Explore the latest in health care reform, including innovations in health care delivery and payment models, the politics of reform, and more.
This before-after study examines changes in 1-year mortality among nonelderly patients initiating dialysis in states that did vs did not participate in Medicaid expansion under the Affordable Care Act in 2014.
This Viewpoint highlights the challenges faced by patients with end-stage renal disease who are homeless, recommends measures to determine the prevalence and outcomes of homelessness among Medicare beneficiaries with end-stage renal disease, and proposes approaches to improve outcomes through supportive housing.
This Viewpoint argues for reform of the US health care system, starting with the elimination of employment-based insurance.
This Viewpoint calls out the limited evidence supporting current pay-for-improvement incentives in the US, and argues that performance improvement programs that emphasize nonfinancial rewards, resources for quality improvement, and team-based recognition would be more consistent with physician motivation and professionalism and would be worth evaluating as a means to reduce health care costs and waste and improve quality.
This study evaluates the association of establishing team-based primary care with health care utilization and costs among chronically ill.
In this Viewpoint, the authors review Medicare & Medicaid Services 340B Payment program and recent rules to curtail expansion of drug discounts beyond serving poor patients.
This cohort study of Medicare data from 2007 to 2015 examines disparities in readmission rates between white and black patients discharged from safety-net or non–safety-net hospitals after initiation of the Hospital Readmissions Reduction Program (HRRP).
This quality improvement study compares the outcomes and costs of Medicare and Medicaid participants who took part in an acute care intervention or a community intervention in Baltimore, Maryland, vs a comparison group drawn from similar Maryland hospitals.
This population-based study uses data from the Surveillance, Epidemiology, and End Results database to examine the association of the Patient Protection and Affordable Care Act with rates of insurance coverage and access to care among patients with head and neck squamous cell cancer.
This Viewpoint discusses how health care organization–focused and physician-focused value-based incentives may be better aligned with patient financial incentives to achieve improvements in population health.
This study uses data from the Comprehensive Care for Joint Replacement program to assess the level of Medicare reconciliation payments and examine these levels by hospital size and teaching hospital status to understand hospital performance.
In this Viewpoint, Don Berwick and colleagues summarize a 2018 National Academies of Sciences, Engineering, and Medicine (NASEM) report on global health care quality emphasizing that universal access will yield improvements in population health only when paired with quality reforms characterized by systems design, transparency, collaboration, anticipatory care, evidence-based decisions, and continuous feedback and learning.
This cohort study uses Medicare data to evaluate whether the announcement or implementation of the Hospital Readmissions Reduction Program (HRRP) was associated with an increase in either in-hospital or 30-day postdischarge mortality following hospitalization for acute myocardial infarction (AMI), heart failure (HF), or pneumonia.
This Viewpoint discusses how entry of business and technology firms into health care might benefit patients and the public’s health through use of platforms, analytics, and marketing expertise that could promote healthy lifestyle choices, make medical information more accessible, improve system interoperability, and reduce barriers to access.
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