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To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a health care thought leader. The October issue features a conversation with Kavita K. Patel, MD, MS, nonresident fellow at The Brookings Institution and editorial board member of AJMC®.

As a field of research, a viable approach to improving health outcomes, and an important area of policy, health literacy has experienced significant growth and considerable evolution since its broad introduction in the 1990s. Despite that history, far too many practitioners, researchers, and policymakers focusing on clinical medicine, health systems, public health, and health policy remain unaware of and unaffected by the best practices of health literacy. While the inherent promise of health literacy is improved health and well-being, the bulk of research has focused on identifying the negative effects of a lack of health literacy. This strategy is a hindrance to further identifying the utility and increasing the uptake of lessons learned about health literacy in government, business, health care systems, and society. The field needs to reverse direction away from that deficit model of health literacy and focus collective efforts on a positive model of how health literacy can and should be prioritized and utilized to improve health at lower costs. This shift from framing health literacy as a problem to proving the viability and strength of health literacy as a solution will present to policymakers a clear choice to either adopt and promote the best practices of health literacy or suffer the consequences of being the leader who ignored a proven, viable solution to the currently unsustainable health care expenditures and ever-increasing burden of preventable disease, disability, and early death. [ABSTRACT FROM PUBLISHER]

The article offers information on accountable care organizations (ACOs) are that aims to improve quality of care while controlling costs for populations of patients in the U.S. ACOs took conceptual shape in 2005 and with an objective to achieve the triple aim of better health, better care, and lower costs, payment and delivery systems.

Under the Affordable Care Act, up to thirteen million adults have the opportunity to obtain health insurance through an expansion of the Medicaid program. A great deal of effort is currently being devoted to eligibility verification, outreach, and enrollment. We look beyond these important first-phase challenges to consider what people who are transitioning back to the community after incarceration need to receive effective care. It will be possible to deliver cost-effective, high-quality care to this population only if assistance is coordinated between the correctional facility and the community, and across diverse treatment and support organizations in the community. This article discusses several examples of successful coordination of care for formerly incarcerated people, such as Project Bridge and the Community Partnerships and Supportive Services for HIV-Infected People Leaving Jail (COMPASS) program in Rhode Island and the Transitions Clinic program that operates in ten US cities. To promote broader adoption of successful models, we offer four policy recommendations for overcoming barriers to integrating individuals into sustained, community-based care following their release from incarceration. [ABSTRACT FROM AUTHOR]

The journey of national health reform legislation from concept to President Barack Obama's desk was long and winding, but not without important guideposts. Core elements of Massachusetts' 2006 health reform-near-universal, affordable coverage; changes in the small-group and individual insurance markets; and an individual mandate to obtain insurance-provided a road map for policy makers charting national health reform. Our experience with the Massachusetts reform informed our work on the Senate Health, Education, Labor, and Pensions Committee in 2008 and 2009. We compare national and Massachusetts health reforms and analyze their implications for the future. [ABSTRACT FROM AUTHOR]

The article discusses the recommendations by the U.S. National Commission on Physician Payment Reform (NCPPR) for the reimbursement, finance and determination by Medicare on the value of healthcare services provided by physicians. The recommendation to eliminate the Sustainable Growth Rate (SGR) is explained. The call for the repeal of the SGR to be paid for with cost-savings from the Medicare program as a whole is also explained.

Rising health care costs will result in reduced payments to providers, but across-the-board provider payment reductions are not the answer. Instead, existing payment systems should be reformed to strengthen value for the dollars spent. This can be accomplished by increasing efficiency, improving quality and outcomes, and lowering costs. Payment system reforms must be practical, transparent, identify opportunities for care improvement, and demonstrate material cost savings. Most importantly, because the current growth in health care costs is unsustainable, these reforms must be able to be implemented today. A set of comprehensive measures is being used by state government and private payers in the United States to adjust payment, based on improved outcomes quality. This article details the use of this set of measures, referred to as potentially preventable events, and demonstrates how they are being applied to achieve health care value. [ABSTRACT FROM AUTHOR]

The article offers a summary of the measures referred to as Potentially preventable events (PPEs) identified as overtreatment, complications and unnecessary services in inpatient and outpatient settings. It cites the 5 types of health care encounters that can be preventable including the preventable admissions, preventable emergency room visits and preventable complications. It cites the quantifiable results shown by PPE measures to improve care outcomes and simultaneously reduce costs.