Medicaid Politics and Policy

Medicaid Politics and Policy

Author: David G. Smith

Publisher: Transaction Publishers

Published: 2011-12-31

Total Pages: 459

ISBN-13: 1412809401

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Medicaid is a story worth telling, one rooted in American history and shaped by its culture and institutions. It has dramatic interest, heroes and heroines, triumphs and tragedies. The authors make this story come alive for the reader by providing a strong connected narrative, detailed accounts of important policy changes, and extensive use of interviews with individuals close to events. They emphasize politics and policy along with history. History is important because Medicaid has developed incrementally, layer by layer, so that almost any provision or activity needs a historical gloss to understand it. The Medicaid program has been especially subject to outside political and policy influences: the state of the economy, trends in federalism, developments in health or welfare programs, and the electoral cycle. Politics helps us understand policy outcomes. But the two go together: a knowledge of policy helps understand what is at stake, and a knowledge of politics what is possible. A central theme of the book is that Medicaid is a "weak entitlement," one less established or effectively defended than Medicare or Social Security, but more secure than welfare or food stamps. Medicaid has the flexibility to adapt (or be adapted) as well as a capacity to defend incremental and opportunistic gains. At the same time, the program lacks an effective mechanism for overall reform. It has grown enormously since its inception to become the largest health insurance system in the country, a source of perennial complaint and, most recently, of continuing crisis. The dual emphasis upon politics and policy is important to make the arcane Medicaid program accessible to the reader, and to distinguish policy grounded in facts and analysis from partisan bombast and ideology. The result is an authoritative account and reference for those seeking to refresh a perspective or to look further.


Book Synopsis Medicaid Politics and Policy by : David G. Smith

Download or read book Medicaid Politics and Policy written by David G. Smith and published by Transaction Publishers. This book was released on 2011-12-31 with total page 459 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid is a story worth telling, one rooted in American history and shaped by its culture and institutions. It has dramatic interest, heroes and heroines, triumphs and tragedies. The authors make this story come alive for the reader by providing a strong connected narrative, detailed accounts of important policy changes, and extensive use of interviews with individuals close to events. They emphasize politics and policy along with history. History is important because Medicaid has developed incrementally, layer by layer, so that almost any provision or activity needs a historical gloss to understand it. The Medicaid program has been especially subject to outside political and policy influences: the state of the economy, trends in federalism, developments in health or welfare programs, and the electoral cycle. Politics helps us understand policy outcomes. But the two go together: a knowledge of policy helps understand what is at stake, and a knowledge of politics what is possible. A central theme of the book is that Medicaid is a "weak entitlement," one less established or effectively defended than Medicare or Social Security, but more secure than welfare or food stamps. Medicaid has the flexibility to adapt (or be adapted) as well as a capacity to defend incremental and opportunistic gains. At the same time, the program lacks an effective mechanism for overall reform. It has grown enormously since its inception to become the largest health insurance system in the country, a source of perennial complaint and, most recently, of continuing crisis. The dual emphasis upon politics and policy is important to make the arcane Medicaid program accessible to the reader, and to distinguish policy grounded in facts and analysis from partisan bombast and ideology. The result is an authoritative account and reference for those seeking to refresh a perspective or to look further.

Medicaid Politics and Policy, 1965-2007

Medicaid Politics and Policy, 1965-2007

Author: David G. Smith

Publisher: Transaction Pub

Published: 2008

Total Pages: 444

ISBN-13: 9781412807371

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Medicaid is a story worth telling, one rooted in American history and shaped by its culture and institutions. It has dramatic interest, heroes and heroines, triumphs and tragedies. The authors make this story come alive for the reader by providing a strong connected narrative, detailed accounts of important policy changes, and extensive use of interviews with individuals close to events. They emphasize politics and policy along with history. History is important because Medicaid has developed incrementally, layer by layer, so that almost any provision or activity needs a historical gloss to understand it. The Medicaid program has been especially subject to outside political and policy influences: the state of the economy, trends in federalism, developments in health or welfare programs, and the electoral cycle. Politics helps us understand policy outcomes. But the two go together: a knowledge of policy helps understand what is at stake, and a knowledge of politics what is possible. A central theme of the book is that Medicaid is a "weak entitlement," one less established or effectively defended than Medicare or Social Security, but more secure than welfare or food stamps. Medicaid has the flexibility to adapt (or be adapted) as well as a capacity to defend incremental and opportunistic gains. At the same time, the program lacks an effective mechanism for overall reform. It has grown enormously since its inception to become the largest health insurance system in the country, a source of perennial complaint and, most recently, of continuing crisis. The dual emphasis upon politics and policy is important to make the arcane Medicaid program accessible to the reader, and to distinguish policy grounded in facts and analysis from partisan bombast and ideology. The result is an authoritative account and reference for those seeking to refresh a perspective or to look further.


Book Synopsis Medicaid Politics and Policy, 1965-2007 by : David G. Smith

Download or read book Medicaid Politics and Policy, 1965-2007 written by David G. Smith and published by Transaction Pub. This book was released on 2008 with total page 444 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid is a story worth telling, one rooted in American history and shaped by its culture and institutions. It has dramatic interest, heroes and heroines, triumphs and tragedies. The authors make this story come alive for the reader by providing a strong connected narrative, detailed accounts of important policy changes, and extensive use of interviews with individuals close to events. They emphasize politics and policy along with history. History is important because Medicaid has developed incrementally, layer by layer, so that almost any provision or activity needs a historical gloss to understand it. The Medicaid program has been especially subject to outside political and policy influences: the state of the economy, trends in federalism, developments in health or welfare programs, and the electoral cycle. Politics helps us understand policy outcomes. But the two go together: a knowledge of policy helps understand what is at stake, and a knowledge of politics what is possible. A central theme of the book is that Medicaid is a "weak entitlement," one less established or effectively defended than Medicare or Social Security, but more secure than welfare or food stamps. Medicaid has the flexibility to adapt (or be adapted) as well as a capacity to defend incremental and opportunistic gains. At the same time, the program lacks an effective mechanism for overall reform. It has grown enormously since its inception to become the largest health insurance system in the country, a source of perennial complaint and, most recently, of continuing crisis. The dual emphasis upon politics and policy is important to make the arcane Medicaid program accessible to the reader, and to distinguish policy grounded in facts and analysis from partisan bombast and ideology. The result is an authoritative account and reference for those seeking to refresh a perspective or to look further.

Medicaid Politics

Medicaid Politics

Author: Frank J. Thompson

Publisher: Georgetown University Press

Published: 2012-09-20

Total Pages: 289

ISBN-13: 1589019342

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Medicaid, one of the largest federal programs in the United States, gives grants to states to provide health insurance for over 60 million low-income Americans. As private health insurance benefits have relentlessly eroded, the program has played an increasingly important role. Yet Medicaid’s prominence in the health care arena has come as a surprise. Many astute observers of the Medicaid debate have long claimed that “a program for the poor is a poor program� prone to erosion because it serves a stigmatized, politically weak clientele. Means-tested programs for the poor are often politically unpopular, and there is pressure from fiscally conservative lawmakers to scale back the $350-billion-per-year program even as more and more Americans have come to rely on it. For their part, health reformers had long assumed that Medicaid would fade away as the country moved toward universal health insurance. Instead, Medicaid has proved remarkably durable, expanding and becoming a major pillar of America’s health insurance system. In Medicaid Politics, political scientist Frank J. Thompson examines the program’s profound evolution during the presidential administrations of Bill Clinton, George W. Bush, and Barack Obama and its pivotal role in the epic health reform law of 2010. This clear and accessible book details the specific forces embedded in American federalism that contributed so much to Medicaid’s growth and durability during this period. It also looks to the future outlining the political dynamics that could yield major program retrenchment.


Book Synopsis Medicaid Politics by : Frank J. Thompson

Download or read book Medicaid Politics written by Frank J. Thompson and published by Georgetown University Press. This book was released on 2012-09-20 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid, one of the largest federal programs in the United States, gives grants to states to provide health insurance for over 60 million low-income Americans. As private health insurance benefits have relentlessly eroded, the program has played an increasingly important role. Yet Medicaid’s prominence in the health care arena has come as a surprise. Many astute observers of the Medicaid debate have long claimed that “a program for the poor is a poor program� prone to erosion because it serves a stigmatized, politically weak clientele. Means-tested programs for the poor are often politically unpopular, and there is pressure from fiscally conservative lawmakers to scale back the $350-billion-per-year program even as more and more Americans have come to rely on it. For their part, health reformers had long assumed that Medicaid would fade away as the country moved toward universal health insurance. Instead, Medicaid has proved remarkably durable, expanding and becoming a major pillar of America’s health insurance system. In Medicaid Politics, political scientist Frank J. Thompson examines the program’s profound evolution during the presidential administrations of Bill Clinton, George W. Bush, and Barack Obama and its pivotal role in the epic health reform law of 2010. This clear and accessible book details the specific forces embedded in American federalism that contributed so much to Medicaid’s growth and durability during this period. It also looks to the future outlining the political dynamics that could yield major program retrenchment.

Entitlement Politics

Entitlement Politics

Author: David G. Smith

Publisher: Transaction Publishers

Published:

Total Pages: 444

ISBN-13: 9780202365886

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Entitlement Politics describes partisan attempts to shrink the size of government by targeting two major federal health care entitlements. Efforts to restructure or eliminate entitlements as such, and to privatize and decentralize programs, along with more traditional attempts to amend and reform Medicare and Medicaid have radically transformed policymaking with respect to these programs. However, they have failed to achieve fundamental or lasting reform. Smith combines historical narrative and case studies with descriptions of the technical aspects and dynamics of policymaking to help the consumer understand how the process has changed, evaluate particular policies and outcomes, and anticipate future possibilities. His account intentionally goes at some length into the substance of the programs, the policies that are involved, and the views of different protagonists about the major issues in the dispute. One unhealthy consequence of politicizing Medicare and Medicaid policy has been to separate public debate from the technical and organizational realities underlying issues of cost containment or program structure. Smith considers this development unfortunate, since it leaves even informed citizens unable to evaluate the claims being made. Ironically, strife over Medicare has complicated the political and policy issues in American life. Only a serious and genuine bipartisan effort bringing forth the best efforts of both political parties--and some of the best industry leaders and policy experts in the field--is likely to achieve genuine reform. The more people and parties know about the history, politics, and policies of these programs, the better our prospects for devising workable, equitable, and lasting solutions. This volume leads the way toward that understanding. David G. Smith is Richter Professor Emeritus of Political Science at Swarthmore College and has been a student of health policy since 1965. Among his books is an earlier study of health policy, Paying for Medicare.


Book Synopsis Entitlement Politics by : David G. Smith

Download or read book Entitlement Politics written by David G. Smith and published by Transaction Publishers. This book was released on with total page 444 pages. Available in PDF, EPUB and Kindle. Book excerpt: Entitlement Politics describes partisan attempts to shrink the size of government by targeting two major federal health care entitlements. Efforts to restructure or eliminate entitlements as such, and to privatize and decentralize programs, along with more traditional attempts to amend and reform Medicare and Medicaid have radically transformed policymaking with respect to these programs. However, they have failed to achieve fundamental or lasting reform. Smith combines historical narrative and case studies with descriptions of the technical aspects and dynamics of policymaking to help the consumer understand how the process has changed, evaluate particular policies and outcomes, and anticipate future possibilities. His account intentionally goes at some length into the substance of the programs, the policies that are involved, and the views of different protagonists about the major issues in the dispute. One unhealthy consequence of politicizing Medicare and Medicaid policy has been to separate public debate from the technical and organizational realities underlying issues of cost containment or program structure. Smith considers this development unfortunate, since it leaves even informed citizens unable to evaluate the claims being made. Ironically, strife over Medicare has complicated the political and policy issues in American life. Only a serious and genuine bipartisan effort bringing forth the best efforts of both political parties--and some of the best industry leaders and policy experts in the field--is likely to achieve genuine reform. The more people and parties know about the history, politics, and policies of these programs, the better our prospects for devising workable, equitable, and lasting solutions. This volume leads the way toward that understanding. David G. Smith is Richter Professor Emeritus of Political Science at Swarthmore College and has been a student of health policy since 1965. Among his books is an earlier study of health policy, Paying for Medicare.

The Political Life of Medicare

The Political Life of Medicare

Author: Jonathan Oberlander

Publisher: University of Chicago Press

Published: 2003-06

Total Pages: 275

ISBN-13: 0226615960

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In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.


Book Synopsis The Political Life of Medicare by : Jonathan Oberlander

Download or read book The Political Life of Medicare written by Jonathan Oberlander and published by University of Chicago Press. This book was released on 2003-06 with total page 275 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.

Fragmented Democracy

Fragmented Democracy

Author: Jamila Michener

Publisher: Cambridge University Press

Published: 2018-03-22

Total Pages:

ISBN-13: 1108245323

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Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.


Book Synopsis Fragmented Democracy by : Jamila Michener

Download or read book Fragmented Democracy written by Jamila Michener and published by Cambridge University Press. This book was released on 2018-03-22 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.

Healthcare Politics and Policy in America: 2014

Healthcare Politics and Policy in America: 2014

Author: Kant Patel

Publisher: Routledge

Published: 2014-12-18

Total Pages: 615

ISBN-13: 1317468821

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This book provides a comprehensive examination of the ways that health policy has been shaped by the political, socioeconomic, and ideological environment of the United States. The roles played by public and private, institutional and individual actors in designing the healthcare system are identified at all levels. The book addresses the key problems of healthcare cost, access, and quality through analyses of Medicare, Medicaid, the Veterans Health Administration, and other programs, and the ethical and cost implications of advances in healthcare technology. This fully updated fourth edition gives expanded attention to the fiscal and financial impact of high healthcare costs and the struggle for healthcare reform, culminating in the passage of the Affordable Care Act, with preliminary discussion of implementation issues associated with the Affordable Care Act as well as attempts to defund and repeal it. Each chapter concludes with discussion questions and a comprehensive reference list. Helpful appendices provide a guide to websites and a chronology. PowerPoint slides and other instructional materials are available to instructors who adopt the book.


Book Synopsis Healthcare Politics and Policy in America: 2014 by : Kant Patel

Download or read book Healthcare Politics and Policy in America: 2014 written by Kant Patel and published by Routledge. This book was released on 2014-12-18 with total page 615 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive examination of the ways that health policy has been shaped by the political, socioeconomic, and ideological environment of the United States. The roles played by public and private, institutional and individual actors in designing the healthcare system are identified at all levels. The book addresses the key problems of healthcare cost, access, and quality through analyses of Medicare, Medicaid, the Veterans Health Administration, and other programs, and the ethical and cost implications of advances in healthcare technology. This fully updated fourth edition gives expanded attention to the fiscal and financial impact of high healthcare costs and the struggle for healthcare reform, culminating in the passage of the Affordable Care Act, with preliminary discussion of implementation issues associated with the Affordable Care Act as well as attempts to defund and repeal it. Each chapter concludes with discussion questions and a comprehensive reference list. Helpful appendices provide a guide to websites and a chronology. PowerPoint slides and other instructional materials are available to instructors who adopt the book.

The Politics of Medicaid

The Politics of Medicaid

Author: Laura Katz Olson

Publisher: Columbia University Press

Published: 2010-06-02

Total Pages: 442

ISBN-13: 0231150601

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Examining the social, political and economic factors that have shaped Medicaid, the author of The Political Economy of Aging: The State, Private Power, and Social Welfare helps readers understand the powerful interests that cause costs to swell and hold elected officials hostage.


Book Synopsis The Politics of Medicaid by : Laura Katz Olson

Download or read book The Politics of Medicaid written by Laura Katz Olson and published by Columbia University Press. This book was released on 2010-06-02 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: Examining the social, political and economic factors that have shaped Medicaid, the author of The Political Economy of Aging: The State, Private Power, and Social Welfare helps readers understand the powerful interests that cause costs to swell and hold elected officials hostage.

Artists of the Possible

Artists of the Possible

Author: Matthew Grossmann

Publisher:

Published: 2014

Total Pages: 273

ISBN-13: 0199967849

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Policy change is not predictable from election results or public opinion. The amount, issue content, and ideological direction of policy depend on the joint actions of policy entrepreneurs, especially presidents, legislators, and interest groups. This makes policymaking in each issue area and time period distinct and undermines unchanging models of policymaking.


Book Synopsis Artists of the Possible by : Matthew Grossmann

Download or read book Artists of the Possible written by Matthew Grossmann and published by . This book was released on 2014 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: Policy change is not predictable from election results or public opinion. The amount, issue content, and ideological direction of policy depend on the joint actions of policy entrepreneurs, especially presidents, legislators, and interest groups. This makes policymaking in each issue area and time period distinct and undermines unchanging models of policymaking.

Jonas and Kovner's Health Care Delivery in the United States, 11th Edition

Jonas and Kovner's Health Care Delivery in the United States, 11th Edition

Author: James R. Knickman, PhD

Publisher: Springer Publishing Company

Published: 2015-04-08

Total Pages: 400

ISBN-13: 0826125298

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"Health care managers, practitioners, and students must both operate as effectively as they can within the daunting and continually evolving system at hand and identify opportunities for reform advances… Health Care Delivery in the United States has been an indispensable companion to those preparing to manage this balance. The present edition demonstrates once again why this volume has come to be so prized. It takes the long view – charting recent developments in health policy, and putting them side-by-side with descriptions and analysis of existing programs in the United States and abroad." —Sherry Glied, PhD, Dean and Professor of Public Service, NYU Wagner, From the Foreword This fully updated and revised 11th edition of a highly esteemed survey and analysis of health care delivery in the United States keeps pace with the rapid changes that are reshaping our system. Fundamentally, this new edition presents the realities that impact our nation’s achievement of the so-called Triple Aim: better health and better care at a lower cost. It addresses challenges and responses to the Affordable Care Act (ACA), the implementation of Obamacare, and many new models of care designed to replace outmoded systems. Leading scholars, practitioners, and educators within population health and medical care present the most up-to-date evidence-based information on health disparities, vulnerable populations, and immigrant health; nursing workforce challenges; new information technology; preventive medicine; emerging approaches to control health care costs; and much more. Designed for graduate and advanced undergraduate students of health care management and administration and public health, the text addresses all of the complex core issues surrounding our health care system in a strikingly readable and accessible format. Contributors provide an in-depth and objective appraisal of why and how we organize health care the way we do, the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system, and other emerging and recurrent issues in health policy, health care management, and public health. The 11th edition features the writings of such luminaries as Michael K. Gusmano, Carolyn M. Clancy, Joanne Spetz, Nirav R. Shah, Michael S. Sparer, and Christy Harris Lemak, among others. Chapters include key words, learning objectives and competencies, discussion questions, case studies, and new charts and tables with concrete health care data. Included for instructors is an Instructor’s Manual, PowerPoint slides, Syllabus, Test Bank, Image Bank, Supplemental e-chapter on the ACA, and a transition guide bridging the 10th and 11th editions. Key Features: Integration of the ACA throughout the text, including a supplementary e-chapter devoted to this major health care policy innovation The implementation of Obamacare Combines acute and chronic care into organizations of medical care Nursing workforce challenges Health disparities, vulnerable populations, and immigrant health Strategies to achieve the Triple Aim (better health and better care at lower cost) New models of care including accountable care organizations (ACOs), patient homes, health exchanges, and integrated health systems Emerging societal efforts toward creating healthy environments and illness prevention Increasing incentives for efficiency and better quality of care Expanded discussion of information technology A new 5-year trend forecast


Book Synopsis Jonas and Kovner's Health Care Delivery in the United States, 11th Edition by : James R. Knickman, PhD

Download or read book Jonas and Kovner's Health Care Delivery in the United States, 11th Edition written by James R. Knickman, PhD and published by Springer Publishing Company. This book was released on 2015-04-08 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Health care managers, practitioners, and students must both operate as effectively as they can within the daunting and continually evolving system at hand and identify opportunities for reform advances… Health Care Delivery in the United States has been an indispensable companion to those preparing to manage this balance. The present edition demonstrates once again why this volume has come to be so prized. It takes the long view – charting recent developments in health policy, and putting them side-by-side with descriptions and analysis of existing programs in the United States and abroad." —Sherry Glied, PhD, Dean and Professor of Public Service, NYU Wagner, From the Foreword This fully updated and revised 11th edition of a highly esteemed survey and analysis of health care delivery in the United States keeps pace with the rapid changes that are reshaping our system. Fundamentally, this new edition presents the realities that impact our nation’s achievement of the so-called Triple Aim: better health and better care at a lower cost. It addresses challenges and responses to the Affordable Care Act (ACA), the implementation of Obamacare, and many new models of care designed to replace outmoded systems. Leading scholars, practitioners, and educators within population health and medical care present the most up-to-date evidence-based information on health disparities, vulnerable populations, and immigrant health; nursing workforce challenges; new information technology; preventive medicine; emerging approaches to control health care costs; and much more. Designed for graduate and advanced undergraduate students of health care management and administration and public health, the text addresses all of the complex core issues surrounding our health care system in a strikingly readable and accessible format. Contributors provide an in-depth and objective appraisal of why and how we organize health care the way we do, the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system, and other emerging and recurrent issues in health policy, health care management, and public health. The 11th edition features the writings of such luminaries as Michael K. Gusmano, Carolyn M. Clancy, Joanne Spetz, Nirav R. Shah, Michael S. Sparer, and Christy Harris Lemak, among others. Chapters include key words, learning objectives and competencies, discussion questions, case studies, and new charts and tables with concrete health care data. Included for instructors is an Instructor’s Manual, PowerPoint slides, Syllabus, Test Bank, Image Bank, Supplemental e-chapter on the ACA, and a transition guide bridging the 10th and 11th editions. Key Features: Integration of the ACA throughout the text, including a supplementary e-chapter devoted to this major health care policy innovation The implementation of Obamacare Combines acute and chronic care into organizations of medical care Nursing workforce challenges Health disparities, vulnerable populations, and immigrant health Strategies to achieve the Triple Aim (better health and better care at lower cost) New models of care including accountable care organizations (ACOs), patient homes, health exchanges, and integrated health systems Emerging societal efforts toward creating healthy environments and illness prevention Increasing incentives for efficiency and better quality of care Expanded discussion of information technology A new 5-year trend forecast