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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 Ted B. Kissell

In California, Certified Enrollment Counselors fill a role under the Affordable Care Act similar to the one that’s often described as a “navigator” on a national level. But under Covered California, CECs and navigators are not the same thing.

Picture of Ryan White

What does health reform look like at the ground level? Very different from the typical media diet of enrollment updates and website glitches.

Picture of Ryan White

The looming March 31 deadline gives ongoing urgency to the efforts of Covered California to refine and improve strategies for reaching groups, such as Latinos and African Americans, whose enrollment numbers have so far lagged.

Picture of R. Jan Gurley

The idea is that Electronic Health Records will reduce paperwork and administrative costs. But as more providers jump onboard, the negative impacts seem to be growing.

Picture of Ted B. Kissell

Insurance agents believe they were an afterthought for Covered California, which from the get-go, placed the emphasis on training county health care workers and counselors at nonprofits to help people find the right coverage for them.

Picture of R. Jan Gurley

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.

Picture of Ryan White

S.F. health officials say their focus is now on retaining and attracting new Medi-Cal patients. The challenge gives fresh urgency to efforts to improve customer service, lower appointment wait times and boost efficiency.

Picture of R. Jan Gurley

Underwhelming results demonstrate that after all the money and effort invested in bureaucracy, Patient Centered Medical Homes do not contribute to actual patient care.

Picture of Ted B. Kissell

When Covered California reports its health insurance enrollment figures each month, one worrying statistic consistently jumps out –- the low number of Latinos signing up. This became the top news story out of the exchange in January, overshadowing the overall positive numbers.

Picture of Ted B. Kissell

In California, the effort to get people signed up for insurance has proceeded with little partisan rancor, and at a quickening pace. December enrollment was nearly four times that of October and November combined. Nonetheless, millions of Californians remain uninsured.

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