At the Native American Health Center in East Oakland, health reform has pushed clinic staff to experiment with new ways of delivering care. But changes in the way care is reimbursed and increased competition for patients still leaves clinic leaders nervous about longterm survival.
The 2015 California Health Journalism Fellowship kicked off with a wide-ranging conversation between Gerald Kominski of UCLA's Center for Health Policy Research and Anna Gorman of Kaiser Health News on the past and future of health reform.
Geographic boundaries can have a big impact on health insurance options, particularly for people living in rural regions. Rural residents tend to fare better on premiums and choices when their area is grouped with an urban neighbor.
At La Clínica de la Raza in Northern California, the surge of new Medicaid enrollees has made it difficult for the clinic to meet the demand for care. But the need to make the most of limited resources has also led the organization to adopt new innovations, such as the "morning huddle."
As Medicare makes a big push towards paying providers based on value rather than volume over the next few years, Accountable Care Organizations will be expected to start making good on their promise to cut costs and improve quality of care. But so far, their track record has been rather mixed.
For La Clínica de la Raza, long a source of care for a diverse Oakland community, the ACA has increased the clinic's share of insured patients. But financial pressures are still a constant reality, and the problem will worsen dramatically if federal funding isn't renewed.
At a Navajo Reservation community in Chinle, Arizona, 734 have enrolled and nearly 20,000 residents have been provided with Affordable Care Act (ACA) information, local health officials said. The potential for enrollment here could make Chinle ground zero for ACA recruitment in Indian country.
"Narrowing of networks" was an abstract concept to me until Blue Shield narrowed my own network of healthcare providers, most of whom I have been seeing for 18 years.
A recent California survey found that even the highest-rated provider group received only a C+ rating from its patients. Does this reveal deep flaws in the way care is delivered or have patients come to expect too much from health care providers?
As a federal "funding bump" expires, the payments California doctors receive for seeing Medicaid patients are dramatically decreasing. At the same time, the state is imposing a 10 percent fee cut that was approved in 2011 but is just now taking effect.
