Thousands of people in California's Coachella Valley head to Mexico every year for health care. Often they seek deals on prescription drugs or dental care. For others, Mexico offers easy access to primary care that is cheap and convenient.
Two rural health researchers from the University of Washington offer their take on how health reform has impacted rural communities, and point to new trends that could improve access and quality of care.
Primary care doctors used to receive more feedback from specialists on the status of referred patients. That happens far less these days, to the detriment of doctors' ongoing clinical education.
This month, early results from one of the key efforts to transform primary care were published, and the results were underwhelming. But here's what we can learn from the initiative.
As physicians, we can find evidence in the research literature to support or discourage almost anything. If we don't have a coherent approach to care, it's quite difficult to decide when we have sufficient evidence to change our practice.
In some states, reimbursements are so low that doctors say they lose money when they see Medicaid patients. And that can make it harder for patients to see their doctor — a recent study found that higher rates improve access to care.
A key goal of health reform has been to get insured individuals to seek out primary care rather than the ER. In the Bay Area, safety net systems are trying new approaches to funnel more patients into primary care, including putting nurses in firehouses.
As hospital closures and physician shortages continue to afflict rural and low-income areas, Walmart is announcing an expansion of in-store primary care clinics in states such as Texas and South Carolina. Will this be the new face of primary care in rural regions?
The data on the much-lauded Patient Centered Medical Home approach, a cornerstone of ACA, shows that it is expensive, onerously bureaucratic, a drain on health care resources, especially for primary care providers, and a distraction from health care delivery.
The Affordable Care Act requires health plans to provide mental health services. That means the newly insured will have the option to seek care anywhere they want. This has thrust publicly run mental health clinics into a new landscape of competition.
