Organization of Healthcare Delivery

Streamlining how health care is delivered in the U.S.’s fragmented system.

An Assessment of State-Led Reform of Long-Term Services and Supports

Nov. 16, 2015

Mary Naylor, Ellen Kutzman, Edward Miller, Pamela Nadash, Peter Fitzgerald

In the Journal of Health Politics, Policy and Law, Mary Naylor and colleagues evaluate the strategies used by state governments to improve long-term services and supports (LTSS) for adults with disabilities and functionally impaired older adults. Three strategies have been most commonly pursued by state governments to improve LTSS: expanding noninstitutioal care, integrating payment and care delivery, and realigning incentives through market-based reforms. Naylor and colleagues evaluate these strategies based on nine dimensions, including: ease of access, quality of care/life,...

Increasing the Value of Health Care: The Role of Nurses

Oct. 16, 2015

A new LDI/INQRI Brief tackles the complexities of assessing health care value and nursing’s contributions to value in terms of outcomes and costs. It highlights evidence published by researchers in the Interdisciplinary Nursing Quality Research Initiative (INQRI), an 8-year program funded by the Robert Wood Johnson Foundation.

How Wide Are Your Physician Networks?

Aug. 24, 2015

In June, we described the first attempt to measure, in a consumer-friendly way, the breadth of physician networks offered by all silver plans on the 2014 health insurance marketplaces. We estimated network size based on the fraction of office-based physicians participating in the network within relevant rating areas in the state. We categorized networks using "T-shirt" sizes:  x-small (less than 10%), small (10%-25%), medium (25%-40%), large (40%-60%), and x-large (more than 60%). We found that nationally, 41% of all networks were either “small” or “x-small”.

Geographic Barriers to Care: the Final Frontier?

Aug. 13, 2015

Although health reform has reduced many financial barriers to care, it has done little to overcome geographic barriers. Two recent studies by LDI Senior Fellows examine disparities in geographic access to specialty care in the United States, specifically gynecologic cancer care and comprehensive stroke treatment. They assess the potential impact of these disparities on health outcomes, and suggest population-based planning as a way to improve access to specialty care.

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