All Publications

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The Influence of Hospice Use on Nursing Home and Hospital Use in Assisted Living Among Dual-Eligible Enrollees

November 13, 2012 - In this study, Commonwealth Fund–supported researchers examined over 12 months the outcomes of assisted living residents who are dually eligible for Medicare and Medicaid, seeking to determine the association of hospice use with nursing home and hospital admission.

In Brief

About Half of the States Are Implementing Patient-Centered Medical Homes for Their Medicaid Populations

November 5, 2012 - Half of state Medicaid programs are taking new approaches to provider payment—focusing on chronically ill populations, using shared teams, aligning payments with national quality standards, and implementing shared-savings programs—to help primary care practices become patient-centered medical homes for their low-income patients.

In the Literature

Jobs Without Benefits: The Health Insurance Crisis Faced by Small Businesses and Their Workers

November 1, 2012 - A new Commonwealth Fund study highlights a nearly decade-long trend of declining health insurance coverage and rising costs for workers in small businesses, particularly employees making less than $15 an hour.

Issue Brief

Child-Only Coverage and the Affordable Care Act: Lessons for Policymakers

October 9, 2012 - The Affordable Care Act prohibited insurers from denying or limiting coverage for children in 2010. In response, some insurers ceased to offer coverage to children in need of individual health insurance, known as a "child-only" policy. This issue brief examines new state legislative and regulatory action to promote the availability of child-only policies.

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

Implementing Insurance Exchanges—Lessons from Europe

August 23, 2012 - Citing the experiences of the Netherlands and Switzerland—where exchanges have been part of the health care landscape for some time—the authors of this study argue that additional measures will be needed to control costs and improve quality.

In Brief

Tackling Rising Health Care Costs in Massachusetts

August 15, 2012 - Massachusetts legislative leaders project the state's 2012 health care cost containment law will save up to $200 billion in health care spending over the next 15 years. The new law will serve as a test case and be closely watched by other states and the federal government.

In the Literature

Including Safety-Net Providers in Integrated Delivery Systems: Issues and Options for Policymakers

August 14, 2012 - This issue brief explores key design considerations for including safety-net providers in integrated delivery systems, which provide or arrange a coordinated continuum of health care services to a defined population, and hold themselves accountable for the outcomes and health status of their patients.

Issue Brief

Addressing Women's Health Needs and Improving Birth Outcomes: Results from a Peer-to-Peer State Medicaid Learning Project

August 8, 2012 - This brief examines seven Medicaid agencies that have worked to develop the programs, policies, and infrastructures needed to identify and reduce women's health risks either prior to or between pregnancies in an effort to lower high rates of maternal mortality, infant mortality, and preterm births.

Issue Brief

The Post-Katrina Conversion of Clinics in New Orleans to Medical Homes Shows Change Is Possible, But Hard to Sustain

August 6, 2012 - Given the right incentives, safety-net primary care clinics can make the transition to become patient-centered medical homes. The results of the New Orleans program, however, underscore that primary care transformation is a long process, and one difficult to achieve and sustain.

In the Literature

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

Strained Local and State Government Finances Among Current Realities That Threaten Public Hospitals' Profitability

August 6, 2012 - This Commonwealth Fund study of 150 safety-net hospitals finds that, to overcome declining government subsidies, safety-net hospitals governed by elected politicians must focus on cost control, quality improvement, and services that attract insured patients.

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

State Health Insurance Exchange Laws: The First Generation

July 25, 2012 - This analysis of state exchange laws offers a glimpse into the choices being made by the 13 states that, together with the District of Columbia, as of May 2012 had begun the process of establishing an exchange, either through legislation or executive order. Also see an interactive map showing the status of state health exchange legislation and key provisions of laws and executive orders.

Issue Brief

Establishing Health Insurance Exchanges: Three States' Progress

July 17, 2012 - This brief outlines differences that stand out in three states' initial approaches: the numbers and types of people initially appointed to the boards governing the exchanges; the role of the board relative to the state legislature; how the exchanges interact with existing insurance markets; and the involvement of stakeholders in each state.

Issue Brief