The Commonwealth Fund Commission on a High Performance Health System believes the government should facilitate communities' efforts to improve care for patients with multiple chronic conditions, through improved primary care, payment reform, and better information.

The belief that cost should be no object in health care has limited efforts to control medical spending; elected officials generally insist that cutting services that yield no value will be sufficient. But eliminating such waste would merely postpone the reckoning.

Primary care physicians, long in the doldrums over their incomes and challenging work–life balance, may be heartened by recent steps taken by policymakers and payers signaling the increased recognition of the foundational role they could play in a ...

The political seas roiled by the Affordable Care Act (ACA) have grown more volatile in the 2 years since its passage. Whether it is the constitutionality of the insurance mandate, the economic feasibility of the Medicaid expansion, or controversy over the ...

Having expanded insurance coverage to 98% of its population, Massachusetts seeks to control health care costs. A new bill includes global payment arrangements, accountable care organizations, malpractice reform, and authority to strike down insurance-premium increases.

In late March, the Supreme Court will examine the constitutionality of the Affordable Care Act, potentially producing a landmark decision. The Court will determine whether, in crafting the ACA's individual mandate and Medicaid expansion, Congress exceeded its powers.

Giving states the right to determine their own essential health benefits is politically savvy. But will it mean shoddy health care for some and top-of-the-line health care for others? And what if variations in quality lead to disability, dysfunction, or premature death?

In December, it was announced that rather than the federal government's defining a single set of essential health benefits, each state will choose from among 10 options. This decision is sound public policy and capitalizes on the strengths of American federalism.

The fate of the Affordable Care Act depends on the outcome of four events in 2012: state legislative sessions, the Supreme Court ruling on the law's constitutionality, the application deadline for grants for establishing health insurance exchanges, and the elections.

Medicaid programs are experiencing turbulence and imposing more spending cuts, most commonly through provider-payment reductions. Simultaneously, many are expanding their contracts with managed-care plans and preparing for health care reform's coverage expansion.

Implementation of accountable care organizations (ACOs) is still at an early stage, but the growing experience with these organizations and the public comments regarding the Medicare ACO program point to five key challenges — and possible approaches to overcoming them.

The Institute of Medicine has recommended that the “essential health benefits” offered under the Affordable Care Act be equivalent in scope to an average small-business plan and “should become more fully evidence-based, specific, and value-promoting over time.”

The Affordable Care Act (ACA) has been under attack in the federal courts for the entire 18 months of its existence. Approximately 30 lawsuits have been filed challenging the law, and review by the Supreme Court by June 2012 now appears likely, given the ...

Does an expansion of health insurance increase or decrease use of the emergency department? Both predictions can be justified logically. Massachusetts' experience with health care reform may help in predicting what will happen to ED use nationwide.

Massachusetts' experience with health care reform may be predictive of the effects of national health care reform. Data on employment in the health care industry were examined to determine the impact of the Massachusetts reform on the state's health care workforce.

Enactment of the Mental Health Parity and Addiction Equity Act in 2008 improved insurance coverage for mental health and addiction treatment. Now, the Affordable Care Act could affect the financing and delivery of such care even more profoundly.