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Elizabeth Fowler is an American lawyer who is Director of the Center for Medicare and Medicaid Innovation. She previously served under President Barack Obama at the National Economic Council. In 2022, she was included by Stat News on their list of leaders in the life sciences and she was elected a Member of the National Academy of Medicine. [1]
Fowler was an undergraduate student in health care management at the University of Pennsylvania. [2] She moved to the Johns Hopkins Bloomberg School of Public Health. [3] Her research considered risk adjustment. [4] [5] After earning her Ph.D. there, she enrolled at the University of Minnesota Law School. She was admitted to the bar in Maryland. [3]
After earning her Juris Doctor degree, Fowler joined the Park Nicollet Foundation in Minnesota. [3] There, she spent almost five years researching health services. She worked as an attorney at Hogan Lovells, a law firm based in Washington, D.C. [3]
Fowler worked at Vice President for Public Policy at Anthem (then WellPoint). During the health reform debate, Fowler served as Chief Health Counsel to Max Baucus [3] and worked on health reform for the United States Senate. [4]
Fowler was appointed special assistant to President Barack Obama, working on economic policy at the National Economic Council. [3] She was involved with the design and delivery of the Affordable Care Act. [3] After leaving the Obama administration, Fowler joined Johnson & Johnson as vice president for Global Health. [6] [7]
In March 2021, [8] Fowler was appointed by Joe Biden to serve as Director of the Center for Medicare and Medicaid Innovation at the Department of Health and Human Services. [3] [9] She is responsible for overseeing the development of innovative payment and service delivery models that aim to reduce spending while preserving or improving quality of care in the Medicare, Medicaid and CHIP programs. In 2022, she was included by Stat News on its list of leaders in the life sciences. [6]
Mark Barr McClellan is the director of the Robert J Margolis Center for Health Policy and the Margolis Professor of Business, Medicine and Health Policy at Duke University. Formerly, he was a senior fellow and director of the Health Care Innovation and Value Initiative at the Engelberg Center for Health Care Reform at The Brookings Institution, in Washington, D.C. McClellan served as commissioner of the United States Food and Drug Administration under President George W. Bush from 2002 through 2004, and subsequently as administrator of the Centers for Medicare and Medicaid Services from 2004 through 2006.
Families USA is a nonprofit, nonpartisan consumer health advocacy and policy organization.
Risa J. Lavizzo-Mourey is an American medical doctor and executive who served as president and CEO of the Robert Wood Johnson Foundation from 2003 to 2017. She was the first woman and the first African-American to head the foundation, which has an endowment of about $8 billion and distributes more than $400 million a year. She has been named one of the 100 Most Powerful Women by Forbes several times, and one of The Grio's History Makers in the Making. She was elected a Member of the American Philosophical Society in 2016.
Donald M. Berwick is a former Administrator of the Centers for Medicare and Medicaid Services (CMS). Prior to his work in the administration, he was President and Chief Executive Officer of the Institute for Healthcare Improvement a not-for-profit organization.
Healthcare reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.
A rural health clinic (RHC) is a clinic located in a rural, medically under-served area in the United States that has a separate reimbursement structure from the standard medical office under the Medicare and Medicaid programs. RHCs were established by the Rural Health Clinic Services Act of 1977, . The RHC program increases access to health care in rural areas by
The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement.
Healthcare rationing in the United States exists in various forms. Access to private health insurance is rationed on price and ability to pay. Those unable to afford a health insurance policy are unable to acquire a private plan except by employer-provided and other job-attached coverage, and insurance companies sometimes pre-screen applicants for pre-existing medical conditions. Applicants with such conditions may be declined cover or pay higher premiums and/or have extra conditions imposed such as a waiting period.
The Leonard Davis Institute of Health Economics (LDI) is the center for health services research, health policy, and health care management education at the University of Pennsylvania. It is based in the Colonial Penn Center on Locust Walk, at the heart of Penn's campus.
There were a number of different health care reforms proposed during the Obama administration. Key reforms address cost and coverage and include obesity, prevention and treatment of chronic conditions, defensive medicine or tort reform, incentives that reward more care instead of better care, redundant payment systems, tax policy, rationing, a shortage of doctors and nurses, intervention vs. hospice, fraud, and use of imaging technology, among others.
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965.
Bundled payment is the reimbursement of health care providers "on the basis of expected costs for clinically-defined episodes of care." It has been described as "a middle ground" between fee-for-service reimbursement and capitation, given that risk is shared between payer and provider. Bundled payments have been proposed in the health care reform debate in the United States as a strategy for reducing health care costs, especially during the Obama administration (2009–2016). Commercial payers have shown interest in bundled payments in order to reduce costs. In 2012, it was estimated that approximately one-third of the United States healthcare reimbursement used bundled methodology.
The Independent Payment Advisory Board (IPAB) was to be a fifteen-member United States government agency created in 2010 by sections 3403 and 10320 of the Patient Protection and Affordable Care Act which was to have the explicit task of achieving specified savings in Medicare without affecting coverage or quality. Under previous and current law, changes to Medicare payment rates and program rules are recommended by MedPAC but require an act of Congress to take effect. The system creating IPAB granted IPAB the authority to make changes to the Medicare program with the Congress being given the power to overrule the agency's decisions through supermajority vote. The Bipartisan Budget Act of 2018 repealed IPAB before it could take effect.
The Center for Medicare and Medicaid Innovation is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation. CMS provides healthcare coverage to more than 100 million Americans through Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.
Karen Davis is president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social policy issues. Davis is an economist, with a career in public policy and research. Before joining The Commonwealth Fund, she served as chairman of the Department of Health Policy and Management at The Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977–1980, becoming the first woman to head a U.S. public health service agency.
Howard P. Forman is a professor of radiology, economics, public health, and management at Yale University. Forman is known for his commentary on the U.S. government's response to the COVID-19 pandemic, his political and healthcare writing on Twitter, and his role in developing national leaders in healthcare.
Patrick H. Conway is an American physician and an advocate of health system transformation and innovation in the public and private sector. He is a practicing pediatrician formerly serving at the Cincinnati Children's Hospital and Children's National Medical Center. He was the chief medical officer and acting administrator at the Centers for Medicare and Medicaid Services (CMS) leading quality-of-care efforts for the nation. He also served as the Director of the Center for Medicare and Medicaid Innovation, responsible for new national payment models for Medicare and Medicaid focused on better quality and lower costs.
Chiquita W. Brooks-LaSure is an American healthcare policy official who is the administrator of the Centers for Medicare & Medicaid Services in the Biden administration since May 2021.
Helen L. Smits was a health policy influencer and advocate in the United States, and lent her voice to several healthcare initiatives abroad. Most notably, she was a recipient of the Fulbright scholarship and served under the Carter and Clinton administrations. She also held positions in government organizations including the National Institutes of Health (NIH) and Healthcare Financing Administration.
Rachel Michele Werner is an American physician-economist. She is the first woman and first physician-economist executive director of the Leonard Davis Institute of Health Economics. In 2018, Werner was elected a Member of the National Academy of Medicine for her investigation into the unintended consequences of quality improvement incentives.
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