Debra A Patt, MD, MPH

As I write this editorial, we who practice medicine face many challenges. Our internal and external environments are changing, and we are asked to do more with less, but we have better tools to perform that work. We have health care reform, which has been met with such opposition that our government temporarily shutdown in October and faced potential default on the national debt. Although it is uncertain to what degree health care reform will succeed at its primary objectives – the provision of services to the underserved and cost control – it is clear that there are changes ahead that will have an impact on our care delivery. Because many states did not embrace Medicaid, it remains unclear how meaningful care will be provided. The technical challenges in registering for the health care exchanges partnered with the very small penalty for not enrolling are likely to precipitate lower-than-anticipated use of the exchanges, which could result in adverse selection of a sicker patient population, and increase proportional costs for patients enrolled in the health care exchanges. How will we manage this change better?

*Click on the link to the left for a PDF of the full article.  

As I write this editorial, we who practice medicine face many challenges. Our internal and external environments are changing, and we are asked to do more with less, but we have better tools to perform that work. We have health care reform, which has been met with such opposition that our government temporarily shutdown in October and faced potential default on the national debt. Although it is uncertain to what degree health care reform will succeed at its primary objectives – the provision of services to the underserved and cost control – it is clear that there are changes ahead that will have an impact on our care delivery. Because many states did not embrace Medicaid, it remains unclear how meaningful care will be provided. The technical challenges in registering for the health care exchanges partnered with the very small penalty for not enrolling are likely to precipitate lower-than-anticipated use of the exchanges, which could result in adverse selection of a sicker patient population, and increase proportional costs for patients enrolled in the health care exchanges. How will we manage this change better?

*Click on the link to the left for a PDF of the full article.  

As I write this editorial, we who practice medicine face many challenges. Our internal and external environments are changing, and we are asked to do more with less, but we have better tools to perform that work. We have health care reform, which has been met with such opposition that our government temporarily shutdown in October and faced potential default on the national debt. Although it is uncertain to what degree health care reform will succeed at its primary objectives – the provision of services to the underserved and cost control – it is clear that there are changes ahead that will have an impact on our care delivery. Because many states did not embrace Medicaid, it remains unclear how meaningful care will be provided. The technical challenges in registering for the health care exchanges partnered with the very small penalty for not enrolling are likely to precipitate lower-than-anticipated use of the exchanges, which could result in adverse selection of a sicker patient population, and increase proportional costs for patients enrolled in the health care exchanges. How will we manage this change better?

*Click on the link to the left for a PDF of the full article.  

You must be the change you wish to see in the world.
– Mahatma Gandhi

In November 2012, the American Society of Clinical Oncology hosted its first annual Quality Care Symposium in San Diego. The attendants and presenters were like-minded individuals who were focused on systematically evaluating and improving cancer care. Throughout the symposium, Donabedian’s structure-process-outcome model was a recurring and unifying framework for evaluating quality metrics. No one questions the importance of improving the quality of care, but many other questions remain: What is quality care? How will it be measured? Will its measurement be comparable across practices? How can small systems that have figured out good solutions to quality care go about reproducing their models of quality care on a larger scale so that we all may benefit?

*Click on the links to the left for PDFs of the full editorial and related articles.

You must be the change you wish to see in the world.
– Mahatma Gandhi

In November 2012, the American Society of Clinical Oncology hosted its first annual Quality Care Symposium in San Diego. The attendants and presenters were like-minded individuals who were focused on systematically evaluating and improving cancer care. Throughout the symposium, Donabedian’s structure-process-outcome model was a recurring and unifying framework for evaluating quality metrics. No one questions the importance of improving the quality of care, but many other questions remain: What is quality care? How will it be measured? Will its measurement be comparable across practices? How can small systems that have figured out good solutions to quality care go about reproducing their models of quality care on a larger scale so that we all may benefit?

*Click on the links to the left for PDFs of the full editorial and related articles.

You must be the change you wish to see in the world.
– Mahatma Gandhi

In November 2012, the American Society of Clinical Oncology hosted its first annual Quality Care Symposium in San Diego. The attendants and presenters were like-minded individuals who were focused on systematically evaluating and improving cancer care. Throughout the symposium, Donabedian’s structure-process-outcome model was a recurring and unifying framework for evaluating quality metrics. No one questions the importance of improving the quality of care, but many other questions remain: What is quality care? How will it be measured? Will its measurement be comparable across practices? How can small systems that have figured out good solutions to quality care go about reproducing their models of quality care on a larger scale so that we all may benefit?

*Click on the links to the left for PDFs of the full editorial and related articles.