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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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In recent years, there's been growing concern that a lack of doctors will keep newly insured patients from accessing care. Now, a new tool can predict the supply of physicians and help journalists ask and answer new questions from the data. Fresh story ideas abound.

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Prop. 45 would grant California’s insurance commissioner the ability to approve or reject health insurance rate increases. While voter support soared over the summer, approval has fallen since then, as the insurance industry invests heavily in defeating the measure.

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In Washington state, a lack of psychiatric beds has led to a court ruling that says patients can't be held against their will in ERs while awaiting long-term care. While the ACA has expanded benefits, it has also revealed just how scarce resources often are.

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In California, millions have been added to the Medicaid ranks. But even the state's most forward-thinking counties are struggling to provide timely health care access to all of these new patients.

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The ACA is projected to save hospitals billions in uncompensated care, with the biggest savings in states that expanded Medicaid. But the good news for some hospitals is tempered by ongoing cuts in federal funding that could threaten the sustainability of safety-net systems.

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In its first year on California's state health exchange, Kaiser trailed three other major insurers in market share. As the second open enrollment period fast approaches, Kaiser is trying to better reach Latinos by beefing up Spanish language outreach, call operators and online services.

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With the upcoming enrollment for California's health exchange expected to be half as long and twice as hard, officials are looking to improve on call wait times, outreach to diverse communities, and persuading the remaining uninsured to sign up.

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A recent policy brief found that public health programs must expand their reach if they're to increase the number of people who receive preventive care. But reaching those who don't routinely seek care means meeting people where they are — culturally, linguistically and geographically.

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The Affordable Care Act has spurred new conversations about how to best deliver mental health benefits. Ideas range from incorporating more mental health services into primary care visits to the use of avatar systems to help schizophrenics control hallucinations.

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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.

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