All Publications

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Measuring Progress Toward Accountable Care

December 14, 2012 - This report on 59 hospital-based organizations that were members of a collaborative created to support the transition to accountable care finds that that organizations are pursuing different paths toward accountable care.

Fund Report

Many Large Medical Groups Will Need to Acquire New Skills and Tools to Be Ready for Payment Reform

November 30, 2012 - A Commonwealth Fund–supported survey of 21 large, multispecialty medical groups—often viewed by policymakers as the prototypes for accountable care organizations—assessed the extent to which large medical groups are prepared to participate in these kinds of contracts.

In Brief

The Impact of Health Reform on the Medicare Advantage Program: Realigning Payment with Performance

October 16, 2012 - The Affordable Care Act enacts a new payment system for private health plans available to Medicare beneficiaries through the Medicare Advantage program. The system aims to reduce the excess payments received by private plans, and reward plans that earn high performance ratings. This brief estimates savings the new policies will bring to Medicare.

Issue Brief

Health Care in the 2012 Presidential Election: How the Obama and Romney Plans Stack Up

October 2, 2012 - With President Obama and Governor Romney offering fundamentally different visions for the nation's health system, the presidential election provides a stark choice for U.S. voters. This analysis contrasts the potential impact of implementing the Affordable Care Act in full with Romney’s proposals to repeal the law, eliminate many of the new requirements for insurance markets, and make changes in Medicaid and Medicare.

Fund Report

Testimony—The Future of Medicare: Converting to Premium Support or Continuing as a Guaranteed Benefit Program

October 2, 2012 - In invited testimony before the House of Representatives Democratic Steering and Policy Committee, Commonwealth Fund president Karen Davis discussed two approaches to sustaining Medicare, the vital public insurance program for seniors and disabled Americans.


Spending Differences Associated with the Medicare Physician Group Practice Demonstration

September 12, 2012 - This Commonwealth Fund–supported study estimated the savings achieved by the Physician Group Practice Demonstration for all beneficiaries and specifically for dual-eligible beneficiaries—a population that has been difficult to manage because of high rates of illness burden, low socioeconomic status, and lack of social supports.

In the Literature

Shared-Savings Payment Arrangements in Health Care: Six Case Studies

August 20, 2012 - This report presents six case studies of pilot shared-savings programs across the country. The cases reveal program variation in the patient populations subject to shared-savings approaches, the health care services covered, the determination of cost savings and payouts to providers, the use of performance targets, and performance measurement.

Fund Report

Risk-Adjusted Payment and Performance Assessment for Primary Care

August 20, 2012 - As part of this Commonwealth Fund–supported study, researchers developed a bundled payment approach, called the Primary Care Activity Level model, to cover the cost of all services that primary care practitioners provide. The intent is not only to promote more efficient care but to better support the use of primary care services.

In Brief

Accountable Care Strategies: Lessons from the Premier Health Care Alliance's Accountable Care Collaborative

August 9, 2012 - This report shares the perspectives of hospitals and health systems taking part in the Premier health care alliance's accountable care implementation collaborative. Lessons relate to the need for ACOs to have certain core structural components; the viability of different organizational models; and more.

Fund Report

The Promise and Peril of Accountable Care for Vulnerable Populations: A Framework for Overcoming Obstacles

August 6, 2012 - According to this Commonwealth Fund-supported study, strategies that support accountable care organization (ACO) formation in diverse settings, as well as the monitoring, measuring, and rewarding of provider performance, may help to ensure that the nation's most vulnerable patients have access to the higher-quality, lower-cost care that ACOs are designed to achieve.

In the Literature

Financial Performance of Health Plans in Medicaid Managed Care

July 26, 2012 - This Commonwealth Fund–supported study reviewed the financial performance of different types of Medicaid managed care plans, finding plans that manage predominantly Medicaid members with multiproduct plans have lower costs.

In Brief

Medicare Beneficiaries Less Likely to Experience Cost- and Access-Related Problems than Adults with Private Coverage

July 18, 2012 - The authors of this Commonwealth Fund-supported study found that Medicare beneficiaries are more satisfied with their health coverage—and have fewer health care access and medical bill problems—than adults with private insurance.

In the Literature

Durable Medical Equipment and Home Health Among the Largest Contributors to Area Variations in Use of Medicare Services

May 8, 2012 - The Commonwealth Fund-supported author of this Health Affairs article examined variations in beneficiaries' use of 13 health care services in 60 communities to investigate: discernible patterns; the extent of variation in service categories across sites; and which services vary to the extent that they account for disproportionate geographic variation in total use.

In the Literature

In Japan, All-Payer Rate Setting Under Tight Government Control Has Proved to Be an Effective Approach to Containing Costs

May 8, 2012 - Japan has been able to maintain access to care and avoid rationing while also taking advantage of the latest medical technology by applying a standardized fee schedule for nearly all health care goods and services and combining hospital and physician fees, according to this Commonwealth Fund–supported research.

In the Literature

Paying More for Primary Care: Can It Help Bend the Medicare Cost Curve?

March 21, 2012 - In this issue brief, researchers used a simulation model to predict the budgetary impact of a permanent increase in Medicare primary care fees.

Issue Brief