthesis of the NASI Medicare projects.

This Medicare brief highlights the findings and recommendations of the National Academy of Social Insurance (NASI) Medicare study panels. These reports grapple with the most important policy challenges facing Medicare and its future, including financing, delivery of health services, and the administration of Medicare. Although each study panel had a specific charge, unifying themes emerge. This brief summarizes the findings of each study panel and identifies the common themes found among them.