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.
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.
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.
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.
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.
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?
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.
New data show that tax credits have dramatically lowered premiums for those on Obamacare plans. But for employees stuck with high-deductible plans, big out-of-pocket costs can drain bank accounts and incentivize going without care.
Telehealth has the potential to lessen physician shortages in rural areas and deliver care to those unable to travel. Proponents hail its efficiency. Why then has it been so hard to harness new technologies to expand care to areas and groups in desperate need?
A recent report finds California's safety-net hospitals could face huge funding shortfalls by decade's end, as federal payments for uncompensated care are cut. Meanwhile, rising medical costs and the remaining uninsured will put added pressures on the system's solvency.
By ensuring care for inmates after release, the Medicaid expansion could improve health and lower recidivism. But efforts to enroll inmates face many challenges, from a lack of basic infrastructure to poor coordination between health, corrections and social services departments.
