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Medicare Essential: An Option to Promote Better Care and Curb Spending Growth

May 6, 2013 - Combining Medicare's hospital, physician, and prescription drug coverage with commonly purchased private supplemental coverage into one health plan could produce national savings of $180 billion over a decade while improving care for beneficiaries, a new Health Affairs study finds.

In the Literature

Insuring the Future: Current Trends in Health Coverage and the Effects of Implementing the Affordable Care Act

April 26, 2013 - Eighty-four million people―nearly half of all working-age U.S. adults―went without health insurance for a time last year or were underinsured because of high out-of-pocket costs relative to income, according to a new study based on findings from the Commonwealth Fund's 2012 Biennial Health Insurance Survey.

Fund Report

Testimony—The Affordable Care Act's Pre-Existing Condition Insurance Plan Program: A Critical Bridge to 2014, But Not a Long-Term Solution for Universal Coverage

April 3, 2013 - In invited testimony before the Committee on Energy and Commerce, Sara Collins testified that the program has been a critical bridge to 2014, but its limitations demonstrate why high-risk pools are an inadequate substitute for the comprehensive insurance market reforms and expanded health insurance options to go into effect under the Affordable Care Act next January.

Testimony

Insurers' Medical Loss Ratios and Quality Improvement Spending in 2011

March 22, 2013 - Health insurance companies reported spending an average of less than 1 percent of the premiums they collected from policyholders in 2011 on activities directly supporting improvement of health care quality, according to a new Commonwealth Fund study.

Issue Brief

Payments in Support of Effective Primary Care for Chronic Conditions

March 18, 2013 - In this Commonwealth Fund–supported article, the authors suggest that "bundled payment" covering all services provided to a patient for treatment of a specific illness or injury would need to be risk-adjusted, so that providers do not have incentives to avoid patients, like those with chronic illness, who can be expected to have higher costs.

In Brief

Ethical Physician Incentives—From Carrots and Sticks to Shared Purpose

March 18, 2013 - The Commonwealth Fund-supported authors of this study recommend using an array of financial and nonfinancial incentives—including performance rankings—to help facilitate a broad "shared-purpose orientation" embraced by all participating clinicians.

In Brief

Paying for Value: Replacing Medicare's Sustainable Growth Rate Formula with Incentives to Improve Care

March 15, 2013 - This brief sets forth a set of policy options to improve the way health care providers are paid by Medicare.

Issue Brief

Early Adopters of the Accountable Care Model: A Field Report on Improvements in Health Care Delivery

March 13, 2013 - Based on interviews with clinical and administrative leaders, this report describes the experiences of seven accountable care organizations (ACOs).

Fund Report

Implementing the Affordable Care Act: Choosing an Essential Health Benefits Benchmark Plan

March 12, 2013 - This issue brief examines state action to select an essential health benefits benchmark plan and finds that 24 states and the District of Columbia selected a plan. All but five states will have a small-group plan as their benchmark.

Issue Brief

A Hospital System’s Wellness Program Linked to Health Plan Enrollment Cut Hospitalizations but Not Overall Costs

March 5, 2013 - In this Commonwealth Fund–supported study, researchers examine the effects of a wellness program begun in 2005 for employees and dependents of a hospital system in St. Louis, Mo.

In the Literature

Aligning Incentives in Medicaid: How Colorado, Minnesota, and Vermont Are Reforming Care Delivery and Payment to Improve Health and Lower Costs

March 1, 2013 - Colorado, Minnesota, and Vermont are working to align incentives between health care payers and providers to improve care delivery and outcomes while controlling costs. This synthesis describes the common drivers of reform across the states and lessons learned.

Case Study

Medicaid Payment and Delivery Reform in Colorado: ACOs at the Regional Level

March 1, 2013 - Colorado is one of a handful of states piloting innovative health care payment and delivery reforms through Medicaid. Under the Accountable Care Collaborative Program, which began enrollment in May 2011, the state Medicaid agency contracts with seven regional organizations to create networks of primary care providers and ensure care coordination for Medicaid enrollees.

Case Study

Medicaid Is One of Multiple Payers in Vermont’s Health Care Reforms

March 1, 2013 - Vermont Medicaid is a key player as the state pioneers multipayer health care delivery and payment reforms. Under Vermont Blueprint for Health, most Medicaid beneficiaries and state residents will be served in 2013 by medical homes with community health teams, with additional support services for Medicaid enrollees with complex conditions.

Case Study

Health Care Payment and Delivery Reform in Minnesota Medicaid

March 1, 2013 - Minnesota's Medicaid program is a leader in piloting innovative health care payment and delivery reforms. This case study is one of three in a series on innovations being undertaken by states to improve quality and efficiency in their Medicaid programs.

Case Study

Testimony—Stabilizing and Strengthening Medicare in the Context of Broader Health Reform

February 27, 2013 - In invited testimony before the United States Senate Special Committee on Aging, Commonwealth Fund president David Blumenthal made the case for comprehensive payment and delivery system changes that produce lower costs and better value not just in Medicare, but across the entire U.S. health system.

Testimony