Donald H. Taylor Jr.
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  • Thoughts on the Robert E. Lee Statue Removal from Duke Chapel
    I became chair of the Academic Council at Duke on July 1, 2017, and was chatting with the Provost a few weeks ago and we agreed there “weren’t any hot button issues” on tap for the Fall semester. That, of course, is no longer true. I support President Price’s decision to remove the statue of […]
    Don Taylor
  • N.C. Medicaid Managed Care Proposal
    The N.C. Medicaid Managed Care proposal was put out today by the Cooper Administration NCMedicaidManagedCare. Don’t look now, but North Carolina looks to be engaging in bipartisan health care reform. You may recall that the Republican-controlled Legislature dictated that the Republican Governor develop and submit a 1115 Medicaid waiver by June 1, 2016, which he did. […]
    Don Taylor
  • Counterproductive cost sharing
    The theory behind cost sharing is that it should deter ineffective care. In reality, it is a blunt and crude instrument that places barriers in front of effective care as well as ineffective care. I want to highlight two papers that look at the misaligned incentives of cost sharing in a pragmatic context. The first […]
    David Anderson
  • RCT of Palliative Care in Heart Failure
    A big team from Duke lead by Joseph Rogers has a new Paper (PAL HF) reporting the results of a RCT of palliative care in late stage Congestive Heart Failure, published today in the Journal of the American College of Cardiology. Patients who got palliative care had better quality of life, higher function and reduced […]
    Don Taylor
  • The Senate bill confuses already confused consumers
    The Senate’s Better Care Reconciliation Act (BCRA)[1] is a significant modification to the current Patient Protection and Affordable Care Act (PPACA)[2] exchange structure in a variety of ways.  One major change is the designation of the benchmark plan which determines the level of subsidy that the federal government provides to individual buyers on a health […]
    David Anderson
  • Does Health Insurance Improve Health?
    An old question has gotten some new evidence. Does health insurance coverage improve health? This is a simple (and important) question that is complicated to answer definitively due to methodological reasons, but the evidence base has grown by two important papers in peer review journals in the past few weeks: Ben Sommers has a recently […]
    Don Taylor
  • A cheat sheet to read the Senate version of AHCA
    The Senate healthcare and tax cut bill is expected to drop soon. Here is a cheat sheet on how to read it. 1) Reconciliation places severe constraints on the bill a) The Parliamentarian is most likely going to be stripping out significant, non-germane to the budget, items that were in the House bill. b) $1 […]
    David Anderson
  • Where to expect higher deductibles this fall on Healthcare.gov
    The Silver plans are supposed to be 70% Actuarial Value (AV). AV is the percentage of costs for the pool that the insurer covers. 70% AV means the insurer pays roughly 70% of the costs, and the people in the pool pay roughly 30% in cost sharing. There are lots of different ways to arrange […]
    David Anderson
  • Time & Motion Study of Community Based Palliative Care
    We have a new paper (open access) in the Journal of Palliative Medicine, providing a Time and Motion study overview of the care delivery model at the heart of our CMMI HCIA-2 innovation award with Four Seasons Hospice in Western, North Carolina (Janet Bull, who is also President of the American Academy of Hospice and Palliative […]
    Don Taylor
  • Hidden good news in the BCBS-NC filing
    Blue Cross and Blue Shield of North Carolina just filed their initial rates for the ACA individual market for 2018. The headline will be that they are asking for a 22.9% average rate increase. The second headline is that they assume that Cost Sharing Reduction subsidies will not be paid. That assumption drives 61% of […]
    David Anderson