In 2007, the COURAGE trial (aka: Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation –a mouthful!) results were reported in the New England Journal of Medicine. This study concluded that for those with stable coronary artery disease, the insertion of stents was no better than medication and lifestyle changes at preventing future heart attacks or strokes, nor did it extend life. There …

Many analyses of the impact of health reform focus on the large increase in expected Medicaid enrollment.  Indeed, our own analysis of potential Medicaid enrollment in Michigan showed as many as 452,000 people could be enrolled come 2014 (link to Cover Michigan) who are not enrolled today. Kaiser’s numbers were slightly higher, at 590,000 potentially new Medicaid enrollees, and more recent Census data suggest the …

The Patient Centered Medical Home Model (PCMH) generates much discussion in health care circles. PCMH demonstration projects are widespread, accreditation organizations are developing and implementing certification programs for PCMH-based practices, and payers – including the federal government – are exploring new reimbursement policies to support medical home-based care. There is a sense of urgency about implementing medical home capabilities. Yet …

In 2006, there were 4.3 million children born in the United States. Approximately 55,000 of those children were born prematurely. Premature births have been increasing consistently since 1990 (though there appears to have been a slight drop in the rate of prematurity in 2007). In 1990, 10.6 percent of children were born prematurely; in 2006, that percentage had increased to …

In the midst of all the focus on election day in the U.S., there was a much overlooked article the same day on changes in the British health care system. The article is about what is called in Great Britain “NICE.” NICE is an acronym that stands for National Institute for Health and Clinical Excellence. NICE was established in 1999 …

During the campaign, there was a great deal of talk about “repeal and replace” the Affordable Care Act if the Republicans won in Congress. Well, the Republicans won the House and made significant gains in the Senate. So, what now? Is a repeal of health care reform a likely outcome in the near future? There is very little that is …

On October 29, CHRT sponsored a symposium to look at issues surrounding the safety net and the future of health care after the Affordable Care Act takes effect. While there are some who believe that getting to (or close to) universal coverage would mean the end of the safety net, our panelists came to the opposite conclusion. That is, we …

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 …

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 …

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 …