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Using Insurance Standards and Policy Levers to Build a High Performance Health System

November 6, 2009 - This Commonwealth Fund issue brief examines an unprecedented use of state health insurance regulatory authority to promote health system reform. In Rhode Island, regulators have used this authority to implement a set of standards to promote increased affordability through a series of requirements aimed at strengthening and expanding the state's primary care infrastructure.

Issue Brief

A Survey of Primary Care Physicians in 11 Countries, 2009: Perspectives on Care, Costs, and Experiences

November 5, 2009 - A new Commonwealth Fund survey of primary care physicians in 11 countries reveals that the United States lags far behind other countries in key areas of access, quality, and use of health information technology—undermining doctors' efforts to provide timely, high-quality care.

In the Literature

Nurses Involvement in Nursing Home Culture Change: Overcoming Barriers, Advancing Opportunities

November 3, 2009 - To be successful, "culture change" initiatives—efforts to help nursing homes transform from institutional hospital-like settings to homes that focus on residents' preferences—depend critically on the care provided for and directed by nursing homes' professional nursing staff.

Literature Abstract

Primary Care and Accountable Care—Two Essential Elements of Delivery System Reform

November 3, 2009 - By combining the core tenets of primary care with high-tech practice innovations like electronic medical records, the patient-centered medical home model can improve quality of care and lower costs. However, it faces several challenges. How can it provide incentives for outside providers to work collaboratively with primary care clinicians? And, how can primary care practices share in the savings that result from decreased need for such services as hospitalizations or emergency room treatment?

Literature Abstract

Don't Take Medicare for Granted: Commentary on the Health Care Opinion Leaders Survey

November 2, 2009 - In a commentary on The Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey, Bruce Vladeck writes that Washington finds itself caught up in the fog of hysteria, misinformation, anxiety and downright dishonesty that so often afflicts Medicare politics.

Commentary

Health Care Opinion Leaders Views on Medicare Reform

November 2, 2009 - In the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders survey, experts in health care and health policy say they favor strengthening Medicare's ability to help control program costs and support broader health system reform.

Data Brief

Slow Spending, Improve Quality in Medicare: Commentary on the Health Care Opinion Leaders Survey

November 2, 2009 - With so much attention being given to healthcare reform, Gail Wilensky writes in this commentary on The Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey findings, it's essential to remember the importance of reforming Medicare as well.

Commentary

State Hospital Rate-Setting Revisited

October 27, 2009 - In an attempt to control rapid growth in hospital costs, beginning in the mid-1970s seven states implemented rate-setting programs to regulate hospital payments. Although all but two have since been discontinued, these states' experiences offer lessons for policymakers as they continue searching for ways to control rising health care costs.

Issue Brief

UPDATED—The Comprehensive Congressional Health Reform Bills of 2009: A Look at Health Insurance, Delivery System, and Financing Provisions

October 23, 2009 - This report prepared by Commonwealth Fund researchers analyzes the similarities, differences, potential impacts, and costs of the three comprehensive health reform bills passed by key U.S. congressional committees. Also see interactive tables for side-by-side comparisons of the system reform and insurance provisions.

Fund Report

Incremental Cost Estimates for the Patient-Centered Medical Home

October 16, 2009 - How much does it cost a physician practice to become a medical home and add new medical home features? A new Commonwealth Fund report finds less than a $1-per-patient difference in costs per month between physician practices with a high level of medical home attributes—such as evening office hours, electronic health record systems, and care management services—and those with lower levels.

Fund Report

Testimony--The Growing Problem of Underinsurance in the United States: What It Means for Working Families and How Health Reform Will Help

October 15, 2009 - In testimony before the U.S. House of Representatives' Committee on Energy and Commerce on October 15, 2009, Commonwealth Fund vice president Sara R. Collins discussed the growing number of Americans with such high out-of-pocket costs relative to their income that are effectively underinsured.

Testimony

Supporting Culture Change: Working Toward Smarter State Nursing Home Regulation

October 9, 2009 - To move toward a new model of nursing home regulation, the states and federal government must strike a balance between the traditional regulatory approach to weed out substandard facilities and a partnership model aimed at promoting high performance. This Commonwealth Fund issue brief highlights the importance of how such a model is structured, as well as the need to adequately train and educate regulatory staff and providers about culture change.

Issue Brief

Aiming Higher for Health System Performance: A Profile of Seven States That Perform Well on The Commonwealth Fund's 2009 State Scorecard

October 8, 2009 - As a companion to the 2009 State Scorecard, this report profiles seven health systems: six that rank among the top quartile of states—Vermont, Hawaii, Iowa, Minnesota, Massachusetts, and Wisconsin—plus Delaware, which was among the most-improved states from 2007 to 2009.

Fund Report

Associations Between Structural Capabilities of Primary Care Practices and Performance on Selected Quality Measures

October 8, 2009 - The Commonwealth Fund-supported study in Annals of Internal Medicine looks at primary care practices in Massachusetts and finds a strong association between clinicians' frequent use of advanced electronic health records and higher practice performance on quality-of-care measures.

In the Literature

Aiming Higher: Results from a State Scorecard on Health System Performance, 2009

October 8, 2009 - The cost and quality of health care, as well as access to care and health outcomes, continue to vary widely among states, according to the Commonwealth Fund Commission on a High Performance Health System's second state scorecard report. The states that led in the first state scorecard, released in 2007, generally continued to lead, often setting new benchmarks and widening the gap between leading and lagging states.

Fund Report