Author Archives: David Grande

Facing What May Be the Affordable Care Act’s Ultimate Challenge: The Gap Separating Evidence from the Policy-Makers Who Need It

Mar 29, 2013, 9:00 AM, Posted by David Grande

David Grande, MD, MPA, is an assistant professor of medicine at the University of Pennsylvania's Perelman School of Medicine, a senior fellow at the Leonard Davis Institute of Health Economics, associate director of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program and an alumnus of the RWJF Health & Society Scholars program. This is part of a series of essays, reprinted from the Leonard Davis Institute of Health Economics’ eMagazine, in which scholars who attended the recent AcademyHealth National Health Policy Conference reflect on the experience.


It’s a time of unprecedented upheaval in U.S. health care. Big changes are bursting through on virtually every front. Legislators and administrators in Washington and 50 state capitals struggle daily to reinvent their health care systems even as they lack an exact blueprint for the new things they’re supposed to be building.

This was nowhere more evident than at the recent AcademyHealth National Health Policy Conference, where state and federal officials and interest groups lined up to present long lists of policy questions that confront them as they grapple with implementation of the Affordable Care Act and mounting public budgetary pressures.

Managing 'Churn'

For instance, in the “Opportunities & Challenges for State Officials” session, New Mexico’s Medicaid Director Julie Weinberg described the unknowns surrounding how “churn” between private and public coverage will change and how new Medicaid eligibility standards will impact enrollment processes.

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