Health affairs
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In the past two years, the United States has made a historic investment in biomedical research. But innovative medicines often stall in the pipeline from microscope to market. To deliver the next generation of cures and treatments to help Americans live longer, healthier, and more comfortable lives, strong, strategic partnerships both within government and among government, academe, industry, and nonprofits are needed at every stage of drug development. In this article I describe actual and potential efforts on the part of the US government--including the Biomarkers Consortium and National Institutes of Health Therapeutics for Rare and Neglected Diseases program--to work with other stakeholders to advance biomedical research and development.
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A major issue for the US health care system will be accommodating the needs of the estimated thirty-two million Americans who will gain insurance coverage under the Affordable Care Act by 2019. For hospitals, a traditional response to this increased demand might be to add resources, such as more staff and beds. ⋯ We argue that once managed efficiently, US hospitals, on average, could achieve at least an 80-90 percent bed occupancy rate--at least 15 percent higher than the current level--without adding beds at capital costs of approximately $1 million per bed. This article outlines a plan for hospitals to accommodate more patients without increasing beds or staff, and for policy makers to require hospitals to make these changes or provide incentives for them to do so.
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In January 2009 Blue Cross Blue Shield of Massachusetts launched a new payment arrangement called the Alternative Quality Contract. The contract stipulates a modified global payment (fixed payments for the care of a patient during a specified time period) arrangement. ⋯ This arrangement exemplifies the type of experimentation encouraged by the Affordable Care Act. We describe this unique contract and show how it surmounts hurdles previously encountered with other global-payment models.