All Publications

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Illustrating Potential Efficiency Gains from Using Cost-Effectiveness Evidence to Reallocate Medicare Expenses

May 28, 2013 - Commonwealth Fund–supported researchers illustrate the potential gains in health and efficiency if decision-makers at the Centers for Medicare and Medicaid Services were to take into account cost-effectiveness when making Medicare coverage decisions.

In Brief

Making Sense of the Change in How Medicare Advantage Plans Are Paid

May 7, 2013 - Under the Affordable Care Act, overpayments to Medicare Advantage plans are gradually being pared back. But will private plans be able to cope with the reduced payments? Using newly available government data, this brief examines average costs among Medicare Advantage plans and variation in costs among plan types.

Issue Brief

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

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

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

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

The Value of Low-Value Lists

February 27, 2013 - In this Commonwealth Fund–supported article, researchers examine the challenges to developing lists of “low-value” services and ensuring that insurers and provider organizations put them to optimal use.

In Brief

Do Medicaid Incentive Payments Boost Quality? Florida's Direct Care Staffing Adjustment Program

February 8, 2013 - In this Commonwealth Fund–supported study, researchers evaluated the effects of a Florida incentive program intended to improve care at nursing homes most at risk for providing poor-quality care.

In Brief

The Visiting Nurse Service of New York's Choice Health Plans: Continuous Care Management for Dually Eligible Medicare and Medicaid Beneficiaries

January 23, 2013 - This case study describes how a large nonprofit home health care provider created health plans to serve this population and, in particular, how its customized care management approach has led to reductions in hospitalizations and readmissions.

Case Study

Regions with Higher Medicare Part D Spending Show Better Drug Adherence, But Not Lower Medicare Costs for Two Diseases

January 8, 2013 - In this Commonwealth Fund–supported study, researchers set out to determine whether there was any relationship between geographic variation in Medicare Part D spending and medication-taking behavior among beneficiaries with diabetes or heart failure.

In Brief