Provision of Utility Shut-off Protection Letters at an Urban Safety-Net Hospital, 2009-2018
Most states prohibit utility companies from terminating service to low-income households when occupants present a medical letter confirming a household member has a chronic serious illness. It is unclear how many patients receive these letters and whether screening for health-related social needs (HRSN) identifies these patients. We analyzed characteristics of adult patients at a safety-net hospital with a utility shut-off protection letter 2009-2018. A total of 2973 patients received a letter; most were non-Hispanic black, and had government insurance. Among patients who received a letter in 2018, 70% were screened for HR...
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Letter to the Editor Source Type: research

A 4-Year Investigation of Ambulatory Health Care Expenditure Concentration and High-Cost Patients: An Experience From a Developing Country
This study used 2013-2016 individual-level claims data of Iranian Health Insurance Organization in East Azerbaijan province. All ambulatory care utilizers were included in the study. We determined characteristics and utilization pattern of high-cost patients as well as their predictors. A total of 1 128 149 patients were included. The top 10% of patients accounted for 62.56% of the total expenditure. This skewed expenditure pattern remained relatively stable over the study period. Female sex, older age, cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes increase the odds of being high cost....
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Clinic-Based Community Health Worker Integration: Community Health Workers', Employers', and Patients' Perceptions of Readiness
Clinic-based community health workers (cCHWs) are a growing workforce who can facilitate medical and social support services, particularly for patients with complex, chronic conditions. We assessed CHWs', employers', and patients' perceptions and readiness for CHW integration into clinical settings. We found varying levels of readiness between the groups, offset by conditional implementation concerns, such as need for clearer training, role delineation, expectations, and trust. Integrating CHWs as members of the complex care team holds promise for optimal patient engagement. Maximizing CHWs' potentials through readiness ef...
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

An Automated Telephone Call System Improves the Reach and Cost-effectiveness of Panel Management Outreach for Cancer Screening
This implementation and comparative effectiveness study compared an automated call system (ACS)-assisted method to enhance staff efficiency in panel management cancer screening outreach compared with standard outreach using manual calls. One panel manager assisted by the ACS at the intervention primary care practice completed outreach workflows for 43% more patients than 2 unassisted panel managers at comparison practices, with 78% more patients in the ACS-assisted panel management program ultimately having a preventive screening gap closed. Outreach cost per completion of 1 or more cancer screenings was $45.39 under stand...
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Comparing Rates of Multiple Chronic Conditions at Primary Care and Mental Health Visits to Community Health Centers Versus Private Practice Providers
This study identifies differences in rates of multiple chronic conditions at primary care and mental health visits to Community Health Centers and private practice providers using 2013 National Ambulatory Medical Care Survey data. Community health center visits had higher rates of 1 or more, 2 or more, and 3 or more chronic conditions for working-age patient visits (ages 18-64). There were no differences in other age groups. After controlling for age and other covariates using logistic regression, community health center visits had 35% higher odds of having any chronic condition and 31% higher odds of having 2 or more chro...
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Implementation Lessons From a Randomized Trial Integrating Community Asthma Education for Children
This study characterized and compared the implementation of clinically integrated community health workers (CHWs) to a certified asthma educator (AE-C) for low-income children with asthma. In the AE-C arm (N = 115), 51.3% completed at least one in-clinic education session. In the CHW arm (N = 108), 722 home visits were completed. The median number of visits was 7 (range, 0-17). Scheduled in-clinic asthma education may not be the optimal intervention for this patient population. CHW visit completion rates suggest that the schedule, location, and content of CHW asthma services better met patients' needs. Seven to 10 visits s...
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Leveraged Primary Care: Lessons From the Trenches
To support primary care physicians (PCPs) in managing populations of patients requires a reengineering of PCP practices, and a new, disruptive model of care management, with the seamless integration of the 2. That is our conclusion, having watched 7 Accountable Care Organizations (ACOs) with direct employer contracts provide care to employed populations over a period of 6 years. We have seen dramatic improvement in outcomes when an ACO provides the needed resources, tears down the silos, and interweaves care management with PCP practices. That is leveraged primary care. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Commentary on “Quality Measurement for Consumers: An Idea Whose Time Should Pass”
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Permanent Interests Versus Paying for Better Outcomes: Two of the 10 Lessons I Learned Over the Past 30 Years Researching the Connections Between Payment and Health Care Quality
In the wake of the election of Donald Trump, I resigned from my research work. I decided to become politically involved and since I am a health care professional, in June 2018, I started a bipartisan political consulting firm, Ask Nurses and Doctors (AND; www.asknursesdoctors.com). This start-up is focused on electing candidates or incumbents committed to health care reform. There are 2 approaches to universal coverage—either the Affordable Care Act or Medicare for All. To implement either approach, there are 10 lessons from my 30 years of research that may be useful to enact universal coverage. (Source: The Journal ...
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Commentary on “Improving Quality Measurement: Design Principles for Quality Measures”
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Improving Quality Measurement: Design Principles for Quality Measures
This article discusses some of these problems and then lays out some principles and procedures that should be used in the development and combination of quality measures. Many of the problems with existing quality measures would have been avoided had these principles been applied as they were developed. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

From the Editor
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: From the Editor Source Type: research

A Closer Examination of the Patient Experience in the Ambulatory Space: A Retrospective Qualitative Comparison of Primary Care With Specialty Care Experiences
This qualitative study explores key patient experience impressions responsible for driving quality. Differences between primary and specialty care patient perspectives were analyzed using a mixed-methods design in high-, median-, and low-quality performing practices. We found that primary care patients highly value provider listening, time spent with provider, and consistent and effective coordination of care. Specialty care patients were found to highly value provider clinical skill acumen/outcomes, being kept informed with timely updates and care instructions, and a stress- and pain-free experience. We conclude that diff...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Effects of Session Standardization and Template Optimization on Improving Access to High-Demand Pediatric Subspecialty Care
This article describes the experiences of a large children's hospital after implementation of clinic session standardization and template optimization. Outpatient specialty clinic sessions were standardized to 4-hour periods, and all unfilled complex appointment slots were made available for any appointment type within 72 hours of the clinic date. Three high-demand outpatient clinical services achieved increased aggregate potential and completed outpatient appointments over a 2-year period. These improvements were mostly due to an increase in providers and were not always coupled to shorter patient lag times. (Source: The ...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Closing the Loop on Electronic Referrals: A Quality Improvement Initiative Using the Care Coordination Model
Primary care providers refer nearly one-third of their patients to specialty care services. Despite provider recommendations, approximately 1 in 4 referrals are never completed. Incomplete referral rates are higher among vulnerable and medically underserved individuals. Sixty-seven percent of federally qualified community health centers report difficulty obtaining specialty care appointments and incomplete referral rates as high as 73%. Effective electronic referral processes can improve health outcomes, reduce waste, and mitigate risks. Using the Care Coordination Model as its framework, this quality improvement initiativ...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Talk to PAPA: A Systematic Review of Patient/Participant (PAPA) Feedback on Interactions With Community Health Workers Using a Depth Analysis Approach
Because of their shared backgrounds, community health workers' (CHWs) care of patients/program participants (PAPAs) is assumed to be acceptable, and often not evaluated empirically. Using PRISMA guidelines, we reviewed 9560 articles from 5 databases, selected 37 articles for full-text review, and developed a 5-dimensional depth analysis (focus, context, meaning, range, and voices) to characterize quality/quantity of PAPA feedback. Depth analyses clarified a spectrum of PAPA responses from extremely positive to ambivalence to outright distrust and frustration with perceived CHW limitations. Designing evaluations with 5-dime...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

More Than Health Care: The Value of Addressing Health, Education, and Social Service Needs Together Through Community Health Centers
Research on social determinants of health shows that factors outside of medical care including environment, education, and income also affect health. Some community health centers seek to address these by providing additional nonmedical services. Community health centers can find it difficult to justify these costs when the benefit is unclear. This review highlights studies on services like those the community health center Mary's Center provides through its Social Change Model, offering health, education, and social services in the Washington, District of Columbia metropolitan area. The review finds that most studies repo...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Understanding Why Urban, Low-Income Patients Miss Primary Care Appointments: Insights From Qualitative Interviews of West Philadelphians
Missed primary care appointments occur frequently among urban, low-income patients—some of the costliest and sickest patients. We conducted semi-structured interviews with 43 patients who reside in West Philadelphia (100% insured by Medicaid, 95% were non-Hispanic African Americans, and 47.1 years old on average) to identify why recent primary care appointments were or might have been missed. Existing transportation options, including public transportation, were considered unreliable and alternative options too costly. In addition, we discovered poor health, family obligations, and work requirements prevented appoint...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

From Volume- to Value-Based Payment System in Washington State Federally Qualified Health Centers: Innovation for Vulnerable Populations
The reimbursement system at 16 Federally Qualified Health Centers in Washington State transformed to a per-member-per-month model with a prospective adjustment for quality performance. The results of this qualitative study suggest that 3 to 5 years would be required to achieve significant progress in the Triple Aim goals of the initiative and also demonstrate that Federally Qualified Health Centers are potentially more advanced in their readiness to offer value-based care. By providing positive financial incentives without downside risk, the state is stimulating replicable models of care, and in longer term such reforms ma...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

It's Time for a New Approach to ACOs
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Accountable Care Organizations in Medicaid
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Policy and Practice Legacy of the New Jersey Medicaid ACO Demonstration Project
The New Jersey Medicaid Accountable Care Organization (ACO) Demonstration was created with a unique combination of features regarding ACO geography, involvement of managed care organizations (MCOs), and shared savings parameters. Ultimately, the Demonstration did not lead to a sustainable accountable care financing model and shared savings were deemphasized. Instead, the ACOs evolved into community health coalitions focused on coordinating and enhancing a wide range of activities in partnership with state government, private health systems, community leaders, and MCOs. Currently, the state is developing policy parameters t...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

From the Editor
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: From the Editor Source Type: research

Accountable Care Program Implementation and Effects on Participating Health Care Systems in Washington State: A Conceptual Model
This study is based on key informant interviews with health care executives representing 5 large health systems that had entered into contracts with the Washington State Health Care Authority to provide accountable care network services under the State Innovation Model initiative. The purpose of this study was to explain effects of accountable care program (ACP) implementation on participating health care systems. Between January 2017 and May 2018, we conducted 2 rounds of semistructured interviews (n = 20). Results indicate the need to present a modified conceptual model aligned with ACP implementation in the current cont...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Medicaid Expansion and Hospitalization for Ambulatory Care–Sensitive Conditions Among Nonelderly Adults With Diabetes
Among nonelderly adults with diabetes, we compared hospitalizations for ambulatory care–sensitive conditions from 2013 (pre-Medicaid expansion) and 2014 (post-Medicaid expansion) for 13 expansion and 4 nonexpansion states using State Inpatient Databases. Medicaid expansion was associated with decreases in proportions of hospitalizations for chronic conditions (difference between 2014 and 2013 −0.17 percentage points in expansion and 0.37 in nonexpansion states, P = .04), specifically diabetes short-term complications (difference between 2014 and 2013 −0.05 percentage points in expansion and 0.21 in nonexp...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Do Hospitalizations Disrupt Loyalty to Ambulatory Care Providers?
We sought to determine whether hospitalizations affect where patients seek ambulatory care. We conducted a retrospective cohort study of 569 adults who were attributed by a commercial payer to a large physician organization (PO) and hospitalized in 2015. Approximately half of the patients (55%) were admitted to the hospital affiliated with the PO; the rest were hospitalized elsewhere. Patients hospitalized elsewhere were significantly less likely to be seen by a PO provider in the 6 months posthospitalization than those hospitalized at the affiliated hospital (adjusted odds ratio = 0.29; 95% confidence interval = 0.17-0.48...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Chronic Condition Measurement Requires Engagement, Not Measurement Alone
This study uses data from Dartmouth-Hitchcock Medical Center and Kaiser-Permanente Colorado to evaluate providing PROMs directly to the primary care physician. We compared changes over time in urinary incontinence, falls, and mental and physical health between clinics providing augmented PROMs (N = 202 patients) and control clinics (N = 102 patients). Both the control and treatment groups exhibited improvements, but there was no significant difference in outcomes over time. These results suggest that measuring and printing out PROMs for primary care physicians will not result in better patient outcomes without physician cl...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Patient Dissatisfaction With Primary Care and Nonurgent Emergency Department Use
This study advances academic discussion by examining whether patient negative experiences during their encounter with a primary care physician (PCP) are associated with nonurgent ED use nationwide in the United States. This retrospective cohort study used data from the 2010-2011 Medical Expenditure Panel Survey. The independent measures were patient perceptions of PCPs' communication and care quality in 2010. The multivariate logit model was employed to analyze the nonurgent ED use as opposed to no ED use in 2011, after controlling for age, gender, race and ethnicity, rural/urban location, marital status, and education lev...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Developing Emerging Leaders to Support Team-Based Primary Care
Teams are increasingly used to deliver high-quality, accessible primary care, yet few leadership programs support the development of team-based care leadership capabilities. The 12-month Emerging Leaders program presents a prototype for how interdisciplinary training targeting frontline staff might be implemented. Emerging Leaders training included didactic content, mentorship, applied peer-to-peer learning, and personal leadership development components delivered in person and virtually. Attendance at training events was high. Nominators and Emerging Leaders noted improvements in knowledge, skills, and attitudes of progra...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Comment on “Connected Access”
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

“Connected Access”: Titrating the Right Dose of Access in the Digital Age
The concept of access to health care has been dominated by the visit-based paradigm. However, with the advent of telehealth, wearables, and mobile applications, much of the information that is exchanged at the time of the provider encounter can be transmitted virtually. This calls for a reconceptualization of access that is not so heavily reliant on “the visit.” We have proposed a concept of connected access that is “dose related,” based on the expertise of the provider and the channel through which a patient and a provider communicate. Particularly relevant to chronic care, the intensity of access ...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Community Health Workers as Organizational Actors in Community Health Centers in 4 Gulf Coast States
This study demonstrates the value that CHWs can bring for clients and clinics as organizational actors. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Impact of Centralized Employment Structure on Community Health Work: A Qualitative Case Study of Community Health Workers and Key Leadership
While community health workers (CHWs) are employed in various arrangements, little is known about the association between organizational structure and CHW experiences. Seventeen in-depth interviews were conducted with CHWs, supervisors, and leadership employed in one centrally organized setting to investigate organizational structure and perceptions of CHW effectiveness. A model that hired employees but assigned them to various settings offered support and unique career advancement opportunities. Coordinated education, ongoing trainings, and persistent supervision were perceived to improve the accuracy of resource informat...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Common Attributes of Successful Care Manager Programs for High-Need, High-Cost Persons: A Cross-Case Analysis
Many programs use care managers to improve care coordination for high-need, high-cost patient populations. However, little is known about how programs integrate care managers into care delivery or the attributes shared by successful programs. We used a case study approach to examine the common attributes of 10 programs for high-need, high-cost individuals utilizing a longitudinal care manager that had achieved success in reducing cost, improving quality, or increasing patient satisfaction. Through interviews with program leaders and document review, we identified 10 common attributes of successful care manager programs, of...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

From the Editor
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: From the Editor Source Type: research

Threading the Needle Between Improving the Affordable Care Act and Medicare for All
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

Can We Find a Path Between Medicare for All and Building on the ACA?
In this article, we explore the political and policy challenges involved in finding a path between incremental health reform and Medicare for All. We begin by clarifying our goals and move to examining the political barriers that any solution must contend with and overcome. Finally, we outline a path forward in which we must embrace the goals of Medicare for All, consider potential coalition dynamics before combining different goals into a single proposal, and acknowledge the important role states can play in advancing reform. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

Medicare for All's Political Reality: A Barista Planning to Marry a Movie Star
Attempting to enact Medicare for All in today's political climate is akin to a Starbucks barista saying he is torn between staying with his girlfriend and marrying Jennifer Lawrence: it is an unrealistic ideal. But if one also takes into account the genuine threat to the Affordable Care Act (ACA) from the Trump administration's decision to support a federal judge's controversial under-appeal ruling that the entire ACA is unconstitutional, the Medicare for All enthusiasm is even more alarming. It also ignores the unprecedented disruption to the lives of tens of millions of Americans such a massive change would create. (Sour...
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

An American Path to Universal Coverage
The politics of health care policy create opportunities driven by public demands for lowering costs and providing health security, constrained by fear of loss of what people have now, fears that will be inflamed by opponents. The best course toward reform will provide people a choice of improved public coverage and the ability to keep improved employer coverage. There are a variety of ways to design these proposals, some of which can be characterized as Medicare for All. Inclusion of a Medicare/public plan in the Affordable Care Act marketplaces is a policy option but one of relatively low significance. (Source: The Journa...
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

Confronting the Post—ACA American Health Crisis: Designing Health Care for Value and Equity
The United States is in the midst of a health crisis marked by unprecedented 3-year declines in life expectancy. Addressing this national crisis requires alignment of public policies, public health policies, and health care policies, with the overarching aim of improving national health and health equity. Aligning national polices to support human needs provides a foundation for implementing post–Affordable Care Act national health care reform. Reform should start with the twin goals of improving health care value and equity. A focus on value, that is, outcomes and processes desired by patients, is critical to ensuri...
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

From the ACA to Even Better Reform
Because health policy decision makers have different economic and political interests as well as different ideological persuasions, those committed to fairer and more comprehensive reform must be prepared to compromise in order to make progress toward their goals. The primary purpose of this essay is to describe a more nearly ideal health care system and identify factors that affect how patients and providers make utilization decisions. Having a clear vision of the ultimate goals to achieve will help participants in the political process to make compromises that advance the effort and to avoid those which undermine it. (So...
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

A Middle-Ground Proposal for Making Health Care Premiums More Affordable
Passage of any health care reform that addresses the rising cost of health care in the United States will be a difficult political challenge unless a middle-ground compromise between government control of health care insurance and free market approaches can be found. On the basis of the competitive market for Medicare supplemental insurance, a Medicare Adherence Policy insurance option is proposed that would leverage Medicare's authority to set prices to create a practical middle-ground reform that can strike a balance between the role of government and the free market. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

Focusing on Health and Not Simply Health Care
As Americans consider the future of health coverage, there is one continually undervalued area worthy of attention, namely prevention. The article reviews the significant gains from the Affordable Care Act as well as the remaining needs to promote health and well-being and not solely focus on the treatment of illness and injury. It identifies changes in policies that would broaden future goals beyond the receipt of clinical care to the creation of a health system committed to also recognizing and addressing the social determinants of health and meaningfully incorporating consumers, particularly those with elevated risk of ...
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

Getting to the End Zone With Medicare for All
Incremental reform is an option put forward to bridge the gap between the advances made by the Affordable Care Act and Medicare for All. Starting with the premise that the barriers to enactment of Medicare for All are less than they appear, this article discusses some specific concerns about Medicare for All and how a well-implemented plan can overcome them. Regarding the bills in Congress as blueprints on which to build a foundation for a well-implemented plan, concerns about utilization, costs, funding, workforce changes, and political objections are all found to be manageable. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

Improve Markets, Not Government Controls, for Real Health Reform
Proposals to replace the existing mix of public and private health financing with a fully nationalized government system (“Medicare for All”) fail to address fundamental problems of high cost, overutilization, and inefficiency. Those proposals are a reaction to the Affordable Care Act, which provided new insurance subsidies but did little to solve the cost problem. Stabilizing the individual insurance market is not the goal. Reform should focus on making the entire insurance market and the health delivery system more efficient and more equitable by promoting consumer choice, market competition, private initiati...
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research

How States Can Lead the Way to Health Reform, Again
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Appreciations Source Type: research

A Brief Remembrance of Rob Restuccia
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Appreciations Source Type: research

Ten Things I Learned From Rob During a Lifetime of Health Care Advocacy
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Appreciations Source Type: research

A Tribute to Rob Restuccia and Thoughts About How We Continue to Move Forward Toward the Promise of Universal Entitlement
Rob Restuccia defined how health care justice and equity is advanced through his pioneering work that led to the passage of the Affordable Care Act (ACA). The evolution of the ACA is unfinished but the roadmap is clear. Next steps include a public option, the unshackling of government's ability to purchase pharmaceuticals and expansion to the entire nation. Through his life's work, Rob Restuccia has taught us how we will get there. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Appreciations Source Type: research

Individuals Matter in Health Care Reform
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Appreciations Source Type: research