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Health Bills Too Timid on Cutting Costs, Experts Say
November 4, 2009
The Washington Post, by Ceci Connolly
Democrats in Congress are embracing the spirit of President Obama's call to slow the runaway rise of health-care costs but are shying away from some of the most aggressive techniques for achieving that. Instead of revolutionizing how care is delivered and paid for, experts say, the legislation being shaped takes a cautious approach to reining in costs. While White House budget director Peter Orszag says a go-slow approach will help determine the best course, others say the ideas are promising enough to pursue aggressively now. Mark McClellan, a physician who ran two health agencies in the Bush administration, endorsed the ideas in the legislation but warned that pilot projects take too long to adopt broadly and that not enough emphasis is being placed on financial rewards and penalties based on health outcomes.
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Senate, House Move Closer on Health Bills as Battle Goes Public
November 2, 2009
Bloomberg, by Kristin Jensen and Laura Litvan
After months of private wrangling, the fight over legislation to revamp the U.S. health-care system will soon spill onto the House and Senate floors. Lawmakers are trying to craft a bill that would cover tens of millions of uninsured Americans while curbing medical costs. Their proposals for purchasing exchanges, government subsidies and a requirement that all Americans have insurance represent the biggest changes to U.S. health care in four decades. If both the House and Senate pass legislation, they will work together on a compromise. And once again leaders will probably turn to a small group of influential lawmakers, said Mark McClellan, a Bloomberg Television contributor and the former head of the Centers for Medicare and Medicaid Services. “The key factor here is the moderates,” he said.
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House Calls A Possible Health Care Solution
November 1, 2009
Associated Press, by Pauline Arrillaga
Where other health care proposals have divided lawmakers, the house-calls idea is winning support from Republicans and Democrats alike as a cost-effective way to provide care. The provision calls for the Medicare program to work with home-based primary care teams to test whether house calls would reduce preventable hospitalizations, ER visits and duplicative diagnostic tests for high-cost, chronically ill patients. That means patients with at least two chronic conditions who have been hospitalized in the past year and require assistance for at least two daily living activities, such as bathing, dressing, walking or eating. Mark McClellan, who ran Medicare under President George W. Bush, called the idea one that "could lead to cost-savings and better outcomes" for patients.
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Could 'Medical Homes' Bring Order to Health Care?
October 28, 2009
Associated Press, by Ricardo Alonso-Zaldivar
A thousand miles from the health care debate in Washington, Dr. Don Klitgaard and his colleagues are carrying out their own reform in a small Iowa community. They've reorganized their clinic so nurses bird-dog patients whose health problems, if ignored, could send them to the emergency room. And for all their patients, they've invested in a computer system that tracks leading indicators of health problems, like blood pressure and blood sugar readings. In this new model, the doctor is part of a team, and the doctor's office is a "medical home." Policymakers from President Barack Obama on down have praised such experiments as key to getting better quality without costly complications. But there is concern over whether Congress will do enough for primary care doctors, the ones expected to carry out the transformation to such a system. Former Medicare administrator Mark McClellan, once a primary care doctor who served as Medicare administrator under President George W. Bush, gives the legislation a "B" or "B minus" overall on the issue. "The steps are in the right direction," said McClellan, "but I wouldn't say it's enormous leaps and bounds."
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Reid Says Bill Will Include Public Option
October 27, 2009
The Washington Post, by Shailagh Murray and Lori Montgomery
Senate Majority Leader Harry M. Reid announced Monday that he will include a government-backed insurance plan in the chamber's health-care reform legislation, a key concession to liberals who have threatened to oppose a bill without such a public option. While Democrats praised its ability to control costs, the opt-out public plan represents a much less dramatic approach to federal coverage intervention than liberal advocates had sought – or insurance companies had feared. Health-care policy experts said the emerging legislation contains few provisions that would clearly drive down costs. "There's still hope that meaningful reforms can be included, but there's a long way to go," said Mark McClellan, a George W. Bush administration health official who is now at the Brookings Institution, which recently released a compendium of ideas for "bending the cost curve." "Concerns about the cost savings proposals being watered down are very real."
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If You Build A Coverage Mandate, Will They Come?
October 26, 2009
The Washington Post, by Alec MacGillis
The question of whether people will follow a government order that they carry health insurance – an issue that will help determine whether universal health care is a success or costly failure – will depend on more than the penalty they would pay for refusing, many economists say. As behavioral economists see it, compliance will depend not only on the penalties and cost of coverage, but also on the ease of signing up for coverage and whether people can be persuaded that it is a widely accepted social norm. Mark B. McClellan, who oversaw Medicare and Medicaid under President George W. Bush, said his promotion of the Medicare drug benefit succeeded for the same reasons. McClellan spent much of 2005 on a bus between enrollment events where "neutral people" would talk up the benefit.
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Health Reform Takes A Step Forward
October 15, 2009
The Economist
The Senate Finance Committee passed a health care bill this past week, with the Congressional Budget Office (CBO) announcing it will cost $829 billion, below the $900 billion threshold President Obama has declared to be the most he can support. However, the biggest problems with this imperfect bill arise from cost. Put bluntly, the bill does too little to modify the underlying drivers of health inflation. Douglas Elmendorf, head of the CBO, said as much this week. Pointing to a report from the Engelberg Center for Health Care Reform, a non-partisan policy outfit, called "Bending the Curve," he suggested reducing Medicare payment updates in regions with especially high cost growth; tort reform and greatly expanding the remit of MedPac, a non-partisan panel of worthies that sets some Medicare policies.
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Health Care Bill Gets Support from GOP Off the Hill
October 11, 2009
NPR, by Andrea Seabrook
As various health care bills wind their way toward the House and Senate floors, the White House is soliciting support from some unlikely allies: Republicans. Recently such high-profile Republicans as California Gov. Arnold Schwarzenegger and Tommy Thompson, health and human services secretary in the Bush administration, have come out in support of an overhaul. The administration hopes this will help win over moderates in Congress. Then there's Mark McClellan, who ran Medicare under President George W. Bush. "Congress needs to act. The health care issues facing this country are both major and urgent," he said. "We have a real opportunity now to make some progress — not just on improving coverage, but also on improving health care. My hope is that we'll take advantage of those opportunities."
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Lobbyists Fight Last Big Plans to Cut Health Care Costs
October 10, 2009
The New York Times, by David Kirkpatrick
As the health care debate moves to the floor of Congress, most of the serious proposals to fulfill President Obama’s original vow to curb costs have fallen victim to organized interests and parochial politics. And now the last two initiatives with real bite that are still in contention — a scaled-back “Cadillac tax” on high-cost health plans and a nonpartisan Medicare budget-cutting commission — are under furious assault. How the measures fare in the final weeks of debate could determine how well the bill lives up to its original promise of curbing health care costs, said Dr. Mark B. McClellan, an administrator of Medicare and Medicaid in the Bush administration who is now tracking the legislation at the Brookings Institution. “It is still up in the air,” Dr. McClellan said, adding, “I’d give them an A for effort, but there is a lot more they could do.”
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Division Fizzes Up Within GOP Over Resistance to Health Plan
October 8, 2009
USA Today, by Richard Wolf
Concerned that their party may prevent progress on one of the nation's most intractable problems, several governors and former Washington power brokers are calling on Republicans in Congress to help pass a health care bill. Their names carry weight. They include former Senate majority leaders Bob Dole and Bill Frist, a heart surgeon; Govs. Arnold Schwarzenegger of California and Bobby Jindal of Louisiana, a health policy expert; New York City Mayor Michael Bloomberg, now an independent; and Mark McClellan, former administrator of Medicare and Medicaid from 2004-06. McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution, expects a health care bill to reach final votes in Congress this year. "At that point, the Republicans have a very important choice," he says.
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Experts Say Baucus Plan Slows Spending But Could Do More
October 7, 2009
The New York Times, by David Herszenhorn
As the Senate Finance Committee anxiously await a new cost analysis of the big health care legislation by the Congressional Budget Office, an analysis of the bill by a panel of experts suggests there are still a number of additional steps that could be taken to tamp down long-term health care costs. The experts, assembled by the Engelberg Center for Health Care Reform at the Brookings Institution, have issued a report making several recommendations — including changes to the Medicare payment system that would put greater pressure on doctors, hospitals and other providers to slow the growth of health care costs in high-spending regions of the country. Engelberg Center Director Mark McClellan praised Mr. Baucus's bill as the only health care proposal advancing in Congress that would reduce long-term health care spending — what policy experts call "bending the cost curve."
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Vote on Key Health Bill Delayed for Cost Report
October 6, 2009
The Washington Post, by Shailagh Murray and Scott Wilson
Senators learned Monday that a committee vote on health-care reform will be pushed back to later this week, and perhaps into next week, as they await an estimate on how much the overhaul would cost. But if the news of the delayed vote disappointed them, Democratic leaders in the Senate took heart from pro-reform statements from some high-profile Republicans, including former Senate majority leader Bill Frist and former health and human services secretary Tommy G. Thompson. Mark McClellan also urged lawmakers on Monday to seize the moment. "The health-care problems facing this country are urgent and large, and we need to do something about them," said McClellan, a former Medicare and Medicaid administrator who is now a fellow at the Brookings Institution. "I don't want to miss this opportunity."
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Lawmakers Face Trouble 'Bending the Curve' (subscription required)
October 3, 2009
National Journal, by Marilyn Werber Serafini
Deep-seated anxiety over rising health care costs, which have strained family finances and government budgets for years, made health care reform a major issue in the 2008 presidential campaign. Yet somewhere along the way, Capitol Hill shifted its focus from controlling costs to covering the uninsured. The best set of proposals, said Mark McClellan, the director of the Brookings Institution's Engelberg Center for Health Care Reform who ran Medicare under President George W. Bush, would "change the whole environment for medical practice gradually over time. Done right, it can reduce the burden on everyone —taxpayers, businesses, and individuals."
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When Medicare is the Piggy Bank
September 28, 2009
Associated Press, by Ricardo Alonso-Zaldivar
President Barack Obama and the Democrats want to pay for much of their plan to cover the uninsured by cutting hundreds of billions from the Medicare budget over the next 10 years. The proposed cuts to hospitals, nursing homes and other providers are bigger than any Congress has imposed since the late 1990s. However, in percentage terms, they're far from the largest ever. And Democrats are also proposing to spend tens of billions to improve Medicare prescription coverage and preventive care. "Seniors should definitely be paying attention," said Mark McClellan, who ran Medicare under President George W. Bush. "There's some redesign, some improvements, but unquestionably there would be some adverse impacts. It's a mixed bag, but it's not like the sky is falling."
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Baucus Bill Doesn't Bend Cost Curve Enough, Experts Say
September 23, 2009
Kaiser Health News, by Mary Agnes Carey and Eric Pianin
Many health care experts and budget hawks say the Baucus legislation doesn't go far enough in taming long-term costs in the nation's $2.5 trillion health care system. And they worry that the cost-control measures included in the bill might get watered down or eliminated as the congressional debate continues. But their view isn't unanimous. Mark McClellan, director of the Engelberg Center for Health Care Reform at Brookings, said "I think they do have a substantial amount of delivery reform" in the Finance bill. He pointed to the bill's proposal to create an independent Medicare commission to make recommendations to Congress on saving money, as well as a new CMS "innovations center" to test ways to make health care more efficient.
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What Baucus Got Right
September 18, 2009
The Atlantic, by Ronald Brownstein
If President Obama actually signs legislation revamping the health care system, it's more likely that the Baucus plan eventually will be seen as the foundation. The reason is that Baucus' draft bill offers the most fiscally sustainable framework yet devised for expanding coverage. It progresses much further than any other Congressional bill toward solving two fundamental and inter-related problems: creating a revenue stream that rises as fast as health care costs, and reshaping the incentives in the medical system in ways that should help "bend the curve" on those long-term cost increases. Mark McClellan, director of the Brookings Institution's Engelberg Center for Health Care Reform, was impressed. "It does bend the [cost] curve in the long term," McClellan said. "They clearly are working hard to make fiscally responsible decisions about health care reform."
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Young Adults Likely to Pay Big Share of Reform's Cost
September 16, 2009
The Washington Post, by Shailagh Murray
As health-care legislation advances through Congress, the young adults who were so vital to President Obama's election are emerging as a significant beneficiary of his top domestic priority, but they are also likely to play a major role in funding any reform. All current bills seek to blunt the additional cost to young adults, mainly through subsidies, but it is not clear what effect that would have. "The primary question is what the premium is and what people get for that," said Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution and a former senior Bush administration official. But for many young adults, health care will become a significant new expense. "It's important for people to know what they're getting into," he said.
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The Long Road to Healthcare Reform
September 13, 2009
Los Angeles Times, by Doyle McManus
President Obama set out a long list of worthy goals in his healthcare speech to Congress last week. If he succeeds in winning a comprehensive healthcare bill, he will have established, for the first time, a federal government obligation to make some kind of health insurance available to every citizen. But it will be only the first step in a process of designing, launching and improving a new healthcare system for a nation of some 300 million. The most intriguing question a bill can't answer is this: How will the practice of medicine — the way doctors, nurses and hospitals actually treat their patients — change to make all this work? There's no question that it will have to change. "If you talk to doctors, they'll tell you, 'Yeah, we're practicing inefficiently, and we know it,' " said Dr. Mark McClellan, who ran Medicare under President George W. Bush and supports the basic thrust of Obama's plan.
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The Menu of Malpractice Reforms
September 13, 2009
The Atlantic, by Philip K. Howard
The President committed in his speech to Congress to promote pilot projects to solve the problem of defensive medicine. "I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs," he stated. "So I'm proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine." Creating special health courts is the proposal advanced by most serious observers to eliminate the incentives for defensive medicine — including by consumer groups such as AARP, patient safety groups, medical societies such as the AMA and the American College of Obstetricians and Gynecologists, and by such thought leaders as Bill Bradley, Mark McClellan, Newt Gingrich, and David Brooks.
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Growth of Government Insurance Outpaces Private Care
September 10, 2009
Associated Press, by Hope Yen and Frank Bass
The number of Americans covered by government-sponsored health insurance plans surged to 87.4 million last year — or 29 percent of the U.S. population — amid a fierce, national debate about whether to create a new U.S.-run plan that any American could join. "The last decade has been marked by a steady increase in public insurance programs," said Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution. "People are certainly having more difficulty affording health insurance."
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What Was Missing in Obama's Speech
September 10, 2009
The New York Times
President Obama's address to Congress on health care, coming after an August marked by confused messages and partisan rhetoric, had to accomplish a lot. It had to show Democrats his firm commitment to pushing through comprehensive reform this year. It had to respond to the intensifying opposition among Republicans. And it had to reassure nervous voters that change won’t leave them with less choice and less coverage. The New York Times editorial board asked some analysts of health care politics — including Engelberg Center director Mark McClellan — what was good about the speech and what was missing.
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Analysis: Obama Willing to Deep-Six Public Option
September 10, 2009
Associated Press, by Jennifer Loven
President Obama has never been wedded to a government-run insurance plan. And he settled that Washington parlor game in his speech to Congress and television-watching public Wednesday night. The president praised the public option but called it only a means to the end of providing more competition, not crucial on its own. Mark McClellan, a health policy expert who at The Brookings Institution who ran Medicare in the Bush administration, said Obama hit it right. "He made clear there is room for negotiation on the public plan, and I think that's where he needs to be in terms of keeping support from the Democratic caucus and leaving the door open for some Republicans," he said.
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Despite Fears, Health Care Overhaul is Moving Ahead
September 8, 2009
The New York Times, by Sheryl Gay Stolberg
While the month of August clearly knocked the White House back on its heels, the uproar does not seem to have greatly altered public opinion or substantially weakened Democrats’ resolve. And despite the fracas of August, the major stakeholders in the health care debate — hospitals, doctors, insurers and the pharmaceutical industry — have not abandoned the negotiations. Mark McClellan, who ran the Food and Drug Administration and later Medicare under President George W. Bush, said he saw the churning in August as a part of the public’s education, a “necessary step in the process” and not a fatal blow. “Everybody is talking about how the public is very concerned about some of the specifics that they’ve heard,” Dr. McClellan said. “But the public is also very concerned about some aspects of the health care system, including the cost, including the security of their coverage. So depending on how this plays politically, I think there is the foundation for building support for broader legislation.”
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Health Reform: Should Insurers Pay?
September 8, 2009
CNNMoney.com, by Jeanne Sahadi
The negotiations over health reform are kicking into high gear. And one of the top issues is whether to make insurance companies pay for some of it. Senate Finance Committee Chairman Max Baucus, D-Mont., proposed a $6 billion annual fee on the industry; each insurer's portion would be based on its market share. Critics say any tax on insurers will be passed along to consumers by way of higher plan costs. If that is the case, however, it may alter the choice of plans by employers, who pay the lion's share of insurance for their workers. "Employers may choose a plan that's less generous. That might mean a little higher out-of-pocket cost [for workers] but lower premiums than they'd spend otherwise," said Dr. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution.
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Six Way Obama Can Take Charge on Health Care
September 8, 2009
Newsweek, by Jeremy Herb
Americans don't get health reform. It's a complex, emotionally charged issue with legislation that's longer than the longest Harry Potter book. A CBS News poll last week found two thirds of Americans think the reform ideas proposed by President Obama are "confusing," and 60 percent say the president has not clearly explained his reform plans. With a major speech to Congress set for Wednesday, Obama has one more chance to convert reform skeptics to reform advocates. Mark McClellan of the Brookings Institution suggests that the president should retool his message to explain that "the absence of reform is what's going to take away what we have now." If people believe that reform will keep them from being adversely affected, they're less likely to oppose it.
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In Health Care Reform Debate, All Sides Agree High Costs Must Be Curbed
September 8, 2009
Dallas Morning News, by Jim Landers
Mark McClellan, a physician and health economist who's spent the year urging Congress and the Obama administration to break with the fee-for-service model, last week rolled out a reform plan written by academics and policy wonks from the political left and right. The plan includes a bundled payment approach. It opposes cutting Medicare payments across the board. It urges more investment in electronic medical records to serve as a foundation for coordinated care delivery. It calls for insurance exchanges where consumers have lots of choices regulated in a manner that pushes insurers to compete on cost and quality. And it includes incentives for consumers to take better care of their own health in return for lower insurance premiums.
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Lack of CMS Chief Prompts Speculation About Strategy
September 7, 2009
American Medical News
The Centers for Medicare & Medicaid Services is going on three years without a permanent, Senate-confirmed administrator. The lack of a nominee for the full position is puzzling to some observers. But there is also agreement among some health policy experts that CMS has been doing a good job this year. "There are a number of people in senior positions in the administration who are very much involved in CMS issues, so it's not like people are ignoring the agency," said Dr. McClellan, now director of the Engelberg Center for Health Care Reform and a senior fellow at the Brookings Institution in Washington, D.C. "Because of the promise of health reform and Medicare and Medicaid in achieving that goal, this is a really important position for the administration, and I think they want to get it right."
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Required Reading
September 4, 2009
The Washington Post
The discussion about health-care reform has featured a lot of talk about "bending the curve" of rising health care costs without a lot of detail about how. A useful new study from the Brookings Institution's Engelberg Center for Health Reform helps fill that gap. The report, "Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth," is the product of 10 health-care experts who span the political spectrum, including Mark McClellan. The group's essential and unsurprising conclusion is that existing mechanisms for purchasing and delivering health care are fundamentally flawed. Individuals don't have the correct incentives — or even adequate information — to reduce costs.
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Bending the Cost Curve: Beware of the Details
September 4, 2009
Dallas Morning News, by William McKenzie
The health care debate really gets down into the weeds when it turns to discussions of controlling health costs. But it's important that we get down into those weeds to understand what's being proposed in Washington. We don't want to end up with the wrong set of reforms. There is a fundamental shift in the way we think about financing health care, and it is something reformers like Mark McClellan of the Brookings Institution have been championing.
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Let’s Get Fundamental
September 3, 2009
The New York Times, by David Brooks
Then I’d ask Obama to go to the Brookings Institution Web site and read a report called “Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth.” This report was written by a bipartisan group of battle-tested experts, including Mark McClellan, David Cutler, Elizabeth McGlynn, Joseph Antos and John Bertko.
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Health Experts Urge Insurance, Pay Changes
September 1, 2009
Reuters, by Susan Heavey
U.S. lawmakers returning next week to work on major healthcare legislation need to focus on insurance market reforms, consumer rebates and other measures that will curb soaring costs over time, economic and health experts said on Tuesday. The group of academics outlined dozens of changes in their report, from restructuring payments under the Medicare insurance program for the elderly and disabled to providing doctors incentive payments for helping avoid costly treatments or complications. "We turned away from focusing just on short-term, isolated individual measures. While those small things like cutting Medicare prices across the board can have some short-term benefit, we don't think steps like that are sufficient," said McClellan, head of the Engelberg Center for Health Care Reform at the Brookings Institution, a Washington think tank that led the group.
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Piecemeal Reforms Won't Control Health Care Costs, Report Says
September 1, 2009
Kaiser Health News, by Andrew Villegas
Creating the proper incentives is a critical step toward controlling the nation's high health care costs, and finding a true solution will require more than a piecemeal reform plan. That message was advanced by a group of 10 health policy experts who on Tuesday released a report, "Bending the Curve," and outlined during a conference call what they see as necessary policy steps. "It's important to see all these steps as part of a comprehensive approach," said Mark McClellan, the director of the Engelberg Center for Health Care Reform at The Brookings Institute. "Not in terms of just individual incremental changes. … The individual steps themselves, if implemented by themselves, may not have much impact on costs, particularly in the short run."
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Obama Hurt by Hands-Off Strategy
September 1, 2009
The Wall Street Journal, by Gerald F. Seib
Among the many problems President Barack Obama confronts on the health-care front, one is fairly simple. He is defending a plan that doesn't really exist. That raises the broader question: What kind of new bill might the president, at this point, offer to draw broad support. Mark McClellan, a health adviser to former President George W. Bush, now is part of a bipartisan group trying to address that question. As Dr. McClellan notes, though, even compromise proposals remain expensive, and controversial. "What August has shown," he says, "is because health care is an issue that people care deeply about...it's easy to criticize any proposal out there, on the left or the right."
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What's In Our Wallet?
August 31, 2009
Modern Healthcare, by Jennifer Lubell
Amid dire statistics released last week that the federal deficit will climb into the trillions over the next decade, healthcare policy experts say that reducing payments to providers wouldn’t be the answer to achieving additional savings in healthcare reform. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution, Washington, and a former CMS administrator, reasoned that reducing reimbursement rates would not be an effective long-term cost-controlling strategy. “What hospitals and providers need more generally is better support when they avoid unnecessary costs, better support for when they get care right the first time. Squeezing prices across the board does not accomplish that,” McClellan said.
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Cardiologists Crying Foul Over Medicare Cuts Hurt Obama Revamp
August 28, 2009
Bloomberg, by Alex Nussbaum and Lisa Rapaport
An Obama administration plan to cut Medicare payments to heart and cancer doctors by $1.4 billion next year is generating a backlash that's undermining the president's health-care overhaul. The proposal by Medicare, the government insurer for the elderly and disabled, is an effort by Obama to focus U.S. medicine on preventive care. The fight by physicians who work with the most expensive patients is weakening support for Obama’s broader goal, legislation to remake the health system, said Mark B. McClellan, 46, a former Medicare chief. “If you can make the health-care debate all about moving slices of the pie around, it’s very easy to generate opposition and very easy to get derailed,” said McClellan, a physician and analyst at the Brookings Institution.
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Elderly Have Their Own Worries on Health Overhaul
August 27, 2009
Associated Press, by Erica Werner
The trepidation that's taken hold among the elderly over Obama's drive to remake the nation's health care system is turning into one more political headache for Democrats as they struggle to reach agreement on sweeping health legislation that can pass the House and Senate after Labor Day. "Seniors are rightly concerned that half a trillion dollars in cuts might have some impact on access and quality of care," said Mark McClellan, a doctor and health economist who ran Medicare for former President George W. Bush and also served in the Clinton administration.
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What Will Become of Health Care Reform Without Senator Ted Kennedy
August 26, 2009
PBS/Nightly Business Report
Senator Kennedy's reputation gave him the clout to to cut bipartisan deals on health care that sometimes disappointed core Democratic constituents. But Mark McClellan, a health care policy advisor to Presidents Clinton and Bush, says that kind of pragmatism is badly needed now if we are to find a way to solve our health care reform problems.
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Getting Cheaper, Better Healthcare at Home?
August 25, 2009
Los Angeles Times, by Noam Levey
The core idea is deceptively simple: By staying in close touch with some of their sickest patients through home visits, doctors and nurse practitioners can avoid admitting them to hospitals, where costs and potential complications multiply. "These patients are having preventable complications. When they get discharged from the hospital, they are having avoidable readmissions," said Dr. Mark McClellan, who oversaw Medicare in the Bush administration. "Improvements in care could yield big savings."
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Moving from Volume-Driven Medicine Toward Accountable Care
August 20, 2009
Health Affairs, by Aaron McKethan and Mark McClellan
Aaron McKethan and Mark McClellan argue in a Health Affairs blog posting that Accountable Care Organizations represent a critical step away from volume-driven health care payment and toward better health and better care at lower cost.
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Mark McClellan on the Health Care Overhaul (Video)
August 19, 2009
Bloomberg TV
Mark McClellan discusses with Bloomberg TV the current landscape of health care reform, emphasizing the need to focus on reform efforts that will ultimately give everyone access to quality care at lower costs.
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Tackling the Mystery of How Much It Costs
August 18, 2009
The New York Times, by Gina Kolata
For the most part, doctor fees are a mystery. If people see a doctor who is part of their insurance network, they are responsible only for deductibles and co-payments, and the price the health insurer pays is often a secret. And if people see a doctor outside their network, they usually have no idea what the charge will be — even though they are responsible for most of it — until the bill comes. But the health care legislation under discussion does not directly address the out-of-network fee issue. And that is intentional, says Dr. Mark McClellan of the Brookings Institution. Dr. McClellan, a former head of Medicare who works closely with policy makers, says the goal of the House and Senate bills is to encourage people to stay in their networks. He added that the result should be networks that provide better care “so that people don’t have so much need to go outside of them."
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Public or Co-op? Comparing Health Options
August 17, 2009
CBS Evening News, by Nancy Cordes
It's no wonder many Americans are perplexed about a public option or confused by co-ops when even lawmakers struggle to explain them. With lower administrative costs, the government could offer lower insurance premiums than the private sector - giving uninsured Americans a more affordable option. "One version of a public option would be like the way the Medicare program is run today where the government pays directly for health care. It sets regulated prices, it's take it or leave it for the doctors and it's big enough so the health care providers generally have to take it," said Mark McClellan, former director of the Centers for Medicare & Medicaid Services.
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McClellan on Health Care Debate (Video)
August 14, 2009
Bloomberg TV
Mark McClellan discusses with Bloomberg TV's Political Capital host Al Hunt cost-saving measures around the country that deliver better health care at lower costs, and the importance of bipartisanship in implementing sustainable reform.
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McClellan Says Health Debate Should Be on Care, Not Insurers
August 14, 2009
Bloomberg, by Kristin Jensen
The Obama administration’s strategy of focusing on insurers in its bid to overhaul the U.S. health-care system misses the point, said Mark McClellan, the former head of the Centers for Medicare & Medicaid Services. “We need to put more of an emphasis on prevention and on getting care right the first time,” said McClellan, who ran the government programs for the elderly, disabled and poor under Republican President George W. Bush. “It’s not just a matter of moving the dollars around or pouring in more money.”
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Opinion: 10 Steps to Better Health Care
August 12, 2009
The New York Times
Mark McClellan, with other distinguished health policy experts, discusses ways to change how health care is delivered so that it is both less expensive and more effective, and offers evidence from around the country that such care is possible.
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How Obama Lost Control of Health Message
August 12, 2009
CQ Politics, by Adriel Bettelheim
For all the rhetorical morale-boosting from Obama to speed a bipartisan approach to health care through Congress, some lawmakers are growing restive over the question of just what sort of big-picture health plan they’re fighting for. Throughout the health care debate, the president has focused more on the importance of completing an overhaul and enumerating the shortcomings of the present health system than explaining precisely what any changes will deliver. But Obama insists he has clearly defined what would work best in a revamped health system and has helped forge consensus on critical questions such as insurance regulations to keep health plans from basing coverage decisions on pre-existing conditions or proposed “insurance exchanges” that would provide consumers with a menu of options to expand choice. “Initially, the administration’s focus was on cost and making the plan pay for itself. Now, it’s about needing reform to keep what you have secure,” said Mark McClellan, a former administrator of the Centers for Medicare and Medicaid and FDA commissioner in the administration of George W. Bush.
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Health Care Message Gets West Wing Tune-Up
August 4, 2009
CQ Politics, by Adriel Bettelheim
Though polls suggest Americans believe fixing the health system is more important than ever, the Obama administration hasn’t elicited much passion for its effort. In fact, Obama’s approval ratings on health care have been steadily falling. The difficulty in rallying support is partly due to the complexity of the subject and the White House’s insistence on stressing abstract cost controls in order to address the cost of retooling the system, variously estimated at around $1 trillion. “It’s a real challenge to on one hand stress how people’s existing relationships with doctors and health plans won’t change if they’re satisfied with them, and at the same time stress how important it is to change the system to stop the trajectory in health spending,” said Mark McClellan, a former Medicare administrator and FDA commissioner in the administration of George W. Bush.
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Dallas Region Among Top Spenders in Health Care
August 3, 2009
Dallas Morning New, by Jim Landers
Faced with data showing Dallas doesn't give good value for money in health care, North Texas medical, insurance and other business leaders are discussing a transformation of one of the area's biggest industries to curb spending and improve quality. "For years, Dallas has struggled with high and rising costs," said Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution. "What's different now is that a critical mass of leaders in health care, business and government believe slowing spending growth and improving care is both achievable and urgent. And they are working together to do it."
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Effects of Taxed Health Benefits Go Beyond Economics, Skeptics Say
July 29, 2009
The Washington Post, by Alec MacGillis
Do Americans spend so much on health care because they are not taxed on the insurance benefits they get at work? Increasingly, the conventional wisdom in the health-care debate says yes. But even as consensus grows, others warn that the effect of taxing health benefits is being greatly overstated. They concede there is a case for limiting the tax exemption, but say that move is not some kind of golden key for bringing spending under control. The economists are undeterred. If benefits were taxed, employees would give more thought to the less costly plan and be more aware of their health-care spending. "The next time you got a W-2 there would be a line listing additional income tax" paid on health benefits, said Mark McClellan, a senior health care official in George W. Bush's administration. "People would pay attention to that."
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A Bipartisan Plan on Health Care? Try Two
July 29, 2009
The Washington Post, by Ruth Marcus
If only Democrats and Republicans could get together and produce a health-care bill that would expand coverage and control costs. But wait -- there is such a proposal. There is a more politically sustainable, deficit-neutral alternative, crafted by three former Senate majority leaders -- Democrat Tom Daschle, and Republicans Bob Dole and Howard Baker. Staffing the work for the Bipartisan Policy Center were Chris Jennings, a veteran of the Clinton health reform efforts, and Mark McClellan, who ran the Medicare and Medicaid programs under George W. Bush. It was released last month, to praise from the leadership of the Senate Finance Committee, but more muted murmurings from the White House. It's time to take another look.
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Meet in the Middle on Health Care
July 27, 2009
Dallas Morning News, by William McKenzie
As the Senate rightly decided to not rush a vote by the August recess, they should now return to the report last month from Democrat Tom Daschle and Republicans Bob Dole and Howard Baker. This respected trio, leaders of the Bipartisan Policy Center, outlined ways Congress could create a health care consensus. Mark McClellan spelled out how some of the ideas would work, and he should know. A physician and economist, he headed Medicare under President George W. Bush and worked on health policies for President Bill Clinton. McClellan also worked with Baker, Dole and Daschle on their bipartisan approach.
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The New Sentinel Network — Improving the Evidence of Medical-Product Safety (subscription required)
July 27, 2009
The New England Journal of Medicine
In 2007, Congress directed the Food and Drug Administration (FDA) to create a new postmarketing surveillance system that will, by 2012, be using electronic health data from 100 million people to prospectively monitor the safety of marketed medical products. In May 2008, the FDA announced the Sentinel Initiative, which would “access the capabilities of multiple, existing data systems." The network of data systems is intended both to detect signals and to confirm signals, including those suggested by other sources, and to do so rapidly and quantitatively. Achieving these goals requires the first large-scale, truly integrated use of the electronic data that are increasingly available in our pluralistic health care system. The first hurdles are determining how best to organize the Sentinel Network, how it should operate, and what steps are needed for its implementation.
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Focus On Health Savings Obscures Other Issues
July 26, 2009
The Washington Post, by Ceci Connolly
President Obama says the primary goal of health reform is to rein in runaway spending, and he points to real-world examples in which doctors and hospitals have improved care and reduced costs. Making the leap from a handful of success stories to restructuring one-sixth of the nation's economy -- and writing it all in legislative language -- is a puzzle he has not solved. As health care consumes more and more of the total economy, it reduces the money available for other expenditures. The question is whether Americans are getting a good return on the investment. The amount of money is not the problem, said former Bush administration official Mark B. McClellan -- it's what we get for it. "If we're living longer, better lives, that health-care spending is a good thing," he said. "The problem is that a lot of that spending is not leading to productive improvements in the quality of life."
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Forget Who Pays Medical Bills, It's Who Sets the Cost
July 25, 2009
The New York Times, by David Leonhardt
Medicare data shows that groups of doctors who collaborate closely and are not paid based on how many procedures they perform generally provide less expensive care and appear to deliver better results. Armed with this data, the doctors who run these groups have been lobbying Congress to make their model a bigger part of health reform. Advocates say such a system could ultimately give doctors more control. Rather than having to organize their schedules around the tests and procedures that insurers agree to reimburse, doctors could opt for the treatments they deem most effective. “It’s a lot more accountability, which is why it’s scary for physicians,” said Dr. Mark McClellan, a former head of Medicare under George W. Bush. “But in some ways it’s also more autonomy.”
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Point Person: Our Q&A with Mark McClellan
July 24, 2009
Dallas Morning News
Mark McClellan, having served in the administrations of both Bill Clinton and George W. Bush, shares his ideas for developing a bipartisan consensus on health reform.
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Providing Better Health Care for Less Money
July 22, 2009
NPR, by Julie Rovner
The health care debate in Washington has basically deteriorated into a choice between raising taxes or cutting care. But that's wrong, says Don Berwick of the Institute for Healthcare Improvement. To try to prove his point, Berwick, along with health luminaries Elliott Fisher of the Dartmouth Medical School, Atul Gawande of Harvard and Mark McClellan of the Brookings Institution, brought doctors and hospital officials to Washington from 10 communities around the U.S. where health spending is lower than average and health care outcomes are better than average.
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What Kind of Health Care do Obama, Lawmakers Get?
July 16, 2009
McClatchy Newspapers, by William Douglas and Margaret Talev
Throughout last year's presidential campaign and this year's debate over fixing the nation's health care system, lawmakers have delivered the same refrain: That the American people deserve the same kind of health care that members of Congress get. In reality, the 435 members of the House of Representatives, the 100 members of the Senate, and President Barack Obama get a pretty sweet deal, better than most Americans. "The federal employee plan is more generous than coverage most people have in the private sector," said Mark McClellan, a health care analyst at the Brookings Institution. "It's probably similar to coverage that people in large established corporations get, and better than what you get if you're in a small business. It's not the creme de la creme, but it's better than what most Americans are getting."
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Health Reform, Technology Must Align to Improve Quality of Care
July 15, 2009
HealthITNews, by Kyle Hardy
Reductions in cost and improvements in care are achievable if national efforts to boost health information technology adoption are coordinated with national health reform plans, according to panelists at a hosted forum of industry and policy leaders in Washington, DC. "We must take concrete steps now toward a healthcare system that pays for better quality and lower costs, rather than the unsustainable status quo of paying primarily for volume of medical services," said Mark McClellan, MD, PhD, director of the Engelberg Center for Health Care Reform and Leonard D. Schaeffer Chair in Health Policy Studies at the Brookings Institution. "By tying support for health IT directly to achieving these quality and cost improvements, the new health IT payments can be a critical step toward achieving this vision."
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Concern Grows that Healthcare Overhaul Won't Cut Costs
July 13, 2009
Los Angeles Times, by Noam Levey
Although still publicly beating the drums for President Obama's healthcare overhaul, representatives of some of the biggest players are beginning to express concern behind the scenes that it won't do enough about the major problem: runaway medical costs. Even the recent agreement between hospitals and the administration to cut federal payments to hospitals by $155 billion over the next decade does little to change the way providers are paid, said Mark McClellan, who headed the Centers for Medicare & Medicaid Services under the Bush administration. Nearly all these projected savings would come from cuts in federal reimbursements, which critics fear could prompt hospitals to simply charge private insurers more. "We need to make it increasingly uncomfortable to deliver care that is inefficient," said McClellan.
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Part B Drug Proposal Would Curtail Medicare Pay Cuts After 2010
July 13, 2009
American Medical News, by Chris Silva
In a major policy reversal from the previous administration, the Centers for Medicare & Medicaid Services has proposed removing physician-administered drugs from the calculation of the Medicare physician payment formula. Doctor pay is reduced across the board when spending on all physician services -- a category that includes Part B drugs -- exceeds annual targets. Removing the costs of the drugs would lessen the extent to which spending would exceed targets and trigger cuts. "Clearly, the fact that the Obama administration now thinks it can take it out shows you the legal interpretation could go either way," said Mark B. McClellan, MD, PhD, who made the decision against the policy change while serving as CMS administrator in the Bush administration from 2004 to 2006. "This is something that was reviewed every year, and there were legal arguments on both sides."
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Big Changes in Medicare Pay Key to Health Reforms
July 9, 2009
Reuters, by Susan Heavey
Recent industry deals to accept lower costs for the Medicare health program are a first step in healthcare reform but more substantial payment changes will be needed to shore up the ailing system in the long term and improve patient care. "The agreements announced so far seem to put most of the weight on squeezing down prices further rather than supporting reforms of how healthcare is delivered," said Mark McClellan, director of the Brookings Institution's Engelberg Center for Health Care Reform and a former Medicare administrator.
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Selling the Greater Good on Health Care
July 8, 2009
CQ Politics, by David Nather
Beyond all the legislative details and compromises that have to be settled, the critical underlying dynamic is people’s anxiety about what a rebuilding of the health care system could mean to them personally. The only player who can truly close the sale on the health care overhaul is Obama himself. Still, the potential is there for a distorted debate to convince people that their health care costs will go up, not down, in various ways. That’s why Mark McClellan, a commissioner of the Food and Drug Administration and administrator of the Centers for Medicare & Medicaid Services under President George W. Bush , says it’s so crucial for Congress to get a bipartisan bill rather than having Democrats ram it through on their own. “They’re understandably nervous about change, and having members from both sides telling them this is the right thing to do could go a long way toward addressing that anxiety,” said McClellan, who consulted on the development of the bipartisan health care proposal by the former Senate majority leaders.
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Electronic Patient Records Now; Healthcare Rationing Later?
July 6, 2009
The Economist
Larry Kocot, deputy director of the Engelberg Center for Health Care Reform at the Brookings Institution, agrees with President Obama that investment in electronic healthcare records could go a long way to reducing costs and improving quality of care. But he argues that, in addition to government-invoked rewards and penalties, the U.S. healthcare sector will need to adopt standards to facilitate data exchange among providers. If such standards are set in a way that will facilitate better quality care through the appropriate use of healthcare data, he argues, then “the healthcare industry will want to use e-health because it works.”
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Government Plan Would Offer Cut-Rate Medical Premiums
July 6, 2009
Associated Press, by Ricardo Alonso-Zaldivar
A strong public plan that uses the government's power to squeeze medical costs could bring about what Obama says he doesn't want to do: disrupt what the president calls the "uniquely American" balance between government and employer coverage. Employers now provide coverage for more than 160 million Americans. "You can't have it both ways," said Mark McClellan, who ran Medicare under President George W. Bush. "Either the government plan can get substantially lower costs by exerting power that other health plans don't have. Or, if you go the other way, and you don't give the public plan any special advantages, and you make sure it doesn't get too big -- in that case it's not going to be any less costly. So what's the point?"
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Medicare's Mixed Legacy
July 4, 2009
The New York Times, by Reed Abelson
Medicare’s monopoly over the insurance market for the elderly allows it to compel important changes in the way medical care is paid for. But it is that same market power that critics worry about as the debate over a new public plan for the uninsured begins. If lawmakers model such a program on Medicare, "its lower costs will tend to drive people into the plan," said Dr. Mark B. McClellan, a physician and economist who ran Medicare under President George W. Bush.
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F as in Fat: How Obesity Policies are Failing in America (video)
July 1, 2009
KXAN.com, NBC News
Experts warn that overweight baby boomers will soon flood Medicare with their obesity-related diseases, like high blood pressure and diabetes. A report released by Trust for America's Health and the Robert Wood Johnson Foundation found that today's 55-64 year-olds are much heavier than today's seniors, and Medicare is already on the brink of bankruptcy. "Add to that the fact that the latest evidence suggests that people with obesity have health care costs that are 20-30 percent higher than people who aren't obese, and you've got the makings for an even more severe financial challenge," said former Medicare administrator Mark McClellan.
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Nationwide Medicare Fraud Ring Busted (video)
June 24, 2009
CBS News
Watchdog groups estimate anywhere from 3 to 20 percent of Medicare spending is fraudulent - up to $70 billion a year, wasted. And Medicare spends less to combat fraud than many private insurers, according to Mark McClellan, who ran the massive program under President Bush. "Doctors billing for more than 24 hours a day worth of services, that should be a red flag," said McClellan. "To detect those kinds of problems, though, you need good computer systems in place, up-to-date monitoring systems."
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Lawmakers Get 'Generous' Health Plans
June 23, 2009
USA Today, by John Fritze
Some proponents of overhauling health care, including President Obama, have suggested everyone should be entitled to the coverage members of Congress receive. Mark McClellan, a doctor and economist at the Brookings Institution, said he believes members of Congress are getting a good deal. "It's significantly more generous than most Americans are getting," said McClellan, who suggests Congress could raise money for a health care overhaul by taxing premiums that exceed those included in their own plan.
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Treating the Ailing Healthcare System (video)
June 18, 2009
Bloomberg TV
"I think the odds are still good. It's a very challenging issue but I would take the setbacks that you were describing today as, really, being a sign of progress in a way. The discussion is now moving from one of general principles about health care reform to how, exactly, can this be done and how can it be paid for -- so the hardest questions for health care reform are getting confronted right now. It still can be done, there are just some very difficult issues left to deal with." - Mark McClellan
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Some Common Ground Emerges in Health Battle
June 18, 2009
USA Today, by John Fritze
At the same time partisan divisions over health care are becoming increasingly stark, Democrats and Republicans in Congress are finding consensus on ideas that ultimately could be included in a final plan. "You're starting to see...agreement not only at the level of broad principles, but at the level of major features for implementing those principles," said Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution.
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Health Care Rationing Rhetoric Overlooks Reality
June 17, 2009
The New York Times, by David Leonhardt
The r-word has become a rejoinder to anyone who says that this country must reduce its health care spending, especially anyone who favors cutting back on treatments that don't have scientific evidence behind them. "Just because there isn't some government agency specifically telling you which treatments you can have based on cost-effectiveness," as Dr. Mark McClellan, head of Medicare in the Bush administration, says, "that doesn't mean you aren't getting some treatments."
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Health plan would tax medical benefits
June 14, 2009
The Washington Times, by Jennifer Haberkorn
"None of the proposed ways of expanding health care benefits are going to be easy to enact politically," said Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution.
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Orszag: ‘Deficit Neutrality’ Key Part of Overhaul Package
June 9, 2009
CQ, by John Reichard
The Brookings event dealt with the issue of expanding federal funding of research comparing the effectiveness of medical treatments and procedures. Both Baucus and Orszag urged expansion of the studies, with Orszag calling it a way to help patients and doctors figure out which treatments work best and to reduce unjustified geographical variations in spending. Baucus said he would add to his health overhaul proposal a bill he introduced last year with Conrad to provide stable funding for an expanded federal research program.
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Health-Care Change Won’t Swell Deficit, Orszag Says
June 9, 2009
Bloomberg, by Nicole Gaouette
“This is not make-believe,” Orszag said today at the Brookings Institution, a policy research foundation in Washington. “These are not untested proposals. These are proposals that have been scored by an appropriately skeptical Budget Office. The package we put together will be deficit neutral over 10 years. There is no ambiguity about that.”
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Blumenthal: Stimulus a 'Sweetener, Not Determinant' of Health IT Adoption
May 21, 2009
Government Health IT, By Mary Mosquera
Health information technology leaders made the case for linking the economic stimulus plans to the broader goals of health reform, including improved health care services and population health, at a conference in Washington, D.C. yesterday. The health IT provisions of the stimulus were designed to correct the failure of the market to sput the adoption of health IT and to demonstrate its value. In doing so, it will also be a tool to meet the aims of health reform, said Dr. David Blumenthal, the nation's health IT coordinator, at a May 20 conference sponsored by the Brookings Institution.
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ONC Chief Urges IT Champions to Back Healthcare Reform
May 21, 2009
Healthcare IT News, By Bernie Monegain
The best way to support the nation's healthcare IT initiatives is to back healthcare reform, says David Blumenthal, MD, the national coordinator for health information technology. "We will not succeed in our agenda unless reform succeeds," Blumenthal said Wednesday during a healthcare forum at the Engelberg Center for Health Care Reform of the Brookings Institution in Washington, D.C. Blumenthal also talked about stimulus money for healthcare IT and the "meaningful use" of information technology in healthcare.
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HIT Best Used in Tandem with Quality, Pay: Experts
May 20, 2009
Modern Healthcare, By Jennifer Lubell
Health information technology reforms need to work in tandem with payment and quality initiatives to be effective, industry experts said at a meeting sponsored by the Engelberg Center for Health Care Reform at the Brookings Institution, Washington. Health IT has a broad range of capabilities and will be a "highly effective tool" in promoting health care reform, but IT alone "won't ensure improvements in quality and cost of care," Mark McClellan, director of the Engelberg Center, told participants; rather, fully integrating payment reforms and quality goals with health IT is the recipe to improve care.
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Health Economists: Savings Will Require Sacrifice
May 11, 2009
Associated Press, By Tom Murphy
A health industry offer on Monday to trim costs by $2 trillion over the next decade found a skeptical audience among health care economists, who say such savings might materialize only if many parts of the industry are ready to sacrifice. Significant changes in the way hospitals and doctors are paid may be necessary, said Dr. Mark McClellan, an economist who ran Medicare and the Food and Drug Administration for President George W. Bush. He noted, for instance, that past attempts to restrain Medicare payments haven't worked in part because they force doctors to cycle more patients through their office to make up for the declining revenue. Doctors then spend less time with each patient or on coordinating that care. He said a system that ties payment more to quality, rather than quantity, must be developed.
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Analysis: Will Health Care Savings Add Up?
May 11, 2009
Associated Press, By Ricardo Alonso-Zaldivar
The White House trumpted the news: health care providers taking a $2 trillion scalpel to their costs and pushing the U.S. toward Barack Obama's vision of health coverage for all. The groups don't just have the national interest in mind, though. Industry is worried that Congress will create a government health plan to compete with private insurers, which would quickly become the biggest in the country and could use its power to set lower payment rates. "I think the reason all these groups want to actively participate in the process is they don't want to see a blunt instrument used to get spending down," said Mark McClellan, who ran Medicare under President George W. Bush. "This is an opportunity to get everyone behind a better approach to improve the way health care works."
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Key Senate Panel Sets Brisk Pace for Health System Reform Package
May 4, 2009
American Medical News, By Doug Trapp
The Senate Finance Committee, whose leaders appear to have taken the helm in the health system reform debate, started a round of public talks with health organizations in a run-up to an aggressive reform timetable. Geisinger Health System President and CEO Glenn Steele Jr. said Congress should start by giving CMS more leeway to launch demonstration projects quickly that are focused on Medicare patients who cost the most and receive the least-coordinated care. That would entail giving CMS clear goals for the patients' health and creating a backup reform plan that serves as a stick to motivate the agency to achieve its primary goals. Dr. Mark McClellan, a former CMS administrator, said the agency would need a bigger budget and more authority. "Medicare, the way it is managed now, does not leave a lot of room for discretion in implementing the kinds of reforms we're talking about today." (subscription required)
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You're Not in Kansas Anymore
May 4, 2009
Modern Healthcare, By Matthew DoBias
Former Kansas Gov. Kathleen Sebelius took over as HHS secretary last week amid the country’s biggest test of its pandemic-fighting capabilities since at least 2005, and as Congress takes the first steps to try to drastically change the way healthcare is provided and paid for in this country. The one-time insurance commissioner will have to quickly become an expert on the finer points of healthcare reform with members of the influential Senate Finance Committee meeting to lay out Congress’ plan for how it wants to alter the healthcare landscape. “Welcome to life at HHS,” said former CMS Administrator Mark McClellan, now the director of the Engelberg Center for Health Care Reform. “It’s a huge set of responsibilities.” (subscription required)
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Medicare to Play Big Role in Health Care Overhaul
April 21, 2009
Associated Press, By Ricardo Alonso-Zaldivar
Older Americans could see big changes in Medicare as a result of a health care overhaul, lawmakers and experts said Tuesday as Congress began working on the sweeping legislation. Medicare should become the test lab for making the entire health care system less wasteful, and savings could be used to strengthen Medicare itself, or plowed into covering the uninsured. Mark McClellan, a former Medicare administrator under President George W. Bush, said the government must move carefully. "As we make these changes, it's important to do it in a way that's not too radical, not too disruptive," he said.
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Inside Look - Fixing Health Care
(video)
April 15, 2009
Bloomberg News
Mark McClellan discusses with Bloomberg News the urgent need for U.S. health care reform and why real reform means changing the way our health care system works. View here »
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FDA's Next Accelerated Approval Process: "Targeted Cancer Drugs"
April 12, 2009
RPM Report, By Cole Werble
Former FDA Commissioners David Kessler and Mark McClellan are urging the agency to develop a new process for accelerated cancer drug approval to take advantage of biomarker identification of specific patient populations and drug activity. Noting that McClellan, FDA commissioner from late 2002 to early 2004 and now the head of the Engelberg Institute at Brookings, has “been doing a lot of thinking on this,” Kessler said that the new process “should be based on pre-specified markers, both positive and negative.”
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Democrats Seek Compromise on Health Care Plan
April 2, 2009
Associated Press, By Ricardo Alonso-Zaldivar
Democrats are seeking a compromise on a bigger government role in insurance coverage as part of President Barack Obama's proposed health care overhaul. At issue is whether middle-class workers and families should have the option of a government-sponsored plan that would compete with private insurers. One potential compromise is based on insurance plans that most states already offer their employees, which would avoid expanding a federal program like Medicare and possibly could be run by a private insurer. Mark McClellan said the proposal was "well-meaning," but that the government is much bigger than any state, so the effects of a federally backed plan on the insurance market would be far greater.
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U.S. Experts Urge Health Reforms in Schools, Cities
April 2, 2009
Reuters, By Susan Heavey
Overhauling the U.S. healthcare system should be more than an intense focus on just how much it costs to treat the sick; more work must be done in schools and cities to give people better access to nutritious food and places to exercise, a panel of experts concluded in a report commissioned by the nonprofit Robert Wood Johnson Foundation. "While getting coverage to all Americans is a very important goal ... it turns out that programs that may have the biggest impact on our health are programs that we don't think about as being healthcare programs at all," said Dr. Mark McClellan, who co-chaired the group's effort to prepare the report.
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Texan Working to Make Medicare Savings a Reality
March 23, 2009
Dallas Morning News, By Jim Landers
Mark McClellan was a major policy figure in health care during the Bush administration. While most of his former colleagues are now in the political wilderness, McClellan is using his post at Washington's Brookings Institution to keep moving in the circle of implementers who want to "bend the curve" of rising health care costs. Along with several other health care experts, McClellan is trying to persuade President Barack Obama's reform team and Congress to pay hospitals and doctors more if they can show they're improving treatment for Medicare patients while lowering costs. "Right now, we are getting what we pay for -- high-volume, high-intensity health care," he said. "Often, there's no support for preventive care."
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Accountable Health Organizations Enter Policy Spotlight
March 13, 2009
CQ Healthbeat, By John Reichard
It's been a big week for the “accountable health organization,” a concept proposed to begin eliminating unnecessary medical services that are estimated to waste $700 billion per year. Engelberg Center Director Mark McClellan and Dartmouth College researcher Elliott S. Fisher co-hosted a forum at Brookings this week to discuss how ACOs are meant to spur teamwork by providers to deliver efficient care, and how savings generated by that teamwork would be shared by big payers like the Medicare program and the doctors and hospitals involved in the organizations. (subscription required)
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The Next Front in the War on Cancer
February 27, 2009
Wall Street Journal, By Mark Thornton
Clinical trials in oncology are necessary, but can they be done more quickly while also providing the same standard of safety and efficacy we have now? At the Brookings Institution’s Conference on Clinical Cancer Research last fall, Former Food and Drug Administration Commissioner David Kessler and other cancer experts proposed using "progression-free survival" (PFS) as a surrogate endpoint for cancer clinical trials. It helps determine whether a cancer has slowed down in response to treatment. By measuring time to progression rather than time to death, oncology clinical trials would take months instead of years.
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Obama Health Plan Opens Tough Negotiation
February 26, 2009
Associated Press, By Ricardo Alonso-Zaldivar
Obama's prescription for the nation's ailing health care system would set aside $634 billion over 10 years in a major effort to cover all Americans — a goal that could cost more than $1 trillion. Half the money would come from tax increases on upper-income earners; the other half from cuts to Medicare and Medicaid. "This is a serious effort to get the process moving," said Mark McClellan, a doctor and health economist who ran Medicare for former President George W. Bush. "The level of financing included indicates it's a serious effort. The specific financing proposals are going to have a very tough time."
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Medicare Spending Still Varies Widely By Region
February 26, 2009
The New York Times, by Reed Abelson
Specific dynamics of Medicare spending in local markets vary, but the current payment method fuels spending by encouraging hospitals and doctors to try to expand their services, according to Dartmouth researchers. Any attempt to rein in health care costs needs to address how doctors and hospitals are paid, where they are rewarded on the basis of the volume of services they perform. “As long as Medicare pays for volume and intensity, that’s what you’re going to get,” said Dr. Mark B. McClellan, who oversaw the Medicare program during part of the previous administration.
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Obama Wants $634 Billion to Start on Health Care
February 26, 2009
Bloomberg, By Aliza Marcus and Alex Nussbaum
President Obama, in his $634 billion plan to expand U.S. health care, proposed prohibiting generic versions of biologics on the market for a period “consistent with” current limits of about seven years, despite biotechnology companies’ push for 12 years of exclusivity. Letting generic-drug companies make their own versions of medicines, however, could save $25 billion in the first decade they’re on the market. In response to the proposed limits, “It’s important and sets a marker, but there are clearly going to be proposals for a longer exclusivity period, and that’s where I expect some negotiation,” said Mark McClellan, a former Food and Drug Administration commissioner now at the Brookings Institution in Washington.
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Drug Makers Fight Stimulus Provision
February 9, 2009
The Wall Street Journal, by Alicia Mundy
The fight over a provision in the stimulus bill that would spend $1.1 billion on research comparing medical treatments is highlighting the tensions behind President Barack Obama's plan to overhaul the health-care system, as pressure increases to find long-run health-cost savings. "Without question, we're headed for more of a public and private push for which medicines work best at the lowest cost in particular patients," said Mark McClellan, former Medicare and Medicaid chief under President George W. Bush.
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Despite U.S. Push, Health e-Records Years Off
February 5, 2009
Reuters, by Susan Heavey
A congressional plan to spend up to $24 billion on health information technology could be a boon for companies that support electronic medical records, but experts and industry leaders have said the key is to ensure those who install electronic records use them to provide better care. "The wrong way to do this would be to just award a bunch of money for health IT in the short run ... this is going to take a little more time and effort," said Mark McClellan, who served in the Bush and Clinton administrations and now heads Brookings Institution's Engelberg Center for Health Care Reform.
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A Time for Change: The Obama Agenda
January 15, 2009
PBS Nightly Business Report
Former Medicare Director Mark McClellan says when it comes to promoting efficiency in our health care system, the current incentive structure is out of whack.
For press inquiries, please contact Brynn Barnett at 202-797-6140.