Importance: The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform.
View Article and Find Full Text PDFSubstance use disorders involving illicit and prescription drugs are a serious public health issue. In the United States, millions of individuals need treatment for substance use disorders but few receive it. The rising number of drug overdose deaths and the changing legal status of marijuana pose new challenges.
View Article and Find Full Text PDFBehavioral health care includes care for patients around mental health and substance abuse conditions, health behavior change, life stresses and crises, and stress-related physical symptoms. Mental and substance use disorders alone are estimated to surpass all physical diseases as a major cause of worldwide disability by 2020. The literature recognizes the importance of the health care system effectively addressing behavioral health conditions.
View Article and Find Full Text PDFThe Open Payments program is a government initiative through which financial relationships between applicable industries and covered physicians or teaching hospitals are publicly reported. The program does not assess these relationships but rather facilitates transparency and allows stakeholders to use this information in making informed decisions. This article outlines the program and its goals, reviews its requirements and when they go into effect, examines the implications for physicians and their patients, and makes recommendations to help physicians and teaching hospitals prepare for its implementation.
View Article and Find Full Text PDFObjectives: Demand for specialty care exceeds supply in many healthcare systems in the United States. Preconsultation exchange has the potential to increase access to specialty care, and increase its timeliness and efficiency, by triaging need and urgency and streamlining the previsit workup. We sought to characterize attitudes toward, use of, and concerns regarding preconsultation exchange among US internists.
View Article and Find Full Text PDFThis article provides an overview of the Patient-Centered Medical Home (PCMH) care model. It provides a history and definition of the concept, a discussion of its growing acceptance by the health-care community, and a review of current public and public-private demonstration projects testing the concept. The role of specialty/subspecialty practices within the PCMH model is described, with a focus on the potential for these practices to serve as a PCMH for a subgroup of patients or, alternatively, as a PCMH "neighbor" that interfaces effectively with PCMH practices.
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