The past year was a momentous one for health care reform. In the summer, the Supreme Court upheld the constitutionality of the Affordable Care Act, enabling vital health care delivery and health insurance reforms to continue and an estimated 30 million Americans to gain health insurance coverage by the end of the decade. At the close of December, 18 states and the District of Columbia had submitted applications to the Department of Health and Human Services to operate their own state-run health insurance exchanges. Nearly all states have taken legislative or regulatory steps to implement the law’s early insurance market reforms, including a ban on gender and age discrimination, and coverage of preventive care services without cost-sharing. Last year also saw the spread of new models of health care delivery, evidence of improvement in health care quality and safety, and an increase in the use of health information technology.
We at The Commonwealth Fund continue to track health system performance and health insurance premium trends, conduct international comparisons, and offer guidance on health reform implementation. Join us as we review the 10 most popular publications of 2012.
1. Rising to the Challenge: Results from a Scorecard on Local Health System Performance, 2012, D. C. Radley, S. K. H. How, A. Fryer, D. McCarthy, and C. Schoen, March 2012.
Rising to the Challenge: Results from a Scorecard on Local Health System Performance, 2012, is the first scorecard from The Commonwealth Fund to assess performance on the local level. It rates 306 local areas in the U.S. on key indicators of health system performance, such as rates of insurance coverage, delivery of preventive care, and potentially preventable deaths before age 75.
2. Health Care in the 2012 Presidential Election: How the Obama and Romney Plans Stack Up, S. R. Collins, S. Guterman, R. Nuzum, M. A. Zezza, T. Garber, and J. Smith, October 2012.
This analysis compares full implementation of the Affordable Care Act with Governor Romney's plan to repeal the law, provide states with Medicaid block grants, and create new tax incentives to purchase individual coverage. It also estimates how these policies would affect state uninsured rates and uninsured rates for different age and income groups.
3. Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality, D. A. Squires, May 2012.
This analysis compared health care spending, supply, utilization, prices, and quality across 13 industrialized countries and found that patients in the U.S. do not receive "notably superior" care compared with our peers internationally, despite health expenditures totaling nearly $8,000 per person in 2009—one-third to two-thirds more than in 12 other advanced nations.
4. State Health Insurance Exchange Legislation: A Progress Report, S. R. Collins, T. Garber, December 2012.
This blog post by the Commonwealth Fund's Sara Collins and Tracy Garber provides a picture of where states stand in establishing the legal authority for their insurance exchanges.
5. Four Health Care Organizations' Efforts to Improve Patient Care and Reduce Costs, A. D. Van Citters, B. K. Larson, K. L. Carluzzo, J. N. Gbemudu, S. A. Kreindler, F. M. Wu, S. M. Shortell, E. C. Nelson, E. S. Fisher, January 2012.
This report synthesizes findings and lessons from case studies of four diverse health care organizations participating in the Brookings–Dartmouth ACO Pilot Program, launched in 2009 to support selected provider groups that are collaborating with private payers to form accountable care organizations (ACOs).
6. Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes, E. H. Wagner, K. Coleman, R. J. Reid, K. Phillips, and J. R. Sugarman, February 2012.
This report outlines and describes the changes that most medical practices would need to make to become patient-centered medical homes.
7. Bending the Health Care Cost Curve: New Era in American Health Care?, K. Davis, January 2012.
Health care spending in 2009 and 2010 grew at the slowest rates in 50 years. This startling news was largely attributed to the shrinking economy. In this blog post, former Commonwealth Fund president Karen Davis suggests that lower longer-term projections point to a shift in the health system.
8. Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost, Utilization, and Clinical Quality, M. B. Rosenthal, M. K. Abrams, A. Bitton, and the Patient-Centered Medical Home Evaluators' Collaborative, May 2012.
This data brief reports on the recommendations of more than 75 researchers who came together to identify a core set of standardized measures to evaluate clinical quality as well as costs and utilization in medical homes.
9. The Performance Improvement Imperative: Utilizing a Coordinated, Community-Based Approach to Enhance Care and Lower Costs for Chronically Ill Patients, The Commonwealth Fund Commission on a High Performance Health System, April 2012.
Noting the "unprecedented opportunity" created by the federal health reform law, the Commonwealth Fund Commission on a High Performance Health System unveiled this community-based plan to enhance health and reduce spending by improving care for chronically ill patients and targeting quality improvement efforts to conditions that can yield the greatest benefit in a relatively short time.
10. Contemporary Evidence About Hospital Strategies for Reducing 30-Day Readmissions: A National Study, E. H. Bradley, L. Curry, L. I. Horwitz, H. Sipsma, J. W. Thompson, M. A. Elma, M. Norine Walsh, and H. M. Krumholz, Journal of the American College of Cardiology, published online July 18, 2012.
This study found that most hospitals participating in a national campaign to reduce preventable hospital readmissions have taken preliminary steps to avoid readmissions of patients with heart failure or acute myocardial infarction, including monitoring readmission rates. But many important practices, such as medication management protocols or alerting outpatient physicians of a patient's discharge within 48 hours, have yet to be implemented broadly.