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Intro -- PHYSICIAN PRACTICES: CHANGES, TRENDS, AND IMPLICATIONS -- PHYSICIAN PRACTICES: CHANGES, TRENDS, AND IMPLICATIONS -- CONTENTS -- PREFACE -- Chapter 1 PHYSICIAN PRACTICES: BACKGROUND, ORGANIZATION, AND MARKET CONSOLIDATION -- SUMMARY -- INTRODUCTION -- PHYSICIAN SUPPLY -- Supporting Practitioners -- PRACTICE CONSOLIDATION -- Market Trends -- Larger Group Practices and Physician Organizations -- Hospital Affiliation and Employment -- Affiliation with Insurers and Other Payers -- Delivery Reforms -- Concierge Practices -- LEGAL ISSUES -- ISSUES FOR CONGRESS -- Medical Spending -- Access -- Coordinated Care/Quality -- APPENDIX. PHYSICIAN INCOME AND PRACTICE COSTS -- Federal Policies Affecting Compensation -- End Notes -- Chapter 2 PHYSICIAN SUPPLY AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT -- SUMMARY -- INTRODUCTION -- SIZE OF THE PHYSICIAN POPULATION -- Measuring the Physician Population -- Determining the Appropriate Size of the Physician Population -- PPACA and the Size of the Physician Population -- PPACA Provisions Targeting the Number of Physicians Trained -- PPACA Provisions Targeting Physician Productivity -- COMPOSITION OF THE PHYSICIAN POPULATION -- Primary Care Supply and Factors Influencing Primary Care Supply -- PPACA and the Composition of the Physician Population -- PPACA Provisions Targeting Primary Care Supply -- Primary Care Content in Physician Training -- Primary Care Physician Payment -- Care Coordination by Primary Care Physicians -- PPACA Provisions Targeting Shortages in Specialties -- GEOGRAPHIC DISTRIBUTION OF THE PHYSICIAN POPULATION -- Health Professional Shortage Areas and Medically Underserved Areas/Populations -- Why Geographic Shortages May Exist -- PPACA and the Geographic Distribution of the Physician Population -- PPACA Provisions Targeting the NHSC

"Problem: As of December 31, 2008, an estimated 663,084 persons were living with a diagnosis of human immunodeficiency virus (HIV) infection in the 40 U.S. states that have had confidential name-based HIV infection reporting since at least January 2006. Although HIV surveillance programs in the United States collect information about persons who have received a diagnosis of HIV infection and acquired immunodeficiency syndrome (AIDS), supplemental surveillance projects are needed to collect information about care-seeking behaviors, health-care use, and other behaviors among persons living with HIV. Data on the clinical and behavioral characteristics of persons receiving medical care for HIV infection are critical to reduce HIV-related morbidity and mortality and for program planning to allocate services and resources, guide prevention planning, assess unmet medical and ancillary service needs, and help develop intervention programs and health policies at the local, state, and national levels. Reporting Period Covered: Data were collected during June 2007-September 2008 for patients who received medical care in 2007 (sampled from January 1-April 30). Description of the System: The Medical Monitoring Project (MMP) is an ongoing, multisite supplemental surveillance project that assesses behaviors, clinical characteristics, and quality of care of HIV-infected persons who are receiving medical care. Participants must be aged >18 years and have received medical care at sampled facilities that provide HIV medical care within participating MMP project areas. Self-reported behavioral and selected clinical data are collected using an in-person interview. A total of 26 project areas in 19 states and Puerto Rico were funded to collect data during the 2007 MMP data collection cycle. Results: The results from the 2007 MMP cycle indicated that among 3,643 participants, a total of 3,040 (84%) had some form of health insurance or coverage during the 12 months before the interview; of these, 45% reported having Medicaid, 37% reported having private health insurance or coverage through a health maintenance organization, and 30% reported having Medicare. A total of 3,091 (85%) of the participants were currently taking antiretroviral medications. Among 3,609 participants who reported ever having a CD4 T-lymphocyte test, 2,996 (83%) reported having three or more CD4 T-lymphocyte tests in the 12 months before the interview. Among 3,567 participants who reported ever having an HIV viral load test, 2,946 (83%) reported having three or more HIV viral load tests in the 12 months before the interview. Among 3,643 participants, 45% needed HIV case management, 33% needed mental health counseling, and 32% needed assistance finding dental services during the 12 months before the interview; 8%, 13%, and 25% of these participants who needed the services, respectively, had not received these services by the time of the interview. Noninjection drugs were used for nonmedical purposes by 1,117 (31%) participants during the 12 months before the interview, and 122 (3%) participants had used injection drugs for nonmedical purposes. Unprotected anal intercourse was reported by 527 (54%) of 970 men who reported having anal sex with a man during the 12 months before the interview. Unprotected anal or vaginal intercourse was reported by 176 (32%) of the 553 men who reported having anal or vaginal intercourse with a woman during the 12 months before the interview. Unprotected anal or vaginal intercourse was reported by 216 (42%) of the 516 women who reported having anal or vaginal intercourse with a man during the 12 months before the interview. Interpretation: The findings in this report indicate that in 2007, most persons with HIV infection who were receiving medical care were taking antiretroviral therapy and had some form of health insurance or coverage; however, some persons were not receiving needed critical ancillary services, such as HIV case management or help finding dental services. In addition, some persons living with HIV infection engaged in behaviors, such as unprotected sex, that increase the risk for transmitting HIV to sexual partners, and some used noninjection or injection drugs for nonmedical purposes, which might decrease adherence to antiretroviral therapy and increase health-risk behaviors. Public Health Actions: MMP data can be used to monitor the national HIV/AIDS strategy goal of increasing access to care and optimizing health outcomes among persons living with HIV. Persons infected with HIV who are not receiving needed ancillary services highlight missed opportunities for access to care and other supportive services, information that can be used to advocate for additional resources. Drug use among persons with HIV infection underscores the continued need for substance abuse treatment services for this population. In addition, prevention services and programs are needed to decrease the number of HIV-infected persons engaging in unprotected sex. The data in this report can be included in local, state, and national HIV/AIDS epidemiologic profiles and shared with community stakeholders. Although data from the 2007 MMP cycle might not be representative of all persons receiving medical care for HIV infection in the United States or in the individual project areas, future MMP cycles are expected to yield weighted national estimates representing all HIV-infected persons receiving medical care in the United States." - p. 1 ; [Janet M. Blair, A .D. McNaghten, Emma L. Frazier, Jacek Skarbinski, Ping Huang, James D. Heffelfinger ; Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC ; Northrop Grumman, Atlanta, Georgia]. ; Cover title. ; "September 2, 2011." ; "U.S. Government Printing Office: 2011-723-011/21066, Region IV"--P. [4] of cover. ; Also available via the World Wide Web as an HTML file or as an Acrobat .pdf file (428.41 KB, 20 p.). ; Includes bibliographical references (p. 11-12).

Intro -- Foreword -- Preface -- Contents -- Part I: The Journey -- 1: International Medical Graduates and the American Health Care System -- Selected Readings -- 2: Research Experience in the USA -- How to Get a Research Experience in the USA? -- Research Experience in the USA -- How Does Research Help if You Go Back to Your Country? -- How Does Research Help to Stay in the USA? -- 3: What After Training? Returning to Your Own Country -- 4: United States Medical Licensing Examination -- Step 1 -- Step 2 CK -- Test Day -- Typical Procedures -- Using Breaks -- Practice Exams/Test Simulation -- Resources -- Step 2 CS -- Resources -- 5: National Resident Matching Program (NRMP) -- Electronic Residency Application Service (ERAS) -- Letters of Recommendation -- Personal Statement -- Program List -- USMLE Board Scores -- Interviews -- Typical Interview Day -- Attire -- Responding to the Interview Offer -- No Response From Program -- Rank List -- Match Week -- Supplemental Offer and Acceptance Program (SOAP) -- 6: U.S. Immigration Law: Legal Pathways for Physician Immigration -- Introduction: Policy Rationale for Physician Immigration -- Stakeholders in Physician Immigration -- The Immigration Process: Immigrant vs. Non-Immigrant Status -- H-1B Non-immigrant Status -- PERM Labor Certification -- The J-1 Program, Home Residency Requirements, and Waivers -- Hardship/Persecution Waiver -- State Departments of Health as IGAs: The Conrad Waiver -- Health and Human Services IGA Clinical Waiver -- Veterans Affairs and Regional Authorities IGA Waiver -- Health and Human Services IGA Research Waiver -- Exceptional, Outstanding, and Extraordinary Abilities -- Extraordinary Ability -- O-1 Non-immigrant Extraordinary Ability -- Outstanding Professors and Researchers -- NYSDOT/ Dhanasar National Interest Waiver

Cover Page -- Title Page -- Copyright Page -- Table of Contents -- Acknowledgments -- Foreword -- Introduction -- PART I: UNDERSTANDING U.S. HEALTH CARE, UP THROUGH OBAMACARE -- PART II: OBAMACARE, THE FUTILITY OF HEALTH REDISTRIBUTION -- PART III: SAVE YOURSELF -- PART IV: FREEDOM IS THE ANSWER -- 1. How We Got Here: A Brief History of US Health Care Through 2009 -- 2. The Deadly FDA -- 3. The Medicare Ponzi Scheme -- 4. The Perverse Economics of US Medicine -- 5. The Inner "Logic" of the Affordable Care Act -- 6. Fatal Flaws of the ACA -- 7. Paving the Way for "Single Payer

Cover -- About This Issue Guide -- Introduction: Health Care: How Can We Reduce Costs and Still Get the Care We Need? -- Higher Spending, Poorer Health -- What Can Be Done? -- Option One: As a Nation and as Individuals, We Need to Live within Our Means -- Competing Values -- Making Medicare Last -- The Conversation -- More at Stake -- What We Could Do -- Option Two: Make Health Care More Transparent, Accountable, and Efficient -- Follow the Money -- The American Way of Birth -- Increasing Coordination, Shutting Out Big Pharma -- End the Seller's Market -- What We Could Do

Intro -- FEDERAL HEALTH CENTERS IMPROVING CARE FOR THE MEDICALLY UNDERSERVED -- FEDERAL HEALTH CENTERS IMPROVING CARE FOR THE MEDICALLY UNDERSERVED -- CONTENTS -- PREFACE -- Chapter 1 FEDERAL HEALTH CENTERS* -- ABSTRACT -- INTRODUCTION -- WHAT IS THE FEDERAL HEALTH CENTER PROGRAM? -- Statutory Authority and General Requirements25 -- Location Requirements -- Fee Schedule Requirements -- Medicaid Coordination and Reimbursement Requirements -- Governance Requirements -- Health Service Requirements -- Reporting and Quality Assurance Requirements -- Licensing and Accreditation Requirements -- Grants that Support Federal Health Centers -- Types of Grants Available to Support Health Centers -- Grant Eligibility and Awarding Criteria -- What Is the Health Center Program's Appropriation? -- What Are the Other Sources of Funding for the Health Center Program? -- WHAT ARE HEALTH CENTERS? -- What Types of Health Centers Exist? -- Community Health Centers -- Health Centers for the Homeless -- Health Centers for Residents of Public Housing -- Migrant Health Centers -- Who Uses Health Centers? -- Where Are Health Centers Located? -- What Outcomes Are Associated with Health Center Use? -- Health Outcomes -- Cost Outcomes -- Access to Health Care -- Which Federal Programs Are Available to Health Centers? -- National Health Service Corps Providers -- J-1 Visa Waivers -- Federally Qualified Health Center Designation87 -- 340B Drug Pricing Program92 -- Vaccines for Children Program94 -- Federal Torts Claims Act Coverage -- Ryan White HIV/AIDS Treatment Grants99 -- Other Federal Grant Programs'0' -- ISSUES FOR CONGRESS -- Health Centers and Health Insurance Expansion in the ACA -- Health Centers and Medicaid Expansion -- Health Centers and ACA Private Insurance Expansions -- Health Center Workforce -- National Health Service Corps Providers

Examined is prewelfare state medical care in GB, from the mid-nineteenth to the mid-twentieth century. It is shown that, prior to 1911, the majority of the population provided medical care for themselves & had developed a variety of schemes that checked the power of organized medicine. By the end of the nineteenth century, about 5% of the population obtained health care via the "poor law," 10%-15% obtained it via free care from charitable institutions, & about 75% paid fees to private doctors. Also discussed is the National Insurance scheme of 1911 & the role of nongovernmental health care in the modern era. 2 Tables. W. Howard

America's 3 trillion healthcare system is undergoing its most tumultuous changes in a half century. Although covering the uninsured and the individual mandate to purchase insurance has received the most attention, these are not the most important developments driving change. Rather, it is the rapidly accelerating movement from a volume to a value based healthcare financing system that will be most responsible for creating a very different healthcare industry by the end of this decade. Unsustainable cost pressures have been mounting on the government and employers as the ultimate purchasers of healthcare. Left unabated, these forces will render our nation economically destitute and our companies globally uncompetitive in the years and decades ahead. Although the Great Recession provided a five year respite, with the growing economic recovery and the addition of millions of previously uninsured to the marketplace, healthcare cost increases are returning. What can be done to prevent a return to double-digit healthcare inflation in a national economy, business and consumer environment that can no longer sustain that? The "Quadruple Aim" is a one goal enhancement (i.e. decreasing medical liability) to that of the better known "Triple Aim", which seeks better care, improved individual and population health and lower costs. The Triple Aim has served as the North Star toward which all reform efforts at least should be pointed. But can achievement of the Triple Aim also result in accomplishing the Quadruple Aim (simultaneously decreasing the risks and actualities of medical liability)? Conversely, what will likely be the enduring value of achieving the Triple Aim if accomplishing the Quadruple Aim is not possible? The overarching theme of this book addresses those questions in the context of a technology-driven, rapidly transforming healthcare industry.

THIS ARTICLE STATES THAT NOWHER IS THE INABILITY OF THE SOVIET STATE TO UPHOLD ITS PART OF THE SOCIAL CONTRACT WITH ITS SITIZENS DEMONSTRATED MORE GRAPHICALLY AS IN HEALTH CARE. THE DUAL ILLNESS THAT PARALYZES THE SOVIET ECONOMY AND SOCIETY MATERIAL PVERTY AND EXHAUSTION ON ONE HAND AND THE TOTAL BREAKDOWN OF LABOR MORE ON THE OTHER-IS LEAVING DEEP SCARS ON SOVIET MEDICINE.

Information on families' use of health care in 1980 is presented in this report. The data discussed here were gathered in the national household sample of the National Medical Care Utilization and Expenditure Survey. In this sample, information was collected on health problems, health care received, expenditures for care, health insurance, and related topics throughout calendar year 1980 from approximately 6,800 families in the U.S. civilian noninstitutionalized population. (The report entirely excludes families with military heads, even if they have civilian members.) For this report, a family was initially defined as (1) two or more persons living together who were related by either blood, marriage, adoption, or a formal foster care relationship or (2) a single person living outside such relationships. But because these data were collected across an entire year, the important concept of "Longitudinal family" was developed. This concept was necessary to deaI with the fact that the composition of a family could change over time and that families could come into existence and go out of existence over time. As the data are based on this dynamic concept of families, all measures of the use of health services are calculated in annual rates. Family data are important for understanding the health care system because decisions to seek and use health care are usually family decisions, health care is usually paid for out of family resources, and family distributions for health-related variables differ from the distributions found for individuals. Data on both multi- pie-person families (families that averaged 1.5 persons or more during the year) and one-person families (families that averaged less than 1.5 persons during the year) are presented in this report. Only findings for multiple-person families, however, are addressed in this section. It is multiple-person families that are usually referred to in discussions of families by both the general public and professional social scientists. General Findings: The burden of illness in the U.S. population, as measured by poor or fair health on a scale of perceived health status, is much more widespread among families than among individuals. For example, 25 percent of families with all members under 65 years of age had a member whose health was rated fair or poor, compared with 10 percent of aH persons under 65. The completeness of health care coverage (by a pub_ lic coverage program or by private health insurance) also differed between families and individuals. Again comparing persons and families under 65 years of age, 29 percent of families had members without full-year coverage, compared with 19 percent of per- sons without such coverage. ; Written by: Marvin Dicker and Jonathan H. Sunshine. ; "February 1987." ; Bibliography: p. 28-29.