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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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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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Cedars-Sinai Medical Center in Los Angeles is among the most famous and expensive hospitals in the country. Experts say it makes a great test case to see whether big-name hospitals can thrive in an era of cost-cutting and shrinking networks.

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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.

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

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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.

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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.

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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.

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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.

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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.

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

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