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Remaking Health Care

This column explores how health reform is changing the ways in which we pay for and deliver health care in the U.S. It also highlights the ways in which our current system is falling short on measures of coverage, access and affordability. On any given week, that could mean a look at how Republican plans to repeal Obamacare could reshape the individual insurance market, how the safety net system is adapting to new financial pressures, or how the trend of doctors and hospitals merging into ever-larger entities is driving up costs. We also explore health care costs and whether the Affordable Care Act or its successor plans can live up to the promise to rein them in. Throughout, we keep watch on how the goals of health reform intersect with the shaping power of markets and human behavior. Contributors include veteran health journalist Trudy Lieberman and independent health journalist Kellie Schmitt, with occasional contributions from independent journalists such as Susan Abram and Sara Stewart.

Picture of Kellie  Schmitt

Across the country, patients who receive out-of-network care can face “exorbitant” charges for medical services compared to Medicare’s rates for the same procedures, and the prices can vary dramatically. But what explains these differences? It depends on who you ask.

Picture of Kellie  Schmitt

Out-of-network "surprise bills" are a growing problem. Patients think they're staying in their coverage network only to receive a bill for thousands of dollars after a procedure from, say, an anesthesiologist who wasn't included in their plan. So far, proposed solutions have proven controversial.

Picture of Kellie  Schmitt

People with insurance are significantly more likely to be diagnosed with a chronic condition than uninsured people. That means that as the number of insured grows, the health system will have to cope with an influx of patients newly diagnosed with conditions such as diabetes and high blood pressure.

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There’s no question that prescription drug prices are skyrocketing in the United States, and consumers aren’t happy about it. What’s more complicated, though, is understanding the complexities of the issue and reporting on what those soaring prices mean for consumers.

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Is health insurance ripe for disruption by newer, tech-savvy market players? Oscar, a newcomer to the California health insurance exchange, certainly hopes so, and has the market valuation to back it up. But will the company's growth and innovation largely be limited to tech-savvy millennials?

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The headlines have recently been dominated by talk of health insurers merging, but it's really part of a broader consolidation trend taking place in health care. Health policy expert Paul Ginsburg explains what's at stake when hospitals and physician groups combine, and how California is different.

Picture of Kellie  Schmitt

From hospital systems to pharmacies, this summer’s health headlines have been filled with tales of consolidation. And no where has the “merger mania” been more evident than the insurance sector. Health policy expert Paul Ginsburg helps us break down the trend in this Q&A.

Picture of Kellie  Schmitt

Tradeoffs are a recurring theme when it comes to Obamacare plans — lower premiums often come with a smaller range of doctors to choose from, as a new database bears out. But as earlier research has shown, the relation between the size of physician networks and quality of care is, well, complicated.

Picture of Kathryn  Kietzman

Last year, California embarked on a bold new experiment to improve how care is coordinated among patients enrolled in both Medicaid and Medicare. But the progress has been anything but smooth for a host of reasons, as UCLA health researcher Kathryn Kietzman explains in this overview.

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The U.S. Supreme Court voted to uphold the Affordable Care Act’s premium subsidies in a 6-3 ruling that prompted President Barack Obama to say the health law “is here to stay.” Here's what some leading experts and voices in the media had to say about the critical decision.

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