What changes are needed to enable the safety net to become a provider of choice? And how does it get done?

The safety net is the delivery system that provides health care to low-income and uninsured populations. Following the recent implementation of health care reform, hundreds of thousands of people in Los Angeles County gained or became eligible for health care coverage. The safety net now has the potential to remain a regular source of care for these newly covered patients who historically have been dependent on the safety net for their health care.

An actuarial analysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost.

Lung cancer screening is not established as a public health practice, yet the results of a recent large randomized controlled trial showed that screening with low-dose spiral computed tomography reduces lung cancer mortality. Using actuarial models, this study estimated the costs and benefits of annual lung cancer screening offered as a commercial insurance benefit in the high-risk US population ages 50-64. Assuming current commercial reimbursement rates for treatment, we found that screening would cost about $1 per insured member per month in 2012 dollars.

Two responses to a premium hike in a program for uninsured kids: 4 in 5 families stay in as enrollment shrinks by a fifth.

This article reports on our study of the effect of premium increases on disenrollment from a health insurance program for low-income immigrant children in Los Angeles County. Two groups of children were compared: those ages 6-18, who were subject to an increase, and those ages 0-5, who were not. Fewer than half of the children in the older group remained enrolled after the premium increase-slightly more than 12,000 children, compared to more than 25,000 at the beginning-and there was a 20 percent decline in overall membership in the program that was attributable to the increase.