Thirty million women will benefit from the health reform law over the next decade, either through new or strengthened insurance coverage, according to a report from The Commonwealth Fund. In the first analysis of its kind, the authors report that the law will stabilize and reverse the growing exposure to health costs that women now experience by subsidizing health insurance for up to 15 million currently uninsured women, and strengthening existing coverage for 14.5 million women who are considered underinsured—those who have health coverage that does not adequately protect them from high medical expenses.
"Historically, women have been more vulnerable to high health care costs and have had greater difficulty paying medical bills because of their lower incomes," said Commonwealth Fund President Karen Davis. "This report provides good news to all women, who will be more likely to get the care they need, with reduced risk of incurring the unaffordable medical bills that have affected so many Americans."
In the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey, respondents weigh in on the provisions of the Affordable Care Act that promote coordination and accountability in the health care delivery system. A strong majority say the proposed payment arrangements and incentives to providers will be effective strategies for fostering coordination and integration in health care delivery. More than eight of 10 leaders feel that developing performance metrics, implementing provisions to increase transparency and public reporting, and establishing an Innovation Center within the Centers for Medicare and Medicaid Services should receive high priority from the Secretary of Health and Human Services.
A Commonwealth Fund–supported study examined a pay-for-performance program in California that assigned new Medicaid enrollees to managed care plans that performed better on selected clinical quality measures. A comparison of performance scores for plans rewarded by the program and scores for plans in a comparison group demonstrated, however, that the program had little additional effect on quality of care.
Efforts to improve patient-centered care have focused on infrastructure and information technology support. However, a true patient-centered approach depends on healing relationships among physicians, patients, and family, with a strong foundation of communication and shared decision-making, according to a new Commonwealth Fund–supported study. Health policy should focus on multiple means for improving healing relationships, including training health care professionals and activating and enabling patients to participate in their care, the researchers say.
A new publication developed by The Joint Commission in collaboration with the National Health Law Program provides recommendations to help hospitals address unique patient needs and comply with new standards for patient-centered communication. The report, Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care: A Roadmap for Hospitals, grew out of a Joint Commission initiative launched in 2008, with support from The Commonwealth Fund.
Most pediatric practices participating in an American Academy of Pediatrics pilot program to implement recommended screening for developmental problems were successful in doing so, according to a recent Commonwealth Fund–supported study. However, far fewer were successful in making and tracking referrals for follow-up care.
Learn about findings from recent Commonwealth Fund–supported studies published in the peer-reviewed literature, including articles on: prescription drug coverage, use, and spending before and after Medicare Part D implementation; transitions of elderly patients from long-term care facilities to hospitals; measuring physicians' beliefs about patient self-management; health care payment reform; high-performance primary care; and an evaluation of the "Green House" nursing homes.
New On The Web
In a new blog post—the first in a series about how U.S. health system financing could be more coherent and transparent—Commonwealth Fund president Karen Davis examines options for paying for coordinated care. The health reform law will inject greater transparency into the health care market and increase the value of what we pay for care. These initiatives are one important step in the evolution of a new payment system that will provide incentives to attain the best results—rather than provide the most services—and in doing so achieve savings from the elimination of wasteful, duplicative, or avoidable treatment. "But changing the method of payment is only one part of the solution," Davis writes. "To make it work, new health care organizations that are accountable for both patient outcomes and the resources devoted to care will need to be formed."
Users of The Commonwealth Fund's performance benchmarking site, WhyNotTheBest.org, can now search for and compare data from more than 900 hospitals on the incidence of central line–associated bloodstream infections (CLABSIs)—one of the most lethal hospital-acquired complications. The data show wide variation in CLABSI incidence, in spite of strong evidence on how to prevent them. They are available on WhyNotTheBest.org through a partnership among The Commonwealth Fund, The Leapfrog Group, and Consumers Union. Click here for information on how to locate hospitals reporting CLABSI data.
The federal government now requires that residents of Medicare- or Medicaid-certified nursing homes be interviewed as part of their clinical assessments. A new video, funded through the Picker/Commonwealth Fund Long-Term Care Quality Improvement Program and developed by the UCLA/Jewish Home, demonstrates best practices for interviews related to residents' cognition, mood, preferences, and pain. The Video on Interviewing Vulnerable Elders (VIVE) also outlines techniques to improve communication with older, frail populations and includes model interviews, with nurses acting out scenarios based on real situations. Visit The Pioneer Network for more information.
The Commonwealth Fund's 2011–12 Harkness Fellowships in Health Care Policy and Practice are open to applicants from Australia, Germany, the Netherlands, New Zealand, Norway, Switzerland, and the United Kingdom. The deadline for receipt of applications is September 13, 2010.
The Harkness Fellowships provide a unique opportunity for mid-career professionals—academic researchers, government policymakers, clinicians, managers, and journalists—to spend up to 12 months in the United States conducting a policy-oriented research study, working with leading U.S. health policy experts and gaining in-depth knowledge of not only the U.S. health care system, but also the health care systems in the fellows' home countries. For details and the application form, please visit http://www.commonwealthfund.org/Fellowships/Harkness-Fellowships.aspx.
On behalf of the Australian Government Department of Health and Ageing, The Commonwealth Fund is pleased to announce the 2011–12 Australian-American Health Policy Fellowship. The deadline for receipt of applications is August 15, 2010.
The fellowship offers a unique opportunity for outstanding, mid-career U.S. professionals—academics, government officials, clinical leaders, decision-makers in managed care and other private health care organizations, and journalists—to spend up to 10 months in Australia conducting research and working with leading Australian health policy experts on issues relevant to both countries. For further information and to obtain an application, please see http://www.commonwealthfund.org/Fellowships/Australian-American-Health-Policy-Fellowships.aspx.