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Hospital Cost of Care, Quality of Care, and Readmission Rates: Penny-Wise and Pound-Foolish?

February 22, 2010 - A study of Medicare beneficiaries admitted to U.S. hospitals with congestive heart failure or pneumonia showed no definitive connection between the cost and quality of care, or between cost and death rates.

In the Literature

The Potential of Global Payment: Insights from the Field

February 18, 2010 - Increasing awareness of cost and quality problems caused by the prevailing fee-for-service payment system has led to a reemergence of interest in global payment. This project interviewed and surveyed physician leaders of small and large organizations to glean insights into global payment successes and failures.

Fund Report

Do Patients Continue to See Physicians Who Are Removed from a PPO Network?

February 11, 2010 - In a study that examined the effect of excluding physicians from a preferred provider organization network, researchers found that most patients did not continue to see excluded physicians.

In the Literature

Improving Chronic Illness Care: A Longitudinal Cohort Analysis of Large Physician Organizations

February 1, 2010 - Results from this Commonwealth Fund–supported survey published in Medical Care show that use of chronic disease management processes—mainly the use of patient registries and support for patient self-management—increased 23 percent between 2000 and 2006.

Literature Abstract

Getting from Here to There in Payment Reform: Necessary Practices and Policies

February 1, 2010 - Successful health reform hinges not only on improving coverage and access to care, but also on delivery system and payment reform, argue The Commonwealth Fund’s Stuart Guterman and Stephen C. Schoenbaum, M.D., in the Journal of Ambulatory Care Management.

Literature Abstract

Western Baptist Hospital: Problem Solving with Pneumonia Care Performance Improvement Teams

January 29, 2010 - Western Baptist Hospital is one of the top-performing hospitals in the country in the pneumonia care process-of-care, or "core" measures. The core measures relate to provision of recommended treatment in four clinical areas: heart attack, heart failure, pneumonia, and surgical care.

Case Study

Health Care Leader Action Guide to Reduce Avoidable Readmissions

January 25, 2010 - Avoidable hospital readmissions are under close scrutiny by policymakers, providing hospitals with added impetus to reduce costs and increase quality of care. A new guide produced by the Health Research & Educational Trust, with support from The Commonwealth Fund and John A. Hartford Foundation, provides a quick, simple resource for hospital leaders to get started on developing an action plan to reduce readmissions.

Fund Manual

Rhode Island's Pediatric Practice Enhancement Project: Parents Helping Parents and Practitioners

January 15, 2010 - Rhode Island’s Pediatric Practice Enhancement Project (PPEP) trains and places parent consultants into pediatric primary and specialty care practices to help families with children and youth with special health care needs coordinate and access the health system, as well as other services (e.g., social services, education, housing).

Case Study

Attributing Sources of Variation in Patients’ Experiences of Ambulatory Care

January 8, 2010 - This study, which seeks to explain the variation in how patients rate their experiences with primary care providers, concludes that individual physicians themselves account for the largest share of this variation, particularly in terms of the quality of their communication with patients and their support for health promotion.

In the Literature

Scott & White Healthcare: Opening Up and Embracing Change to Improve Performance

January 8, 2010 - Founded in 1897 in Temple, Texas, Scott & White is the largest multispecialty health care system in the state, and delivers a comprehensive continuum of care to its health plan members and constituents. This case study explores Scott & White's quality improvement measures and how they are linked to greater system efficiency.

Case Study

Are Electronic Medical Records Helpful for Care Coordination? Experiences of Physician Practices

December 29, 2009 - A study of small- and medium-sized physician practices found that electronic medical record systems can help coordinate patient care within practice offices. However, because of interoperability issues, they are less able to support coordination between clinicians and across settings. Other challenges, like information overflow and reimbursement, also impede physicians' ability to use EMRs to improve patient care and coordination.

In the Literature

Texas Health Harris Methodist–Cleburne: A System Approach to Surgical Improvement

December 24, 2009 - This case study describes the strategies and factors that appear to contribute to high performance on surgical care improvement measures at Texas Health Harris Methodist–Cleburne. It is based on information obtained from interviews with key hospital personnel, publicly available information, and materials provided by the hospital during May through June 2009.

Case Study

St. Luke's Medical Center: Bottom-Up Approach to Quality Improvement in Pneumonia Care

December 23, 2009 - This case study describes the strategies and factors that appear to contribute to high performance on pneumonia care measures at St. Luke’s Medical Center. It is based on information obtained from interviews with key hospital personnel, publicly available information, and materials provided by the hospital during July and August 2009.

Case Study

Parkview Medical Center: Underscoring the Importance of Communication in Pneumonia Care

December 22, 2009 - This case study describes the strategies and factors that appear to contribute to high performance on pneumonia care measures at Parkview Medical Center. Hospital leaders credit the organization's strong performance in pneumonia care to the regular communication and reinforcement provided by quality improvement staff.

Case Study

Medicare Advantage Reforms: Comparing House and Senate Bills

December 21, 2009 - This Commonwealth Fund issue brief compares approaches to reducing Medicare Advantage payments and other provisions in the House and Senate bills that aim to improve the value that Medicare obtains for the dollars it spends.

Issue Brief