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“Nobody wanted to talk about it. This happened during the time of three presidents, and frankly I’m not so sure to blame them either. This was hidden, which is why it spread,” Quinones said. “It’s only basically the last two or three years that people have been paying any attention to it, and that’s not a reasonable assumption that in three years that you would resolve this major problem that’s been festering for almost a generation.”

“We now have emerging evidence in Medicare and commercial insurance of how care coordination and prevention can help patients with chronic conditions avoid costly hospitalizations and ER visits,” said Kavita Patel, a policy expert at the Brookings Institution who’s also a practicing physician. “This really should become the standard across Medicaid programs.”