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Choices Ahead

The run up to the midterm elections says a lot about American ambivalence about reforming the health care system. The rhetoric about health reform – and the public’s reaction to that rhetoric – underlines why it has been so difficult to reform the health care system for the past 100 years– and, why it still might fail. In general, whenever …

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Can ACOs Create a High Performing Healthcare System in America?

The idea of the “Accountable Care Organization” (ACO) appears to have taken hold well in advance of a clear understanding of what these organizations might be or how they will fit into the overall health care system. At Blue Cross Blue Shield of Michigan, we’ve been using the term “Organized Systems of Care” (OSC) since 2005, when we began transforming …

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The Hidden Story Behind the Development of Evidence Based Guidelines or, Why It is So Hard to Reduce Health Care Spending Trends

Almost a year ago now, new guidelines on mammography screening were released by the U.S. Preventive Services Task Force (USPSTF). The new guidelines updated 2002 recommendations, and based on recent research recommended against routine screening of women ages 40-49. Instead of routine screening, the USPSTF concluded that the decision about screening women 40-49 should be left up to individual women and …

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Health Care Reform – The Six Month Mark

September 23, 2010 may well prove to be a particularly important day in the health care reform journey. On that day, six months after the Affordable Care Act was signed into law, several key provisions went into effect that were designed to help people see some immediate benefits in advance of the full blown implementation of the law starting in …

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National Health Care Reforms Are Already Beginning

September 23, 2010 marks six months since our new national health care reform law, also known as the Patient Protection and Affordable Care Act (PPACA), became effective. It remains a controversial undertaking for some, yet a positive step for others. The law’s implementation is a long and complex journey. Much of the spotlight has been on PPACA reforms that begin …

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Actuarial Projections and the ACA: The Good News Story You Never Heard

This week, the esteemed journal Health Affairs published the latest findings from the office of the Chief Actuary of the Centers for Medicare and Medicaid Services (CMS), with new estimates on the cost impact of the Affordable Care Act (ACA). CMS actuaries are now projecting that annual growth in health spending for 2010-2019 will be 0.2 percent higher than projections …

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To scan or not to scan

There is an increasing consensus that many high tech radiology procedures are overused but no agreement on what to do about it. An important review study reported in the Archive of Internal Medicine concluded that exposure to even one CT scan can produce cancer later in life. The editorial in the Archive notes that every day more than 19,500 CT …

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Pain Should Be Getting Our Attention!

The Affordable Care Act was signed into law on March 23, 2010. As health care reform is implemented and the United States continues to devote extensive resources to health care; there are real opportunities to improve health care quality and equity by improving pain care. Specifically, pain research practice and policy can substantively inform the broader national health care policy …

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