A New Era in American Health Care

In a new blog post, Commonwealth Fund President Karen Davis and Vice President Sara Collins write that the historic action by the House of Representatives in passing comprehensive health reform legislation will usher in a new era in American health care—one in which all Americans will be able get the care they need without incurring financial hardship, and no American will be denied health insurance coverage simply because they have a preexisting medical condition.

Many Americans will feel the effect of the reform this year, as significant changes start to go into effect. Within the year:

• underwriting of children in the individual market will be prohibited;
• young adults will be able to stay on their parents' health plans to age 26;
• insurance companies will be prohibited from revoking coverage when people become ill, and from setting lifetime limits on benefits;
• small businesses will be eligible for new tax credits to offset their premium costs;
• people with preexisting conditions will be eligible for subsidized coverage through a national high-risk pool;
• new limits will be set for the percentage of premiums that insurers can spend on non-medical costs and, beginning in 2011, carriers that exceed those limits will be required to offer rebates to enrollees;
• Medicare will provide $250 rebates to beneficiaries who reach the doughnut hole; and
• Medicare will eliminate cost-sharing for preventive services in Medicare and private plans.

"The U.S. will now join all other major industrialized countries with a system for ensuring access to essential health care, and we will lay the foundation for a high performance health system that yields access to care for all, improved quality, and greater efficiency," write Davis and  Collins. "It is a victory for all Americans, who deserve the finest health system in the world." Read more »

Health Care Expenses Are Growing Burden for Many Americans

The percentage of Americans facing high out-of-pocket health care expenses and insurance premiums continues to increase, according to a new Commonwealth Fund–supported study published by Health Affairs. In 2006, nearly one of five Americans—19.1 percent of the nonelderly population—lived in families spending more than 10 percent of before-tax income on health care, up from one of seven Americans (14.4%) in 2001. The study found that even before the onset of the economic recession, the financial burden of health care—the ratio of total out-of-pocket spending for health care services and premiums to total family income—was increasing for many Americans. People with private health insurance, including those with employer-sponsored coverage, were affected the most, as out-of-pocket spending rose faster than family incomes. Read more »

Primary Care and Prescription Drug Coverage Abroad, Lessons for the U.S.

This issue brief explores the provisions of health coverage and cost-sharing for primary care and prescription drugs in Denmark, England, France, Germany, the Netherlands, and Sweden and draws lessons for policy reform and insurance design in the United States. Although none of the six countries spends more than 11 percent of gross domestic product on health care—compared with 16.2 percent in the United States—they are able to provide a level of access to and financial protection for primary care and prescription drugs that far exceeds what is available in this country. Read more »

HRET Guide: Helping Hospital Systems Achieve High Performance

Multi-hospital health systems are the most common organizational structure in the hospital industry. With Commonwealth Fund support, the Health Research and Educational Trust (HRET) has prepared A Guide to Achieving High Performance in Multi-Hospital Health Systems to inform system leaders about what they can do to ensure that patients across all of their hospitals receive high-quality care. The best practices fall into four categories:

• Establishing a system-wide strategic plan with measurable goals.
• Creating alignment across the health system with goals and incentives.
• Leveraging data and measurement across the organization.
• Standardizing and spreading best practices across the health system.

Visit the HRET Web site to review the audio file and presentation files from a recent webinar on high-performing hospital health systems, during which leaders from three systems discussed their experiences in improving care. Read more »

Timelines for Health Reform Legislation

Just-passed health care reform legislation includes numerous provisions affecting health care coverage, the health care delivery system, and sources of revenue for financing reform. Some of these provisions will go into effect immediately, while some will be implemented over the next decade. To help navigate through the legislation, we have created the following timelines:

• Health Care Reform Implementation: Health Insurance Provisions 
• Health Care Reform Implementation: System and Delivery Reform Provisions 
• Health Care Reform Implementation: Revenue Provisions 
  

Toolkit: Integrating Care for Dual Eligibles

With Fund support, the Center for Health Care Strategies created an online toolkit for states working to better integrate care for "dual eligibles"—those who are covered by both Medicare and Medicaid. Dual eligibles account for nearly half of all spending in Medicaid and a quarter in Medicare. The toolkit covers critical issues for advancing integrated care models, including policy options, program design, financing, performance measurement, and consumer engagement. Read more »

Webinar on Getting to Zero: Strategies to Eliminate Central Line-Associated Bloodstream Infections

Central line–associated bloodstream infections (CLABSIs) are one of the most lethal types of complications, sickening thousands of hospital patients each year. Despite strong evidence on how to prevent CLABSIs, there is wide variation in infection rates among U.S. hospitals. Join a webinar on Wednesday, April 14, at 2:30 p.m. E.D.T. to explore the reasons for this variation and strategies from hospitals that have been able to "get to zero," with no infections over a sustained period of time. The event will feature Lucian L. Leape, M.D., adjunct professor, Department of Health Policy and Management, Harvard School of Public Health; Peter J. Pronovost, M.D., Ph.D., director, Johns Hopkins University Quality and Safety Research Group; and Brian S. Koll, M.D., medical director and chief, infection prevention, Beth Israel Medical Center. Anne-Marie J. Audet, M.D., M.Sc., vice president of The Commonwealth Fund's Program on Quality Improvement and Efficiency, will moderate.

To register for this free, 60-minute webinar, go to:
https://commonwealthfundevents.webex.com/commonwealthfundevents/onstage/g.php?t=a&d=660740228.
Read more »

NYAM Lecture Series: Health Reform and New York State

On April 15, the New York Academy of Medicine's (NYAM) Section on Health Care Delivery will present "Models of Accountable Care Organizations in New York—Issues of Quality and Cost," the third lecture in its series on health care reform and New York State. Stephen C. Schoenbaum, M.D., M.P.H., the Commonwealth Fund's executive vice president for programs, will moderate. For more information or to register, visit the NYAM Web site. The next lecture, "Health Care Reform and Access to Coverage," will take place on May 12. Read more »