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Health Affairs, vol. 31 no. 8

Tuesday, August 14th, 2012 | Posted in Collections, Faculty, News, Resources, Students by Tomaro Taylor | Comments Off on Health Affairs, vol. 31 no. 8

The most recent edition of Health Affairs is available at the FMHI Research Library.

Volume 31, number 8: “Challenges Facing the Safety Net”

Medicaid Expansion Public Hospitals Coordination & Integration Quality Measures Emergency Care
Accountable Care Complex Patients Coverage for Children Disparities
Emergency Preparedness Diabetes Care The Care Span Web First

Medicaid Expansion

  • The Supreme Court’s surprising decision on the Medicaid expansion: How will the Federal Government and states proceed? (Rosenbaum & Westmoreland, p. 1663)
  • In 2011 nearly one-third of physicians said they would not accept new Medicaid patients, but rising fees may help (Decker, p. 1673)

Public Hospitals

  • Strained local and state government finances among current realities that threaten public hospitals’ profitability (Kane, Singer, Clark, Eeckloo, & Valentine, p. 1680)

Coordination & Integration

  • How five leading safety-net hospitals are preparing for the challenges and opportunities of health care reform (Coughlin, Long, Sheen, & Tolbert, p. 1690)
  • Safety-net providers in some US communities have increasingly embraced coordinated care models (Cunningham, Felland, & Stark, p. 1698)
  • Integrating community health centers into organized delivery systems can improve access to subspeciality care (Neuhausen, Grumbach, Bazemore, & Phillips, p. 1708)
  • In ten California counties, notable progress in system integration within the safety net, although challenges remain (Pourat, Davis, Salce, Hilberman, Roby, & Kominski, p. 1717)
  • Shining a light on the reinvention of the safety net (p. 1728)
  • The post-Katrina conversion of clinics in New Orleans to medical homes shows change is possible, but hard to sustain (Rittenhouse, Schmidt, Wu, & Wiley, p. 1729)

Quality Measures

  • Based on key measures, care quality for medicare enrollees at safety-net and non-safety-net hospitals was almost equal (Ross, Berheim, Lin, Drye, Chen, Normand, & Krumholz, p. 1739)

Emergency Care

  • Case studies at Denver health: ‘Patient dumping’ in the emergency department despite EMTALA, the law that banned it (Rosenbaum, Cartwright-Smith, Hirsh, & Mehler, p. 1749)
  • Solutions to emergency department ‘boarding’ and crowding are underused and may need to be legislated (Rabin, Kocher, McClelland, Pines, Hwang, Rathlev, Asplin, Trueger, & Weber, p. 1757)
  • California hospitals serving large minortiy populations were more likely than others to employ ambulance diversion (Hsia, Asch, Weiss, Zingmod, Liang, Han, McCreath, & Sun, p. 1767)

Accountable Care

  • The promise of peril of accountable care for vulnerable populations: A framework for overcoming obstacles (Lewis, Larson, McClurg, Boswell, & Fisher, p. 1777)

Complex Patients

  • A discharge panel at Denver health, focused on complex patients, may have influenced decline in length of stay (McKenzie, Kukolja, house, Loehr, Hirsh, Boyle, Sabel, & Mehler, p. 1748)

Coverage for Children

  • Increase in Federal match associated with significant gains in coverage for children through Medicaid and CHIP (Patrick, Choi, & Davis, p. 1796)


  • Differences in life expectancy due to race and educational differences are widening, and may may not catch up (Olshansky, Antonucci, Berkman, Binstock, Boersch-Supan, Cacioppo, Carnes … & Rowe, p. 1803)

Emergency Preparedness

  • A hospital system’s response to a hurricane offers lessons, including the need for mandatory interfacility drills (Verni, p. 1814)

Diabetes Care

  • Substantial Medicare savings may result if insurers cover ‘artificial pancreas’ sooner for diabetes patients (O’Grady, John, & Winn, p. 1822)
  • Medical groups can reduce costs by investing in improved quality of care for patients with diabetes (Kralewski, Dowd, & Xu)
  • Greater adherence to diabetes drugs is linked to less hospital use and could save nearly $5 billion annually (Jha, Aubert, Yao, Teagarden, & Epstein, p. 1836)

The Care Span

  • Low cognitive ability and poor skill with numbers may prevent many from enrolling in Medicare supplemental coverage (Chan & Elbel, p. 1847)

Web First

  • In the wake of the Supreme Court decision, many stakeholders still support the Affordable Care Act (Ario & Jacobs, p. 1855)
  • Medicare beneficiaries less likely to experience cost- and access-related problems than adults with private coverage (Davis, Stremikis, Doty & Zezza, p. 1866)
  • The sharp slowdown in growth of medical imaging: An early analysis combination of policies was the cause (Lee & Levy, p. 1876)
  • The ‘alternative quality contract,’ based on a global budget, lowered medical spending and improved quality (Song, Safran, Landon, Landrum, He, Mechanic, Day, & Chernew, p. 1885)

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