Annals of family medicine
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Annals of family medicine · Sep 2014
Cost, utilization, and quality of care: an evaluation of illinois' medicaid primary care case management program.
In 2006, Illinois established Illinois Health Connect (IHC), a primary care case management program for Medicaid that offered enhanced fee-for-service, capitation payments, performance incentives, and practice support. Illinois also implemented a complementary disease management program, Your Healthcare Plus (YHP). This external evaluation explored outcomes associated with these programs. ⋯ The Illinois Medicaid IHC and YHP programs were associated with substantial savings, reductions in inpatient and emergency care, and improvements in quality measures. This experience is not typical of other states implementing some, but not all, of these same policies. Although specific features of the Illinois reforms may have accounted for its better outcomes, the limited evaluation design calls for caution in making causal inferences.
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Caring for patients is an act of interpretation: we labor to understand the significance of a particular symptom and, when we have reached a diagnosis, we convert our medical jargon into plain language for the benefit of the patient. Caring for patients of limited English proficiency-a population that needs a very literal form of interpretation-underscores this lesson. Working with predominantly Spanish-speaking patients has shown me the importance of bearing witness to patients' struggles and has brought me to realize that good physicians must work to forge a common language with all their patients, not only with those who do not speak English.
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Annals of family medicine · Sep 2014
Comparative StudyA tale of 2 countries: the cost of my mother's cardiac care in the United States and India.
When my mother fell ill while visiting me in the United States, I had the opportunity to compare costs of surgical cardiac care in the United States and India. I faced challenges in making well-informed decisions in the United States due to the lack of cost transparency and the minimal flexibility offered in choice of care, whereas in India costs are readily available and allow most people to freely choose their preferred type of care.