Urgent care wont replace primary care. Heres why. About seven years ago, the California Healthcare Roundtable and Health Affairs sat down to prepare a white paper on the emerging phenomenon of urgent care centers, and what it might mean for primary care. At the time the group couldn’t agree that urgent care (UC) was a disruptive innovation, but it seemed clear to all participants that it represented a threat to primary care: ...

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This is what population health looks like It is a beautiful day here in my little college town. The sun is shining and at 11 a.m. it is about 78 degrees with a barely perceptible breeze. People are out walking on Main Street and riding their bikes. The mountain nearby calls: I can go for a hike today with my dog and still be within 20 minutes or so ...

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5 health care megatrends to watch for Recently, Cisco chairman and CEO John Chambers told me that U.S. health care is at a tipping point. A positive one, he hopes, but the truth is no one knows for sure which direction the system will tip. At the close of our interview, I asked Chambers what health care topic he’d like me to cover in the future. He asked me to ...

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The new VA secretary, Robert A. McDonald, speaking to a room-full of reporters, acknowledged for the first time that the department needed to hire "tens of thousands of new doctors, new nurses, new clinicians." It is now accepted that a shortage of employees directly involved in treating patients was a main driver in the waiting-list scandal that rocked the agency this year. The second, and equally important driver, was the artificially created benchmarks, that ...

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Just a few years ago it seemed that advocates for health care transparency had scored a big victory. The Centers for Medicare & Medicaid Services (CMS) announced that they would rate nursing homes by awarding five stars to the best and fewer stars to lower-quality facilities. Families searching for care for loved ones would have access to a familiar rating system to help them make choices. After all, star ratings for ...

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Part of a series. Employers have seen their health care costs rise dramatically over the years. To compensate, they have expected employees to pay an increasing portion of the health care insurance premium, expected employees to pay significant co-pays with each physician visit and have purchased policies that restrict individuals to a narrow network of doctors and hospitals. Largely these have not worked. They have offset some of the expenditures but ...

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The Canadian health care system is often held up as an example to model or to avoid at all costs in the debates on health care in America, and elsewhere.  Yet there are a startling number of misconceptions -- on both sides of the partisan divide -- about how the Canadian health system actually works, often from experts who should know better.  Here are the facts. 1. Doctors are self-employed, not ...

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When I hear the term "charity hospital," my thoughts turn to the grand bastions of 20th century public hospitals -- Bellevue Hospital in New York City, Cook County Hospital in Chicago, and San Francisco General Hospital. These hospitals were generally affiliated with medical schools and relied on government appropriations, rather than fees, to provide care for the poor. Decades of legislation have brought about sweeping changes in hospital financing, accounting, and social ...

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I read an article recently that implied the practice of hospitals acquiring physician groups encouraged “clinical integration and multidisciplinary team-based health care.” I guess that would depend on your definition of clinical integration. The American Hospital Association has a particularly cogent one, which is: “[A practice] needed to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, ...

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It's been pretty quiet lately on the Obamcare front. So quiet, that there has been a flurry of articles recently over how Obamacare has dropped to a second or even third tier issue and will hardly matter come election-time. Wishful thinking. Obamacare has largely been out of the news cycle for a couple of months but that is about to change. A few thoughts. The 2015 rate increases have been largely modest. Does that prove Obamacare ...

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