Health Care Delivery

Peter B. Bach, MD, MAPP, director, Center for Health Policy and Outcomes, and attending physician, Memorial Sloan-Kettering Cancer Center, says there are a couple of challenges with the accountable care organization (ACO) and patient centered medical home (PCMH) care models.

Call it the $2.8 trillion enigma. That's the amount Americans spent on health care in 2012. The good news is that health spending slowed unexpectedly for the fourth consecutive year. The enigma is that no one really knows why. Despite many theories, there's no expert consensus.

Hospital officials, Democratic lawmakers and advocates for the poor complained Monday that the state's proposed rule on health insurance navigators could cripple efforts to educate Texans about their coverage options.

Across the country, Medicaid expansion varies among states. Some experts worried about whether that variation would drive Americans to relocate to other states so that they could obtain better medical coverage. However, those concerns are likely to prove unfounded, according to a recent study from Harvard.

The share of individuals who will gain insurance coverage under the federal healthcare reform law will vary sharply from state to state, according to a report released Monday by the Kaiser Family Foundation.

New federal estimates show that U.S. health spending growth continued to grow at a historically low rate in 2012 even as the economy rebounded.

An annual report from the Centers for Medicare & Medicaid Services finds that health spending totaled $2.8 trillion in 2012, which accounted for 17.2% of the nation's gross domestic product (GDP) and was down slightly from the 17.3 % of GDP in 2011.

Republican leaders in Idaho on Friday dampened expectations about broadening Medicaid healthcare eligibility this year for poor residents in the state, on the same grounds they balked in 2013: Before taking extra federal money, the existing system should be overhauled to encourage beneficiaries to take personal responsibility for their health.

While government officials have spent months scrambling to fix the federal health law's botched rollout, another issue is looming that could create new headaches for states, health plans and patients.

The Affordable Care Act has been touted as a means to control costs and improve quality of care. One initiative in that effort is to steer patients away from visiting the emergency department (ED). That undertaking may prove to be challenging.

January 2014 has arrived, and with that Affordable Care Act coverage begins. Over the next 12 months, the administration will thoroughly consider the ways in which it can control the rising costs of healthcare in the United States. This is especially true for the nation's Medicare program.

Emergency rooms may be a preferred choice for care among 3.9 million people newly enrolled in the U.S. Medicaid program for the poor, according to a study that suggests Obamacare's costs may be higher than expected.

A coverage gap in the Affordable Care Act (ACA) means that many children will not be eligible for dental coverage, which was mandated as one of the 10 essential health benefits for adequate health insurance.

Hospitals and medical practices across the United States are bracing for confusion and administrative hassles as new insurance plans under President Barack Obama's healthcare law take effect.

Over two million people have enrolled in health insurance plans through the federally run HealthCare.gov and state healthcare enrollment websites, a US administration official said on Tuesday. HealthCare.gov covers 36 states, and another 14 states have their own websites.

A look back at some of the InFocus blog highlights of 2013.

Insurance companies aren't crazy about their share of the health law's taxes, but mostly they've complained to politicians and regulators.

Healthcare reform is already presenting new challenges and opportunities for endocrinology, a specialty that is under significant stress in the United States. A critical workforce shortage has drained the pool of practicing endocrinologists, just as the Affordable Care Act (ACA) is expected to send millions of newly insured people into the system.

Len Nichols, director of the Center for Health Policy Research and Ethics (CHPRE) and a professor of Health Policy at George Mason University, discusses how hospitals can achieve the triple aim.

The Centers for Medicare & Medicaid Services announced Friday that it is seeking a second round of applicants to the Pioneer ACO Model. It is also soliciting suggestions for new accountable care organization models that encourage greater provider integration and financial accountability.

The business of treating patients via telehealth in the U.S. will dramatically increase to nearly $2 billion in revenue within five years due to a confluence of events in the health care industry from doctor shortages to provider payment changes under the Affordable Care Act.

Millions of people facing the cancellation of health insurance policies will be allowed to buy catastrophic coverage and will be exempt from penalties if they go without insurance next year, the White House said Thursday night.

The director of Minnesota's health insurance exchange, April Todd-Malmlov, abruptly resigned this week, making the exchange the fourth state program to see a leadership change in the midst of mounting criticism over the rollout of President Obama's new health care law.

In an effort to avoid a coverage gap in health insurance, those covered under the Pre-existing Condition Insurance Plan (PCIP) will get until January 2014 to enroll into a new plan through the state or federal healthcare exchange website.

To keep premium prices down for individuals and small businesses buying coverage through new online marketplaces, insurers have created smaller networks of hospitals. But consumers and policy experts have wondered, just how small?

Access is an important component of the Triple Aim (cost, quality, access), and it has also been stressed as a significant factor in health reform initiatives. As the influx of uninsured increasingly seeks care, and if the number of providers available to provide primary care decreases as projected, achieving access to quality and cost-effective care may become more problematic.

Enrollment in new Obamacare exchanges may be lagging, but experts said Thursday that the health law's massive expansion of Medicaid could place more than 8 million low-income people in the program before the first year is up.

About 85,000 people with a history of serious illnesses, who are enrolled in high-risk insurance pools created under the health care law, will get a month's reprieve before they lose that coverage.

The US health system has undergone notable transformations over the last 2 decades. Independent community hospitals haveconsolidated horizontally with others to form hospital healthcare systems, with many of the larger ones covering wide-ranging geographies, generating billions of dollars in operating revenues.