In many countries, primary care clinicians serve as the foundation for health care and the “gatekeepers” for more specialized referrals. A new international survey of primary care physicians in eleven countries finds that American doctors are significantly behind many of their counterparts elsewhere in providing access to high-quality care and use of health information technology, [...]

Editor’s Note: Tim Jost wrote 3 posts analyzing the House health reform bill HR 3962. The first looks at financing reforms, the second post delves into the public option, health insurance exchanges, and more.
In this final post, I will explore the remaining 1600 pages of HR 3962.  Although these provisions have received less attention (except [...]

Editor’s Note: In addition to Arnold Milstein and Pranav Kothari (pictures and bios above), coauthors of this post include Rushika Fernandopulle MD, MPP, of Harvard Medical School and Renaissance Health in Boston, and Theresa Helle of the Boeing Company in Seattle. For more on health care delivery system innovations and reforms, see the Sept-Oct 2009 issue of Health Affairs, [...]

Preventing and more effectively managing chronic illness are critical national health priorities. Patients with chronic disease currently account for three-quarters of overall health spending. Multiple morbidities are common: More than half of Medicare beneficiaries are treated for five or more chronic conditions yearly. Nine chronic ailments account for nearly 60% of the recent rise in [...]

Editor’s Note: In addition to Arthur Garson (photo and bio available above), coauthors of this post include Margaret Whitehead, Tracy Buni, Catherine Sommers, and Karen Rheuban.
Given current trends, access to health care will worsen considerably in the next 15 years. The first wave of baby boomers is now turning 65, and health care utilization for this [...]

Editor’s Note: In a recent Health Affairs essay titled “What ‘Patient-Centered’ Should Mean: Confessions Of An Extremist,” Don Berwick surveyed the debate in the health policy community over how the principle of “patient-centeredness” should be defined and implemented. He argued for “a radical transfer of power and a bolder meaning of ‘patient-centered care,’ whether in [...]

Editor’s Note: Dr. Patchin wrote the blog post below in her official capacity as Chair of the Board of Trustees of the American Medical Association.
Health Affairs recently published an interview with Kerry Weems, former acting administrator of the Centers for Medicare and Medicaid Services. In the interview, inaccurate statements were made about the role of the [...]

Federal support for graduate medical education (GME) training positions has been capped for more than a decade and it is no secret that the country’s teaching hospitals are restive. They want “more cap.” A number of bills have been introduced in the House and Senate proposing an increase in the Medicare funded GME cap by [...]

The train has left the station. Everyone is on board: health policy leaders both public, like the Institute of Medicine (IOM) and the National Committee for Quality Assurance (NCQA), and private, like the Institute for Healthcare Improvement (IHI) and the Commonwealth Fund; influential medical societies like the American College of Physicians and the American College [...]

Given the strong emphasis on medical specialization and the beleaguered state of primary care, Democratic and Republican policymakers and a host of private-sector interests are promoting the resurrection of the generalist doctor in the physician workforce. But most graduating medical students who matched to residency positions this year have not yet gotten the message. And [...]

How does a health care system learn about neglected and abused children—the ones who’ve fallen through the cracks—so they can be helped? That was the story and exploration in a Narrative Matters essay by Janette Kurie titled “Where’s David?”
Kurie recently read an excerpt from her essay on NPR’s “Morning Edition.” In it she tells a [...]

The most-read posts on Health Affairs Blog this January included much health reform advice to the Obama Administration and calls to action on health IT and rebuilding primary care. Additional commenting is always welcome.

Top 20 Health Affairs Journal Articles For 2008
by Jane Hiebert-White

Complete The Work On Health Information Technology
by David Brailer

Daschle: What Can We Expect [...]

Editor’s Note: There is widespread agreement that the nation’s primary care infrastructure is woefully inadequate. For example, at the Senate hearing on his nomination to be Secretary of Health and Human Services, Sen. Tom Daschle spoke of health care as a pyramid, with primary care at the bottom and specialized care at the top. He [...]

Editor’s Note: There is widespread agreement that the nation’s primary care infrastructure is woefully inadequate. For example, at the Senate hearing on his nomination to be Secretary of Health and Human Services, Sen. Tom Daschle spoke of health care as a pyramid, with primary care at the bottom and specialized care at the top. He [...]

The contrast could hardly have been more sharp. In a week when The New England Journal of Medicine published a series of perspectives exhorting the United States to reinvent primary care before it collapses, speakers at the annual international symposium of The Commonwealth Fund emphasized how primary care physicians formed the critical core of health-care [...]