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Value-Driven Health Care Purchasing: Four States that Are Ahead of the Curve

August 15, 2007 - In the absence of a strong national directive for health care reform, some states have resorted to higher cost-sharing for public employees, tightened Medicaid eligibility and benefit cuts, or caps on spending. But a handful of states and counties are taking an entirely different approach in addressing rising health costs and quality concerns: obtaining greater value for their health care dollars through "value-based purchasing."

Fund Report

Value-Driven Health Care Purchasing: Case Study of Washington State's Puget Sound Health Alliance

August 15, 2007 - The Puget Sound Health Alliance in Washington seeks to improve the quality of health care by 1) using guidelines for evidence-based medicine to develop performance reports and 2) aligning incentives in purchasing and consumer decision-making to promote quality and reduce costs.

Fund Report

Value-Driven Health Care Purchasing: Case Study of Wisconsin's Department of Employee Trust Funds

August 15, 2007 - The Wisconsin Department of Employee Trust Funds (ETF), the largest purchaser of employer coverage in the state, has pursued value for state and local government employees and their families through a number of means, including: public reporting of health plan performance; tiered premiums used to encourage members to purchase more efficient plans; financial rewards to health plans that meet cost and quality benchmarks; an innovative pharmacy benefit management model emphasizing transparency; and a statewide public–private health data repository.

Fund Report

Value-Driven Health Care Purchasing: Case Study of the Massachusetts Group Insurance Commission

August 15, 2007 - The Massachusetts Group Insurance Commission (GIC) is the state's largest purchaser of health care after Medicaid, covering more than 267,000 state employees, retirees, and their dependents. In 2003, the GIC launched the Clinical Performance Improvement initiative, focused on improving provider performance and quality of care.

Fund Report

Value-Driven Health Care Purchasing: Case Study of Minnesota's Smart Buy Alliance

August 15, 2007 - The Smart Buy Alliance is a group of public and private health care purchasers in Minnesota working together in hopes of driving greater quality and value in the market. Its members--including the state agencies overseeing Medicaid and public employee health benefits, along with coalitions of businesses and labor unions--represent about 60 percent of state residents.

Fund Report

Lessons from Local Access Initiatives: Contributions and Challenges

August 14, 2007 - Community health initiatives--locally crafted responses to health care access problems--have been steadfast in their efforts to connect uninsured and medically indigent people to health care services and health insurance. This report offers five case studies of community health initiatives that seek to improve access and coverage for those most likely to be uninsured: low-income, nonelderly adults.

Fund Report

Reauthorizing SCHIP: Opportunities for Promoting Effective Health Coverage and High-Quality Care for Children and Adolescents

August 9, 2007 - The July 2007 House and Senate bills reauthorizing the State Children's Health Insurance Program (SCHIP) include provisions to enhance quality in the program. In this report, noted child health experts offer strategies for promoting effective health coverage and achieving high quality through SCHIP and Medicaid.

Fund Report

Health Care Opinion Leaders' Views on the Quality and Safety of Health Care in the United States

July 30, 2007 - As health care quality and patient safety concerns rise, the latest Commonwealth Fund Health Care Opinion Leaders survey finds leaders united behind several key reform measures: more than half (56%) support the creation of a new public-private entity to coordinate quality efforts and form a national quality agenda; 95% believe that fundamental payment reform is needed; and three-fourths (73%) say that greater organization and integration of provider care is necessary for improved quality and efficiency.

Data Brief

Measuring Hospital Performance: The Importance of Process Measures

July 27, 2007 - The authors of a new Data Brief prepared for the Commonwealth Fund Commission on a High Performance Health System contend that the process measures used by the Hospital Quality Alliance can have an impact on quality and health outcomes.

Data Brief

An Analysis of Leading Congressional Health Care Bills, 2005-2007: Part II, Quality and Efficiency

July 26, 2007 - The U.S. health care system will become a high performance health system only with strong leadership from the federal government in partnership with the private sector. A prior report analyzed the likely effect on U.S. health system performance of congressional legislative proposals to extend health insurance coverage. This report addresses the major bills introduced over 2005-2007 designed to advance the quality and efficiency of the health system.

Fund Report

The Inverse Relationship Between Mortality Rates and Performance in the Hospital Quality Alliance Measures

July 16, 2007 - If the lowest-performing U.S. hospitals performed as well as top-performers on specific quality measures, 2,200 fewer Americans would die each year, according to a new Fund-supported study.

In the Literature

Measuring and Reducing Waiting Times: A Cross-National Comparison of Strategies

July 16, 2007 - In this study, former Commonwealth Fund Harkness Fellows examine strategies used to reduce waiting times in five countries: Australia, Canada, England, New Zealand, and Wales. Among the five, the researchers found that England achieved the most sustained improvement in reducing waiting times, due to "major funding boosts, ambitious wait-time targets, and a rigorous performance management system."

In the Literature

Denver Health: A High-Performance Public Health Care System

July 12, 2007 - In March 2006, members of the Commonwealth Fund Commission on a High Performance Health System paid a visit to Denver Health, Colorado's largest health care safety-net provider, to learn more about how this fully integrated health system has managed to achieve a national reputation for high performance. A new Fund report shows how Denver Health could serve as a model for other public and private health systems around the country.

Fund Report

Use of Health Services by Previously Uninsured Medicare Beneficiaries

July 12, 2007 - A new Commonwealth Fund-supported study by Harvard Medical School researchers finds that chronically ill Medicare beneficiaries who were previously uninsured used health services more intensively and required costlier care compared with their previously insured counterparts.

In the Literature

Congressional Testimony-- Universal Health Insurance: Why It Is Essential to a High Performing Health System and Why Design Matters

June 26, 2007 - Our nation's failure to provide adequate health insurance to millions is a major factor in the inconsistent performance of the nation's health system, testified Commonwealth Fund vice president Sara Collins, Ph.D., before the United States Senate.