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The medically vulnerable—for example, people with disabilities and the chronically ill—undoubtedly face
unique challenges in accessing affordable, high-quality care. They often pay more for health care, lack a
usual source of care, and face other access barriers like travel distance and communication difficulties.1 The
National Coalition on Health Care (NCHC) emphasizes that cost containment is not about reducing benefits,
limiting access, or shifting costs. Rather, NCHC’s goals for cost containment aim for a sustainable system that
will bring improvements in access, quality, and value to a level where even the neediest patients can obtain
the appropriate level of care at an affordable price.
1
Long, Sharon K., Teresa A. Coughlin, and Stephanie J. Kendall. "Access to Care Among Disabled Adults on Medicaid." Health Care
Financing Review 23.4 (2002): 159-73. Available at: https://www.cms.gov/HealthCareFinancingReview/downloads/02Summerpg159.pdf.
2
Batavia, Andrew I. “Health Care Reform and People with Disabilities.” Health Affairs, 12, no.1 (1993):40-57. Available at:
http://content.healthaffairs.org/content/12/1/40.full.pdf
3
Fisher, Elliot et al. “Health Care Spending, Quality, and Outcomes: More Isn’t Always Better.” The Dartmouth Institute for Health Policy and
Clinical Practice. February 27, 2009. Available at: http://www.dartmouthatlas.org/downloads/reports/Spending_Brief_022709.pdf
4
National Coalition on Health Care. Building a Better Health Care System: Specifications for Reform. Washington, D.C., 2009. Available at:
http://nchc.org/sites/default/files/resources/specs_for_reform.pdf
5
Id. at 9
6
Id. at 21
7
Id. at 21–22
8
Id. at 23
National Coalition on Health Care June 1, 2011
Prepared by Yue Pui Chin
2. Develop medical homes and accountable care organizations, which emphasize
patient-centered and coordinated care, in order to meet the unique needs of individual
patients and improve overall quality.