Is health care on the edge?

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Researchers at the Department of Health and Mental Hygiene, Baltimore, say that the U.S. health care system has reached a tipping point when there is both little doubt about the kind of change that is needed and much uncertainty about how to achieve it.

“At the national level, progress in advancing health care is slow and halting. The Centers for Medicare & Medicaid Services is promoting accountable care and other innovations through the Medicare and Medicaid programs. However, broad changes are not on the horizon, and Congress is distracted by efforts to undo the Accountable Care Act (ACA). Ironically, addressing the increasing costs of health care would reduce the pressure on the federal budget and make political conflicts in Washington easier to resolve,” Joshua Sharfstein, MD, and colleagues were quoted as saying.

Researchers say that at the state level, there is evidence of application of some key principles. “There are bundled payments in Arkansas, coordinated care organizations in Oregon, health care cost targets in Massachusetts, and global budgets for hospital care in Maryland—each championed by the states’ respective governor,” researchers said.

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