Two randomized trials of pay for performance (P4P) published last week in JAMA give more insight on using financial incentives to improve compliance with guideline-based practice.

The first by Bardach et al. was done in small (<10 clinicians) primary care clinics in New York City, which was unlike most previous studies conducted in large health care systems. In this study, one cluster of 42 clinics received performance reports and bonuses (max $200/patient) if improvements were made on appropriately prescribed aspirin, shared smoking cessation interventions, controlled blood pressure, and controlled cholesterol levels....

On the 12th anniversary of the September 11 terrorist attacks, we remember those we lost, those who came to the rescue, and all of us who came together as a national and global community. Today, people all over are commemorating not the terror, but the strength and courage of humanity. Yet, it cannot go unnoticed that many people are still suffering from the aftermath of such a tragedy.

Health issues abound, with more than 1,100 people who worked or lived near the World Trade Center (WTC) in New York diagnosed with cancer, and many others in New York, D.C., and elsewhere with various types of respiratory diseases and mental health trauma.

For the people of New York, the New York City Health and Hospitals Corporation, a member of America’s Essential Hospitals, offers medical and mental health services through its WTC Environmental Health Center....

As wildfires continue to ravage the Western United States, Dr. David Pate, president and CEO of Boise, Idaho-based St. Luke’s Health System, recognized the dedication of staff members as they worked to respond to the community’s health needs.

The original version of this post appeared on Dr. Pate’s blog, “Prescription for Change.” For more stories of excellence in emergency response, explore those highlighted this month by America’s Essential Hospitals.

Faced with a very large and aggressive fire in our area, the outstanding St....

The Affordable Care Act gave me hope that coverage expansion would be the law of the land: Young people are able to stay on their parents’ health insurance plans until they’re 26! People with pre-existing conditions can’t be denied coverage! More people will be eligible for Medicaid coverage!

Sounds good, right? But it remains to be seen how many more people will really be covered.

Remember last summer when the Supreme Court ruled that states have the option to expand their Medicaid programs to cover more people? As a result of that ruling, approximately half of the 50 states have decided that they aren’t going to expand in 2014....

My friends in the GOP are at a crossroads. The party once stood strong behind “Repeal, Repeal, Repeal!” in reference to the Affordable Care Act, but now that the Obama administration is recognizing some challenges in implementing the law, things have changed.

Shawn Gremminger and I have been discussing this for over a year now. At what point will the rhetoric shift so we can actually make some productive changes to the law? (cough.. cough..(DSH cuts, anyone?!) Both parties have done a terrific job at standing their ground. For the most part, Democrats refuse to change any part of the law while Republicans will be happy to change the entire law by repealing it… completely.

 Like all dysfunctional couples, neither side refuses to admit they are wrong and we sit in this awesome stalemate, also known as 2010-2013....

The age-old philosophical question, "If a tree falls in the forest and no one is around to hear it, does it make a sound?" has always reminded us the fact that objects of sense exist only when they are perceived. When it comes to health care, the relevant analogy is: If the best care or good care, as in the case below, is provided, and patients/families are not engaged, does it make an impact on the patient experience of said care? Well, we will come back to the obvious answer at the end of Amina’s story below.

The Institute of Medicine (IOM), in its 2001 report titled “Crossing the Quality Chasm: A New Health System for the 21st Century,” provided a more detailed examination of the immense divide between what we know to be good health care and the health care that people actually receive.

This report outlined the “six aims” necessary for improvement of the health system....

In California’s public hospitals, over 50% of patients have limited English proficiency and it is expected that this percentage will only increase over the next several years. As a result, patient experience in the safety net will continue to be greatly influenced by language barriers; and the effectiveness of our care greatly dependent on the availability and effectiveness of interpreter services.

Dakle, kako je to susresti se sa sistemom zdravstva na jeziku kojim ne vladate? Kako je to iskusiti jezičnu barijeru pri susretu sa svojim liječnikom bez pomoći prevodioca? Na neki način, to je kao kad biste željeli razumjeti ovaj dio teksta bez poznavanja hrvatskog jezika, a znajući da je baš taj dio teksta jako bitan za vaše zdravlje....

I’ve written previously on this blog about the imperative of delaying the Affordable Care Act’s (ACA) Medicaid Disproportionate Share Hospital (DSH) cuts, I am not disappointed to announce that the early-year DSH cuts are even more absurd that before. Not only is it now clear that more than half of the 50 states will choose not to expand Medicaid in 2014, but we now know that the Employer Mandate – one of the ACA’s various provisions designed to increase coverage – will not be implemented until 2015. Top White House advisor Valerie Jarrett announced the delay in implementing the employer mandate on the White House blog on July 2....

Last month, the Essential Hospitals Engagement Network (EHEN), formerly the NAPH Safety Network, kicked off its health equity improvement work with a special webinar, “Achieving Equity in Care in the Safety Net.” The EHEN is the only Partnership for Patients (PfP) hospital engagement network (HEN) that is focusing exclusively on hospitals caring for the most vulnerable and diverse patients.

Background on disparities
Health disparities are population-specific differences in the presence of disease, health outcomes, care quality and access to care that exist across racial and ethnic groups. Disparities represent a lack of efficiency within the health care system and account for unnecessary costs....

When Asiana Flight 214 crash landed at San Francisco International Airport on Saturday, local hospitals – including America’s Essential Hospitals member San Francisco General Hospital – went into disaster mode.

The Boeing 777 aircraft reportedly crashed into the runway after the plane descended too slowly and its engines began to stall. The latest news reports indicate that investigators now are turning their attention to possible pilot error....