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Remaking Health Care

This blog explores how health reform is changing the ways in which we pay for and deliver health care in the U.S. 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 whether Trumpcare will affect the trend of doctors and hospitals merging into ever-larger entities. We also explore health care costs and whether Obamacare or its successor plans can live up 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, David Lansky, executive director of the Pacific Business Group on Health, and independent health journalist Kellie SchmittRyan White, content editor of Center for Health Journalism Digital, serves as the blog's principal editor. 

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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.

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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.

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A May report found a modest increase in Medi-Cal spending could give about 700,000 undocumented Californians access to care. Meanwhile, in the Salinas Valley, some say an employer-sponsored trust could provide essential care to farmworkers.

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After Obamacare's passage, California expanded its Medicaid benefits to allow those with mild to moderate mental health problems to receive care. But as the state's Medicaid numbers surge, some say there aren't enough providers to meet the rising demand.

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In response to the growing shortage of primary care doctors, some advocate for expanding the roles of nurse practitioners to expand access and lower costs. But the suggestion has met with pushback from some physician groups.

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Of the many projections made about the Affordable Care Act, one number stands out among the rest: 62 million. That’s the number of individuals who will gain mental health and substance abuse coverage under the ACA.

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Are patients more likely to comparison shop when states increase pricing transparency? A recent report found that while New Hampshire's effort was effective in highlighting price gaps between providers, consumer response was tepid and costs didn't go down.

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In the Health Leads program, physicians and health care providers “prescribe” basic resources to their patients such as food, housing, electricity, heating, even job training. The emerging model represents a shift in the way we think about health and the social factors that shape it.

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My son's soccer injury prompted a few reflections on medical costs and coordination of care – issues more easily contemplated from a safe distance than from the emergency room.

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The U.S. faces an impending doctor shortage because not enough new ones are being trained to meet the needs of the U.S. population and a large portion of doctors are reaching retirement age. Will impending changes within the medical industry further exacerbate the problem?

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