Wednesday, April 23, 2014
Inquirer Daily News

Paula Stillman

POSTED: Monday, April 21, 2014, 5:03 PM
Filed Under: Paula Stillman

I have had the opportunity to examine health care through the lens of a patient, provider, health system, self-insured entity, and a commercial and government supported insurer.  In order for health care reform to make sense, we need to follow its incentives and disincentives, understand who is responsible for spending the health care dollar, and follow the flow of money.  Unfortunately, in this time of transition, these are all very complex.

Obamacare presents an opportunity to expand the number of individuals with health care coverage and to begin to decrease the cost shifting of caring for the uninsured.  However, fixing health care requires that we fix the way payments are allocated and spent.

If payment is made the traditional way with a separate fee for each service provided, providers have little incentive to be efficient.  But what is the alternative?  There are several, and they all have problems of their own.

POSTED: Wednesday, January 22, 2014, 6:00 AM
Filed Under: Paula Stillman

How often have we witnessed an adorable, inquisitive and charming toddler and wondered what does the future hold?  What happens to that child in adolescence?  Why do some of these children fail in school, choose unhealthy lifestyle options, have children at an early age and contribute to the cycle of poverty?  I often wish that I could bring these adorable children into my home and use my resources to help them succeed.

As a former pediatrician, I was always interested in treating the acute and chronic manifestations of illness.  If we could just get children immunized, get vision and hearing checked, and do preschool exams, we could contribute to the development of healthy responsible adults.

I have since changed careers and am now more interested in population health at the macro level.  I realize that social and educational issues are at least as important as health care in determining the future of young children.

POSTED: Thursday, November 21, 2013, 6:00 AM
Filed Under: Paula Stillman

Our nation continues to struggle with providing health care to the people who are on the lower end of the socioeconomic ladder.  Not being able to afford health care and not having health care coverage is a disaster, especially when you have a chronic condition.

My son, an internist, published an article, “Dead Man Walking,” in this week’s New England Journal of Medicine (Stillman & Tailor, 2014) describing several patients in his practice who had inadequate health care coverage.  This problem is widespread and exists, right here, in North Philadelphia.

To address this problem in North Philadelphia, Temple University Health System, has trained and employed a number of Community Health Workers (CHWs) to help this defenseless population.  The CHWs are highly motivated individuals from our community who undergo an intensive five week training program and then are asked to serve as liaisons between our highest cost, highest risk most vulnerable patients and their health care providers.  We assign the CHWs to patients with chronic illness who do not have a primary care physician, are frequently admitted to the hospital and use the emergency department instead of visiting a physician’s office for non-acute health care needs. 

About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
Neil I. Goldfarb President & CEO of the Greater Philadelphia Business Coalition on Health
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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