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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 Judy  Silber

In its first year on California's state health exchange, Kaiser trailed three other major insurers in market share. As the second open enrollment period fast approaches, Kaiser is trying to better reach Latinos by beefing up Spanish language outreach, call operators and online services.

Picture of Kellie  Schmitt

With the upcoming enrollment for California's health exchange expected to be half as long and twice as hard, officials are looking to improve on call wait times, outreach to diverse communities, and persuading the remaining uninsured to sign up.

Picture of Judy  Silber

A recent policy brief found that public health programs must expand their reach if they're to increase the number of people who receive preventive care. But reaching those who don't routinely seek care means meeting people where they are — culturally, linguistically and geographically.

Picture of Kellie  Schmitt

The Affordable Care Act has spurred new conversations about how to best deliver mental health benefits. Ideas range from incorporating more mental health services into primary care visits to the use of avatar systems to help schizophrenics control hallucinations.

Picture of Judy  Silber

In addition to the big insurers, California's state health exchange includes a handful of smaller, region-specific plans. While some have found more early success than others, collectively these plans offer consumers choice and, in some cases, more affordable options.

Picture of Kellie  Schmitt

One way the Affordable Care Act aims to spur innovations in health care delivery is through the CMS Innovation Center. Four California-based projects give a sense of the kinds of programs and ideas the office is currently funding and tracking.

Picture of Judy  Silber

For hundreds of thousands of Californians waiting for their Medicaid applications to be processed, affordable health coverage is still a dream. The delays, partly caused by tech glitches, come with real human costs for those in application limbo and in need of care.

Picture of Kellie  Schmitt

For one mental health counselor in Washington state, Obamacare has improved mental health care for many of her clients. With some providers seeing an uptick in newly insured clients, more adults and children are getting long-needed care.

Picture of Erica Mu

Obamacare's enrollment period largely overlaps with the holidays, when potential enrollees' budgets and mental resources are stretched. So why not schedule enrollment season after the holidays, when tax refunds could give low-income consumers an extra nudge?

Picture of Erica Mu

News reports on health reform tend to focus on patients and consumers. But how are doctors faring? Some voice complaints of administrative kinks, reimbursement struggles, and coverage confusion. But not all of these problems are new, and some docs emphasize the gains being made.

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