Publications: Health Care Quality

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Tucson and Southern Arizona: A Desert Region Pursuing Better Health and Health System Performance

April 17, 2014 - The southern Arizona region encompassing Tucson outperforms many other regions with similar socioeconomic characteristics, which may stem from the emphasis providers place on delivery system innovation and best practices and the prevalence of managed care arrangements.

Case Study

Grand Rapids and West Central Michigan: Pursuing Health Care Value Through Regional Planning, Cooperation, and Investment

April 17, 2014 - The region of West Central Michigan encompassing Grand Rapids and surrounding communities performs especially well on measures of prevention and treatment quality, avoidable hospital use, and costs of care.

Case Study

Opportunity for Regional Improvement: Three Case Studies of Local Health System Performance

April 17, 2014 - Case studies of three U.S. regions that ranked relatively high on the Commonwealth Fund’s Scorecard on Local Health System Performance, 2012, despite greater poverty compared with peers, revealed several common themes.

Case Study

The Role of Medicaid Managed Care in Health Delivery System Innovation

April 10, 2014 - This report examines health care providers' perspectives on the role of managed care in improving health services for low-income adults in four communities: Milwaukee, Wisconsin; Oakland, California; Seattle, Washington; and Washington, D.C.

Fund Report

Identifying Meaningful Outcome Measures for the Intensive Care Unit

March 31, 2014 - In this study, Commonwealth Fund–supported researchers surveyed nearly 200 physicians about their views on nine quality and safety indicators proposed for ICU care: three infectious conditions occurring more than 48 hours after ICU admission, as well as six noninfectious conditions occurring more than 24 hours post–ICU admission.

In Brief

Association Between Participation in a Multipayer Medical Home Intervention and Changes in Quality, Utilization, and Costs of Care

February 25, 2014 - In this study, Commonwealth Fund–supported researchers surveyed practices participating in the Southeastern Pennsylvania Chronic Care initiative, one of the earliest and largest multipayer medical home pilots in the United States, to examine the quality care delivered, use of medical services, and the costs of care.

In Brief

Patient-Centered Medical Home Transformation with Payment Reform: Patient Experience Outcomes

February 10, 2014 - Commonwealth Fund–supported researchers compared patients' experiences in a primary care clinic that implemented the PCMH model, along with lean process changes (which seek to maximize value and reduce waste) and a new approach to physician reimbursement, with patients' experiences in a similar clinic that did not make such changes.

In the Literature

Use of Telemedicine Can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare

February 5, 2014 - Results from a new Commonwealth Fund–supported study in Health Affairs led by Harvard Medical School's David C. Grabowski confirm that telemedicine can be a cost-effective alternative to a trip to the hospital.

In the Literature

Assessing the State of Safe Medication Practices Using the ISMP Medication Safety Self Assessment for Hospitals: 2000 and 2011

February 4, 2014 - U.S. hospitals have made great strides over the past decade in instituting practices to improve medication safety, according to results of the most recent Medication Safety Self Assessment.

In the Literature

Two-Year Impact of the Alternative Quality Contract on Pediatric Health Care Quality and Spending

January 31, 2014 - In the first two years of the Alternative Quality Contract, an incentive-based provider payment program implemented by Blue Cross Blue Shield of Massachusetts, there was a significant, albeit modest, improvement in the quality of children’s preventive care, but no change in health care spending.

In the Literature

The Effect of Bundled Payment on Emergency Department Use: Alternative Quality Contract Effects After Year One

January 31, 2014 - In this study, Commonwealth Fund–supported researchers examined Blue Cross Blue Shield's experiment with a global payment system in Massachusetts and its impact on emergency department use.

In Brief

Global Budgets and Technology-Intensive Medical Services

January 31, 2014 - This Commonwealth Fund-supported study found evidence that, over the first two years of Blue Cross Blue Shield's experiment with a global payment system in Massachusetts, overused medical services were successfully targeted.

In Brief

Where Are We on the Diffusion Curve? Trends and Drivers of Primary Care Physicians' Use of Health Information Technology

January 24, 2014 - Commonwealth Fund researchers analyzed data from surveys of primary care physicians conducted in 2009 and 2012 to check on the progress of health IT adoption and to see how certain factors—like being part of an integrated health system or using shared technical assistance programs—can influence technology take-up.

In the Literature

Failure to Rescue in Safety-Net Hospitals: Availability of Hospital Resources and Differences in Performance

January 21, 2014 - Hospitals serving larger proportions of Medicaid and uninsured patients than other hospitals were found to have significantly higher "failure-to-rescue" rates for surgical patients experiencing postoperative complications. This disparity in mortality could not be explained by hospitals' differing access to sophisticated clinical technology or other resources.

In the Literature

Analysis of Early Accountable Care Organizations Defines Patient, Structural, Cost, and Quality-of-Care Characteristics

January 6, 2014 - There is strong enthusiasm for ACOs among policymakers and some health industry leaders, but there is little information available about the early entrants in these still very young programs. This study identified ACOs that had joined the Medicare programs as of fall 2012 to collect baseline information about their patient populations, quality, hospitals, and costs.

In the Literature