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Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations, and How Reform Is Helping

July 13, 2012 - Twenty percent of U.S. women ages 19 to 64 were uninsured in 2010, up from 15 percent in 2000. This issue brief examines the implications of poor coverage for women in the United States by comparing their experiences to those of women in 10 other industrialized nations, all of which have universal health insurance systems.

Issue Brief

The 'Alternative Quality Contract,' Based on a Global Budget, Lowered Medical Spending and Improved Quality

July 12, 2012 - A Commonwealth Fund-supported study of a global reimbursement pilot project in Massachusetts found the payment models achieved average two-year savings of 2.8 percent. These results indicate such programs may be effective at controlling health care spending and improving quality.

In the Literature

Patient-Centered Innovation in Health Care Organizations: A Conceptual Framework and Case Study Application

July 6, 2012 - Drawing on peer-reviewed research and organizational change theory, the authors of this Commonwealth Fund–supported study identified attributes associated with the successful implementation of patient-centered innovation in health care.

In Brief

The Cultural Complexity of Medical Groups

July 6, 2012 - Adapting to new models of care, like the patient-centered medical home, requires an understanding of the different types of cultures that are present in physician groups and how those varying cultures influence performance. This Commonwealth Fund–supported study examined eight multispecialty medical practices, looking for evidence of seven common cultures found in physician organizations.

In Brief

From Striving to Thriving: Systems Thinking, Strategy, and the Performance of Safety Net Hospitals

July 3, 2012 - By contrasting the characteristics of six high-performing safety-net hospitals with those of three low-performers, Commonwealth Fund–supported researchers found that the high-performers excelled at coordinating patients, engaging in partnerships, and investing in human capital.

In Brief

Enhancing Medicare's Hospital-Acquired Conditions Policy to Encompass Readmissions

July 3, 2012 - To determine the financial impact of restricting payment to hospitals for patient readmissions, this Commonwealth Fund–supported study assessed the frequency of readmissions at California hospitals that could be tied to avoidable medical complications.

In Brief

The Changes Involved in Patient-Centered Medical Home Transformation

July 3, 2012 - What are the necessary characteristics of a medical home, and what changes must physician practices make to their infrastructure, organization, and care delivery processes to fully transform? Commonwealth Fund–supported researchers reviewed the professional literature and convened a panel of experts to find out.

In Brief

After-Hours Care and Its Coordination with Primary Care in the U.S.

July 2, 2012 - This Commonwealth Fund–supported found that primary care offices that offer after-hours care achieve physician buy-in; effective communication; make appropriate staffing adjustments, and make an overall commitment to improving access and continuity in patient–provider relationships.

In the Literature

Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals

July 2, 2012 - This issue brief examines nine hospitals that recently implemented a comprehensive electronic health record system and finds that the systems facilitate patient safety and quality improvement in many ways.

Issue Brief

Using Insurance Exchanges to Govern Health Insurance Markets in Multipayer Systems

June 27, 2012 - A central component of the Affordable Care Act is the establishment of state-based health insurance exchanges. Now under development in many states, the exchanges are scheduled to be operational by January 1, 2014, and will be available to individuals and small businesses.

International Innovation

Improving Patient Safety And Lowering Malpractice Costs Through "No-Fault" Compensation Systems

June 27, 2012 - The current medical malpractice system in the United States is widely regarded as flawed. One proposal to fix it is to replace the current litigation system with an administrative or "no-fault" system. New Zealand, Sweden, and Denmark all operate such no-fault systems.

International Innovation

Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers

June 26, 2012 - This Commonwealth Fund-supported study of federally funded health centers calls for evidence-based payment for medical homes.

In the Literature

Unintended Consequences of Steps to Cut Readmissions and Reform Payment May Threaten Care of Vulnerable Older Adults

June 20, 2012 - In this Health Affairs article, Commonwealth Fund–supported researchers examine the impact of three provisions in the Affordable Care Act meant to address the fragmentation in care experienced by older adults: the Hospital Readmissions Reduction Program, the National Pilot Program on Payment Bundling, and the Community-Based Care Transitions Program.

In the Literature

Geographic Variation in Access to Care—The Relationship with Quality

June 13, 2012 - Analyzing data from The Commonwealth Fund's Scorecard on Local Health System Performance, a New England Journal of Medicine Perspective finds widespread differences across local areas in residents' ability to access care, with implications for receipt of preventive care and outcomes.

In Brief

Facilitating Improvement in Primary Care: The Promise of Practice Coaching

June 11, 2012 - This issue brief clarifies the essential features of practice coaching and offers guidance for health system leaders, public and private insurers, and federal and state policymakers on how best to structure and design these programs in primary care settings.

Issue Brief