Integrated care is now a recognized paradigm for health care reforms around the globe. The need to address the problem of fragmented systems of care that undermine the performance of health care systems and result in poor quality care and outcomes to people has become a key policy ambition in many countries and regions. For example, in the Americas, resolutions have been passed in support of in...

Background & purpose: Since 2005, a reform known as Rural Insurance and Family Medicine Scheme has introduced to primary health care network in Iran in rural areas and small towns. The content of the reform implies a substantial change in those aspects of health centers that mainly could be categorized as structural quality. Although, this is the requirement of all health care providers, they a...

Analyzing National Health Reform Strategies With a Dynamic Simulation Model. Milstein B, Homer J, Hirsch G. Proposals to improve the US health system are commonly supported by models that have only a few variables and overlook certain processes that may delay, dilute, or defeat intervention effects. We use an evidence-based dynamic simulation model with a broad national scope to analyze 5 polic...

National health care reform and scrutiny on rising health care costs have created a climate in which health care providers must improve the value, or quality per cost, of patient care. Radiology in particular is at an important crossroads given the heavy use of imaging and the associated large percentage of health care expenditures. At this critical juncture, it is important for radiologists to...

Collaboration among health care providers and across systems is proposed as a strategy to improve health care delivery the world over. Over the past two decades, health care providers have been encouraged to work in partnership and build interdisciplinary teams. More recently, the notion of networks has entered this discourse but the lack of consensus and understanding about what is meant by ad...

Over the last 7 years, State and Federal policymakers have reformed State medical assistance programs and, in the process, have grappled with goals of both containing program costs and expanding health insurance coverage to the uninsured. Currently, nearly one-quarter of all States have implemented health care reform demonstrations, and this article summarizes trends seen since health care refo...

The health care reform signed by President Obama in March 2010 mirrors the Clinton reform proposal of 1993 in that both excluded undocumented immigrants from federal insurance coverage. In both cases substantive discussion of their possible inclusion was stifled by political timidity. This paper begins with a brief descriptive overview of undocumented immigrants in the U.S. and their health car...

With the demise of health care reform at the national level, much of the attention has shifted to state-level efforts. Recently, several states have begun looking to the Medicaid program as a way to solve their health care problems. A principal way in which states are implementing health care reform is through the Section 1115 research and demonstration Medicaid waiver program. The 1115 waiver ...

The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of qualit...

This study examines the level of health care coverage and health care concerns among a sample of 222 West Central Wisconsin residents. More than 68% of respondents felt that Wisconsin health care has at least major problems, and only 2.7% felt that there were no problems. Approximately 60% were extremely or very worried about not being able to afford health care services, whereas more than 70% ...