The Commonwealth Fund Connection serves as a roundup of Fund publications, charts, and multimedia added to the Commonwealth Fund Web site in the last two weeks, and also offers links to other timely content.
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What's New
Recent trends in the numbers of Americans who are uninsured or underinsured demonstrate just how critical the Affordable Care Act's new premium tax credits and other insurance affordability provisions will be to ensuring the health and financial security of working families, Commonwealth Fund vice president Sara R. Collins, Ph.D., testified at a Oct. 27 congressional hearing.
Invited to speak before a health care subcommittee of the U.S. House of Representatives Committee on Oversight and Government Reform, Collins said the health reform law's array of affordable insurance programs and new consumer protections set to launch in 2014 will substantially reverse these trends. In 2010, the number of uninsured people climbed to 49.9 million, over 13 million more than a decade ago, and the number of underinsured—those who have coverage but face high out-of-pocket costs relative to income—rose to 29 million, from 16 million in 2003. Under the reform law, about 90 percent of legal U.S. residents who are currently uninsured would become eligible for Medicaid or tax credits to pay for private health coverage purchased through the insurance exchanges. Read more »
Recent Releases
The Affordable Care Act will transform the U.S. health care system in many ways. A new Commonwealth Fund–sponsored supplement in Columbia Journalism Review looks at how hospitals, physicians, employers, insurers, and states are preparing for the changes ahead and experimenting with approaches to improving access and quality and controlling rising health care costs. Read more »
A new issue brief focuses on national disease management programs in Germany, which have improved the quality of care and increased patient satisfaction while reducing hospitalizations, mortality rates, and drug costs. The authors note that the programs were effective, even though they were implemented in a health system that—like the U.S. health system—does not have a strong emphasis on primary care. Key factors in their success include sustained funding and rapid, extensive implementation. Read more »
A new Commonwealth Fund issue brief explores how electronic consultations can enable primary care clinicians and specialists to communicate about patients at times that are mutually convenient. The researchers found that early adopters of "e-consultations," conducted through e-mail, a Web site, or a shared electronic medical record, say the approach leads to increased access to specialists, more appropriate referrals for patients, and better coordinated care. Read more »
New on the Web
Medicare physician fees are scheduled to be reduced by 27.4 percent on January 1, unless Congress acts to override that reduction or eliminate the sustainable growth rate (SGR) mechanism that is used to determine the annual update. In a new blog post, Commonwealth Fund vice president Stuart Guterman says that Congress must no longer "kick the can down the road" by temporarily overriding the physician fee cuts but instead "take the difficult but necessary step of repealing and replacing the SGR." Read more »
The Centers for Medicare and Medicaid Services has released its final regulations for accountable care organizations (ACOs), or groups of health care providers that agree to be held accountable for the cost and quality of care for a defined group of patients—and have the opportunity to share in any savings they achieve. To learn more about the how the ACOs will work and their potential to improve performance, see the Commonwealth Fund's collection of ACO resources. Read more »
In his latest post in an international series on The Commonwealth Fund Blog, New Republic senior editor Jonathan Cohn discusses quality and health outcomes in the Netherlands, as well as recent Dutch efforts to encourage insurers to compete on quality as well as costs. "Insofar as American policymakers hope that competition can improve the quality of health care while reducing (or at least restraining) its cost, the future of the Dutch reforms are certainly worth watching," Cohn says. Read more »
The Centers for Medicare and Medicaid Services (CMS) recently began publishing performance data on hospital-acquired infections, certain surgical complications, and avoidable deaths on its Hospital Compare Web site. In a new post on The Commonwealth Fund Blog, Anne-Marie J. Audet, M.D., and Shreya Patel, M.P.H., say the new measures will lead to a healthy process of public vetting and debate. "As the data are released, many eyes will be looking at them, probing their implications, comparing, and conducting root-cause analyses," they say. "This attention can only lead to improvement—both in the measures themselves and in the care delivered." Read more »
Coming Soon
The Commonwealth Fund’s new international survey of more than 18,000 adults with serious and chronic illnesses compares performance on measures of access to care and quality of care. The surveyed countries include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Read more »
An upcoming report will provide data on premiums for employer-sponsored family health insurance between 2003 and 2010, as well as the share of premiums that employees are asked to pay. Read more »
Fellowships
The Commonwealth Fund/Harvard University Fellowship in Minority Health Policy is designed to prepare physicians for leadership roles in promoting health policies and practices that improve access to high-quality care for minority, disadvantaged, and vulnerable populations. The application deadline for the 2012–13 fellowship is January 3, 2012. For more information, please visit: http://www.commonwealthfund.org/Fellowships/Minority-Health-Policy-Fellowship.aspx. Read more »
Applications for the 2012–13 Harkness Fellowships remain open to individuals from Germany, Norway, Sweden, the Netherlands, and Canada. The Commonwealth Fund's Harkness Fellowships in Health Care Policy and Practice 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.
Deadlines for receipt of applications are as follows:
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Germany, Norway, and Sweden: December 2, 2011.
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The Netherlands: January 4, 2012.
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Canada: February 14, 2012.
Note that the application process for Australia, New Zealand, Switzerland, and the United Kingdom is now closed.
Read more »