Designing Effective Health Care Quality Transparency Initiatives

Profiles two well-designed healthcare quality transparency initiatives from California and Massachusetts. Examines key design and implementation elements, including provider engagement, reliable data, consumer-friendliness, and feedback to providers

Limited Options to Manage Specialty Drug Spending

Outlines rising trends in costs of and spending on specialty drugs; health plans' efforts to curb specialty drug spending, including patient cost sharing and utilization management; and efforts to integrate medical and pharmaceutical coverage

Financial and Health Burdens of Chronic Conditions Grow

Points to rising rates of chronic conditions and obesity; growing numbers of patients with problems paying medical bills, even with insurance; and contributing factors such as declining private coverage and delays in accessing care. Outlines implications

Striking Jump in Consumers Seeking Health Care Information

Examines shifts in how Americans seek health information from sources other than their doctors. Looks at growing Internet use and information-seeking for others, education as a factor, and the impact of information-seeking on perceptions of health issues

Word of Mouth and Physician Referrals Still Drive Health Care Provider Choice

Examines how consumers choose physicians, specialists, or medical facilities, including the use of physician referrals, word-of-mouth recommendations, health plan information, and the Internet. Explores implications for consumer-directed health care

Checking Up on Retail-Based Health Clinics: Is the Boom Ending?

Outlines trends in the growth of retail-based clinics providing basic care at pharmacies and other retail settings. Examines who uses them, where, for what services, and why; insurance coverage and reimbursement rates; and variations in state regulation

State Prescription Drug Price Web Sites: How Useful to Consumers?

Compares ten sites and identifies key limitations due to data omissions, gaps between insured and uninsured consumers, and varied program implementation. Presents alternative policy options such as requiring price lists from pharmacies

San Diego: Major Providers Pursue Countywide Networks and New Patient Care Models

San Diego has long been a geographically well-defined health care market with high managed care penetration and a consolidated provider sector. In recent years, hospital systems have faced increasing cost pressures as commercial health plans have responded to employer demands for more affordable premiums. Safety-net providers expanded capacity to deal with the large Medi-Cal expansion that began in 2014, but continue to grapple with how to provide adequate care for a new enrollee population that is far sicker, with more complex medical and social service needs, than the providers' previous patient base.Key developments include:While the hospital market remained largely stable in recent years, most of the smaller hospitals have been losing volume and struggling financially.Major systems are pursuing population health strategies and increasingly using provider-sponsored health plans to take full risk for more patients.The challenges of independent practice are leading many primary care physicians to choose employment at system-affiliated groups.In the two years since Medicaid eligibility was first expanded under the ACA, San Diego's Medi-Cal managed care enrollment almost doubled to 700,000. Many Medi-Cal enrollees without a regular primary care provider sought care at hospital emergency departments, and access gaps for many kinds of specialty care and behavioral health care were even more severe.San Diego County's commitment to providing health care for low-income residents continues to be limited, although the county Health and Human Services Agency has become more active in fostering collaborations between health and other social services

Workplace Clinics: A Sign of Growing Employer Interest in Wellness

Examines the increasing employer demand for workplace clinics, clinic management models, types of services, challenges, regulations, and the clinics' potential impact, including their ability to raise productivity and help contain healthcare costs

Key Findings From HSC's 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform

Presents findings about hospital payment rate increases, hospital-physician alignment, and insurance premiums, funding for safety-net providers, and their implications from HSC's site visits to twelve nationally representative metropolitan communities