Veterans experiencing housing insecurity face severe health risks. They have high rates of chronic disease, mental health disorders, and substance use. These conditions drive emergency department visits and hospitalizations far above population norms. Homelessness and unstable housing are powerful social determinants of acute care use. Addressing them is essential to improve outcomes and reduce costs.… Read More »
A new year brings a clear choice. In 2026, The Medical Care Blog will focus more directly on how policy decisions shape health. Not just health policy in isolation, but policies across and intersecting between housing, labor, education, transportation, climate, and criminal legal systems. This approach is often called Health in All Policies. The idea… Read More »
For years, analysts warned that the enhanced Affordable Care Act (ACA) premium subsidies, which were temporarily extended during the COVID-19 pandemic, masked the true cost trajectory of the individual market. This fall, that warning has become reality. The 2026 open enrollment window (Nov 1 – Jan 15, with a deadline of December 15 for coverage… Read More »
The Affordable Care Act (ACA) Marketplace Open Enrollment season starts November 1, 2025 in most states. The premiums insurers charge are increasing. And, with enhanced premium tax credits set to expire at the end of the year, out-of-pocket premiums are expected to increase drastically. Additionally, changes to Marketplace enrollment and eligibility rules in this year’s… Read More »
WASHINGTON — Nationwide, states are racing to win their share of a new $50 billion rural health fund. But helping rural hospitals, as originally envisioned, is quickly becoming a quaint idea. Rather, states should submit applications that “rebuild and reshape” how health care is delivered in rural communities, Centers for Medicare & Medicaid Services official Abe Sutton… Read More »
Given the impending evisceration of Medicaid, potential cuts to Medicare, and reductions in medical foreign aid, many ill individuals will face decreased access to supplies, equipment, and staff, necessitating difficult decisions about who receives care and how much treatment they will receive. Those making these decisions will have the uncomfortable choice of refusing treatments. This… Read More »
Imagine being discharged from the hospital, IV bandage still fresh, only to recover on a sidewalk with no shelter, no food, and no doctor to check on you. In the turbulent landscape of American healthcare, medical respite (MR) services have emerged as one of the most promising interventions for people experiencing homelessness. Medical respite programs… Read More »
The Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2026 Medicare Physician Fee Schedule. And big changes may be coming–including some potential for payments to primary care to increase, and for payments to other specialties to decrease. Though the changes are controversial, they might be just what primary care needs.… Read More »
If you have been following the debate about Medicaid cuts, you know it’s a giant program, America’s largest in terms of the number of people it covers. But you may be confused about how many people Medicaid actually covers. Is it 71 million Americans, the number most commonly used in The New York Times and… Read More »
This post from KFF Health News is republished here in line with The Medical Care Blog’s declaration that our theme for 2025 is ‘the Political Determinants of Health‘. As fired and retired scientists rallied outside in the Atlanta heat, an advisory panel that Robert F. Kennedy Jr. handpicked to replace experts he’d fired earlier met… Read More »
There has been a constant battle for Medicaid in America – from states slashing Medicaid reimbursements or refusing to expand access, to Congress now threatening to cut and restrict Medicaid funding altogether. The program, which funds 78.4 million of our most vulnerable patients, is a necessity to primary care. Medicaid beneficiaries look like pregnant women… Read More »
The transition to value-based care (VBC) is fundamentally transforming the healthcare landscape, and 2025 is poised to be an inflection point to see whether the promise of VBC can be realized. For healthcare professionals – and especially for ambulatory care practices – embracing the nuances of this dynamic environment is essential not only for delivering… Read More »
About a month ago (March 27th to be exact), the Department of Health and Human Services (HHS) announced a sweeping reorganization plan. The government will create a new umbrella agency: the Administration for a Healthy America (AHA). Some have hailed this as a bold step toward modernization. In effect, the AHA will absorb and restructure… Read More »
When we talk about chronic illness, the conversation usually centers on medications, treatment plans, or physical symptoms. But for those who live with long-term health conditions, it’s often about so much more than what’s happening in the body. Chronic illness doesn’t just disrupt routines, it affects how people work, plan, connect with others, and, crucially,… Read More »
As an epidemiologist and assistant professor dedicated to the education of primary care physicians, I feel compelled to address the alarming measles outbreak currently unfolding in Texas and neighboring states. This situation not only underscores the resurgence of a disease once considered successfully contained but also highlights the detrimental impact of disinformation and recent government… Read More »
This article is from a partnership that includes WABE, NPR, and KFF Health News. It was republished for free. It was selected to run as a part of this year’s theme at The Medical Care Blog, highlighting the Political Determinants of Health. On a sunny weekday in Atlanta, a small crowd of people gathered for a rally… Read More »
The recent budget resolution passed by the House of Representatives proposes significant spending cuts, including approximately $880 billion from programs under the jurisdiction of the House Committee on Energy and Commerce, which encompasses Medicaid. This proposal has raised concerns about potential reductions in Medicaid funding, a program that currently provides health coverage to over 72… Read More »
President Donald Trump’s return to the White House sent a clear signal about Medicaid to Republicans across the country: Requiring enrollees to prove they are working, volunteering, or going to school is back on the table. The day after Trump’s inauguration, South Carolina GOP Gov. Henry McMaster asked federal officials to approve a work requirement… Read More »
*This post was originally published on KFF Health News on November 8, 2025. It is published with open permission by that site. A new federal watchdog audit is ratcheting up pressure on government officials to crack down on billions of dollars in overcharges linked to Medicare Advantage home visits. But so far, the Centers for Medicare & Medicaid… Read More »
Note: The 2024 election wraps-up in short order. KFF once again published a thoughtful analysis of competing positions on health care–in this case the Affordable Care Act. And we are republishing that here. Enjoy. -The Editors Health care is suddenly front and center in the final sprint to the presidential election, and the outcome will… Read More »
Note: It’s election season. And time to take a look at the health policy positions of the presidential candidates. KFF published this thorough and well-sourced analysis of the candidates’ competing positions on everything from health care and abortion to public health and gun violence. Enjoy. -The Editors The general election campaign is underway, spotlighting former… Read More »
I asked the question as a panelist at a health equity gathering, “Who does our health system serve?”. As a family medicine physician who sits perilously between patients and corporations (insurance, pharmaceutical, durable medical equipment, etc.), my answer was quite simple. Our health system serves the profit motives of those with hands in the jar.… Read More »
For new readers, the editors and the majority of contributors to The Medical Care Blog recently authored and signed onto a special consensus statement about climate change, labeling it the “greatest threat” to global public health. As part of the plan to publish that statement, we also declared that the drivers and health risks of… Read More »
I am a health economist, trained to make sense of messy data. I generally work amidst a sea of numbers. But I’ve found that seeking out stories in health services research–those of doctors and patients–can help me anchor what’s truly important in research. These stories may also help researchers communicate the value of their work… Read More »
A special supplemental issue of Medical Care supports the growing recognition that patient economic outcomes matter in health care. Sponsored by the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services, the issue highlights studies that explore the relationship between economic outcomes, patient care, health outcomes and equity. Patient-centered… Read More »
Medicare for All is Not Happening… 10 years from now will we have Medicare Advantage for All? Grandmother and granddaughter in the same health plan? Others have written that the US should achieve universal health insurance coverage, better health outcomes, and lower costs via comprehensive programs such as “Medicare for All”, as proposed by Senator… Read More »
In this post, we examine how the COVID-19 pandemic affected frequencies of diagnoses and claims costs in the Affordable Care Act (ACA) marketplaces in 2020 and 2021. The ACA marketplaces are critical sources of coverage for millions of Americans and were increasingly so during the COVID-19 pandemic due to job losses and coverage disruptions. The… Read More »
As part of its partnership with the Patient-Centered Outcomes Research Institute (PCORI), Medical Care has published its first PCORI-sponsored article collection, which provides specific information about the costs that healthcare systems can expect to incur in promoting the uptake of specific evidence-based programs. In September’s special issue, five project teams that received Implementation Award funding from PCORI… Read More »
The United States Preventive Services Task Force has recommended lung cancer screening for at-risk groups since 2013, and updated again in 2021. This is a simple procedure involving a low dose of radiation used to take a CT image of the chest. If utilized by most eligible Americans, screening could reduce lung cancer mortality by… Read More »
California just took a significant step toward single payer health care. On Oct 7, Governor Gavin Newsom signed Senate Bill 770 (Unified Health Care Financing) into law. Introduced by Senator Scott Wiener (D-San Francisco), the law directs the Secretary of the California Health and Human Services Agency to research, develop and pursue a waiver framework… Read More »
This entry was one of the winners of our Summer 2023 student blog contest! Trends in Life Expectancy The recent decline in life expectancy in the United States is largely attributed to the well-known COVID-19 pandemic and opioid epidemic. However, these recent crises are not the sole drivers of the stagnation and subsequent drop in… Read More »
The ACA marketplaces continue to be an important source of health insurance for millions of Americans. Achieving health equity for these enrollees may require more than simply providing coverage. The number of individuals who selected a Affordable Care Act (ACA) marketplace plan increased from 8 million [PDF] in 2014 to 16 million [PDF] in 2023.… Read More »
Last month, the Centers for Medicare and Medicaid Services (CMS) Innovation Center announced its newest alternative payment model for primary care, Making Care Primary (MCP). MCP builds upon lessons learned from previous CMS primary care models: the Comprehensive Primary Care Initiative, the Comprehensive Primary Care Plus (CPC+) initiative, the Maryland Primary Care Program, and Primary… Read More »
Over the past 25 years, significant strides have been made in shifting services for people with dementia and Alzheimer’s disease to home and community settings. Home and community-based services (HCBS) enable people with various forms of dementia to receive care in a familiar setting while promoting their independence, well-being, and overall quality of life. As… Read More »
The disproportionate impact of COVID-19 on underserved communities underscored the need for systemic change and renewed efforts to reduce health disparities in people with social risks. This post describes a partnership between Inovalon and Humana to develop a new health equity composite quality measure to identify disadvantaged populations with the largest care disparities and determine… Read More »
Medicare Advantage should be making news. It’s not because the Medicare trust fund continues to run on fumes, which it does. Nor is it because Medicare was taken “off the table” in recent debates about cutting the federal budget, which it was. Rather, it should be getting a lot of attention for new data about its… Read More »
It isn’t what supporters of single-payer health care might prefer. But a Medicaid-for-all program, based on the already expansive safety-net program, might open new doors to universal coverage. And rising familiarity with the program is creating a window of opportunity. My realization began with several conversations First, it was a friend going through a divorce… Read More »
Better care coordination may improve access to primary care for people who are dually eligible for Medicare and Medicaid. Recent evaluations of the Financial Alignment Initiative (FAI)–an initiative incentivizing the financial alignment of Medicare and Medicaid–suggests care coordination could improve access to primary care services for some dually eligible beneficiaries. Care coordination alone, however, may… Read More »
It’s that time of year again–APHA’s Annual Meeting! This year we’ll be meeting in Boston Nov. 6-9 with a digital event Nov. 14-16. I’m looking forward to seeing colleagues this year and getting to catch up with so many interesting people. Of course, I’m also excited about the excellent Medical Care Section Program. Here’s a… Read More »
A recent JAMA article noted that only one-third of new drug approvals through the accelerated approval process by the FDA in the US or the conditional marketing authorization in the EU have shown therapeutic value. Many of these drugs are high cost, and this begs the question if we are spending our health care dollars appropriately. … Read More »
The Medicaid Outcomes Distributed Research Network (MODRN) was started by AcademyHealth and is a collaborative research network of state Medicaid agencies and university partners. The goal of the network is to allow analysis and learning about Medicaid by facilitating comparison across states and aggregate data with a shorter lag time than other available sources. This… Read More »
In 2026, Medicare will negotiate prescription drug prices with manufacturers. It is a dramatic reversal of a stranglehold placed on Medicare back in 2003. And it may be one of the most impactful policy changes to the government program since its creation. But there is a catch…we have to wait. President Biden signed the Inflation Reduction… Read More »
The Medical Care Blog is preparing for its full return later this month. Until then, we are continuing to highlight articles published by our contributors on timely topics. A federal bill is pending that would allow Medicare to begin negotiating drug prices for the very first time. Even though it would begin with only 10… Read More »
It is not too late to fix the US healthcare system. But every day spent in this folly, the problem gets worse. It is time to move this conversation forward. We are excited to share that in November 2021, the American Public Health Association (APHA) formally adopted a policy statement titled “Adopting a Single-Payer Health… Read More »
Reuter’s announced in January that diabetes deaths in the United States continue to surge well above pre-pandemic levels with over 100,000 Americans dying from diabetes in 2021. Given COVID-19’s relationship to diabetes, we may see this trend continue. Increasing deaths from diabetes is a clear call to action for new solutions. Historically, diabetes has been… Read More »
In a previous post, we shared highlights from an event about fixing health care featuring Dr. Michael Fine, a family medicine physician, former public health official, and the author of Health Care Revolt. The faculty of the Department of Public Health at California State University Los Angeles led the event as part of a department-wide book read.… Read More »
Like others working at the intersection of public health and medicine, my faith in primary care has long been unshakeable. Increasingly actualized as the Patient-Centered Medical Home (PCMH), primary care has experienced a decade plus of attention thanks to efforts at retooling and rebranding the field. But in the last week, a tiny crack formed… Read More »
Children with complex health needs (CCHN) are a unique pediatric patient population. They have chronic medical and/or behavioral conditions that need ongoing health care. They use a disproportionate share of hospital resources. And they face greater social challenges when compared to other children. In North Carolina (where we work) and across the country, CCHN fail… Read More »
The Alzheimer’s Association’s 2021 Alzheimer’s Disease Facts and Figures report [PDF] shares that currently, six million Americans are living with Alzheimer’s disease, a number that has increased 145% since the turn of the century. Around the world, there are 50 million people living with Alzheimer’s disease or related dementia. Only a quarter of would-be patients… Read More »
The COVID-19 pandemic has strained healthcare and public health. Many workers in these industries have felt growing frustration with leadership. They face a barrage of medical misinformation, ethical strains, and burnout. Now more than ever, authentic leadership is critical in supporting healthcare workers and advancing public health. This post will describe authentic leadership and examine… Read More »