“It’s past time to get serious about transforming care.” That’s how Health Affairs Editor-in-Chief Susan Dentzer opens the January issue of the journal. The articles in this month’s issue examine strategies and challenges to achieving high quality care at lower costs. With expansion deadlines looming, delivery transformations are top of mind for providers and decision makers. Coverage expansions coming through the ACA will create an increase in demand for primary care, and author Linda Green addresses the math behind the physician/nurse shortage data. Health insurance exchanges will play an important role in defining how individuals access health care, and authors examine lessons from San Francisco’s ‘pay or play’ program and consumers’ experiences with the Massachusetts Connector. Increased adoption of health IT resources is a popular solution to transforming care. However, an analysis by AcademyHealth members Arthur Kellermann and Spencer Jones of electronic medical record use has called into question some commonly held assumptions about EMRs. They found that despite large investments, EMR use will not translate to cost savings unless health IT systems can work with each other.
“We believe that the original promise of health IT can be met if the systems are redesigned to address these flaws by creating more standardized systems that are easier to use, are truly interoperable, and afford patients more access to and control over their health data. Providers must do their part by reengineering care processes to take full advantage of efficiencies offered by health IT, in the context of redesigned payment models that favor value over volume.”In other words, having data is not enough. True success will depend on how providers can translate that data into policy and practice to improve outcomes and reduce costs. Overall, the issue takes an in-depth look at some of the key questions providers, policymakers, and patients are facing in an evolving health care environment. The following AcademyHealth members were published in the January issue of the journal: Primary Care Physician Shortages Could Be Eliminated Through Use Of Teams, Nonphysicians, And Electronic Communication Linda V. Green Slow Progress On Meeting Hospital Safety Standards: Learning From The Leapfrog Group’s Efforts John Moran and Dennis Scanlon Mobile Clinic In Massachusetts Associated With Cost Savings From Lowering Blood Pressure And Emergency Department Use Zirui Song US Spending On Complementary And Alternative Medicine During 2002–08 Plateaued, Suggesting Role In Reformed Health System Matthew A. Davis Small Physician Practices In New York Needed Sustained Help To Realize Gains In Quality From Use Of Electronic Health Records Andrew M. Ryan, Tara F. Bishop, and Lawrence P. Casalino ANALYSIS & COMMENTARY: What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology Arthur L. Kellermann and Spencer S. Jones San Francisco’s ‘Pay Or Play’ Employer Mandate Expanded Private Coverage By Local Firms And A Public Care Program Carrie H. Colla and William H. Dow The Experience Of Massachusetts Shows That Consumers Will Need Help In Navigating Insurance Exchanges Anna D. Sinaiko, Dennis Ross-Degnan, Tracy Lieu, and Alison Galbraith The Redistribution Of Graduate Medical Education Positions In 2005 Failed To Boost Primary Care Or Rural Training Candice Chen, Imam Xierali, and Robert Phillips Regions With Higher Medicare Part D Spending Show Better Drug Adherence, But Not Lower Medicare Costs For Two Diseases Bruce Stuart, J. Samantha Shoemaker, and Amy J. Davidoff Blacks And Hispanics Are Less Likely Than Whites To Complete Addiction Treatment, Largely Due To Socioeconomic Factors Brendan Saloner The Affordable Care Act Has Led To Significant Gains In Health Insurance And Access To Care For Young Adults Benjamin D. Sommers After-Hours Access To Primary Care Practices Linked With Lower Emergency Department Use And Less Unmet Medical Need Ann S. O’Malley Health Affairs is an official journal of AcademyHealth.